Document Detail

A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions.
MedLine Citation:
PMID:  21070197     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the efficacy of skin protection wheelchair seat cushions in preventing pressure ulcers in the elderly nursing home population.
DESIGN: Clinical trial with participants assigned at random to a skin protection or segmented foam cushion. Two hundred thirty-two participants were recruited between June 2004 and May 2008 and followed for 6 months or until pressure ulcer incidence.
SETTING: Twelve nursing homes.
PARTICIPANTS: Nursing home residents aged 65 and older who were using wheelchairs for 6 or more hours per day and had a Braden score of 18 or less and a combined Braden activity and mobility score of 5 or less. Participants were recruited from a referred sample.
INTERVENTION: All participants were provided with a fitted wheelchair and randomized into skin protection (SPC, n=113) or segmented foam (SFC, n=119) cushion groups. The SPC group received an air, viscous fluid and foam, or gel and foam cushion. The SFC group received a 7.6-cm crosscut foam cushion.
MEASUREMENTS: Pressure ulcer incidence over 6 months for wounds near the ischial tuberosities (IT ulcers) were measured. Secondary analysis was performed on combined IT ulcers and ulcers over the sacrum and coccyx (sacral ulcers).
RESULTS: One hundred eighty participants reached a study end point, and 42 were lost to follow-up. Ten did not receive the intervention. There were eight (6.7%) IT ulcers in the SFC group and one (0.9%) in the SPC group (P=.04). There were 21 (17.6%) combined IT and sacral ulcers in the SFC group and 12 (10.6%) in the SPC group (P=.14).
CONCLUSION: Skin protection cushions used with fitted wheelchairs lower pressure ulcer incidence for elderly nursing home residents and should be used to help prevent pressure ulcers.
David Brienza; Sheryl Kelsey; Patricia Karg; Ana Allegretti; Marian Olson; Mark Schmeler; Jeanne Zanca; Mary Jo Geyer; Marybeth Kusturiss; Margo Holm
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2010-11-10
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  58     ISSN:  1532-5415     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-02-03     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2308-14     Citation Subset:  IM    
Copyright Information:
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.
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MeSH Terms
Aged, 80 and over
Frail Elderly*
Homes for the Aged / statistics & numerical data
Human Engineering
Nursing Homes / statistics & numerical data
Orthotic Devices*
Patient Satisfaction
Pennsylvania / epidemiology
Pressure Ulcer / epidemiology,  prevention & control*
Skin Care / methods*
Grant Support
Comment In:
Evid Based Nurs. 2011 Jul;14(3):79-80   [PMID:  21646383 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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