Orthopaedic Seat Cushion for Patients for Pressure Ulcer Prevention

by BMEC HfH August 10, 2021

Pressure ulcers are skin breakdowns caused primarily by excessive applied pressure. Heat, moisture, friction, poor nutrition, vascular problems, and inability of a person to move are also contributing factors to this, among many others. Presence of these ulcers already has a significant negative impact on an individual and failure to provide protection to the skin for these not to occur, imposes more complications and risks. Prevention of pressure ulcers is a vital measure, and this include proper hygiene, pressure relief, proper skin inspection, and provision of appropriate seating surfaces.

For seating surfaces or seat cushions, they are chosen based on the medium and properties of the materials used in their construction: foam, air, gel, or combination types. They vary in efficacy based on pressure distribution, provision of stability, ability to insulate, or conduct heat, and the reliability of their performance over time (Frontera & DeLisa, 2010). Seat cushions are preferably prescribed and designed specific to the medical and functional needs of an individual and should promote improved positioning, pressure relief, and comfort.

Questions to Consider in Choosing Seat Cushions

Does the seat provide adequate support to promote good sitting posture?
Will the pressure distribution of the seat prevent pressure sores?
Is the shape of the seat cushion appropriate for the user’s body contours?
Does the person need a custom-shape to accommodate deformities and maximize support?
Are special combinations of foam, air, or gel seat cushions needed to maximize comfort and pressure relief?

Note: Adapted from Physical Rehabilitation 6^th Ed. by S.B. O’ Sullivan, T.J. Shmidtz, G.D. Fulk, 2014, p.1418, FA Davis Company

Seat Cushions
Cushion Type	Image	Application	Benefits	Limitations
Plain Rectangular foam		Low-risk patients	Inexpensive	No pressure relief regions; wears out easily; low maintenance
*Contour-molded with gel-filled inserts		Higher risk patients prone to ulcers	Molds to body contours	Heavier than regular foam cushions; uncomfortable when cold
*Matrix or air-filled elastic capsules		High-risk patients who cannot maintain skin integrity with foam products	Improved pressure relief; bladders can be tied off to create pressure relief regions	More expensive than foam cushion; bladders can be punctured; high maintenance
Carve and assemble foam		For patients with asymmetries needing custom cutouts	Lightweight, Low-cost	Custom-fitted; hard to replicate
Alternating air cell inflation		Very high-risk patients with intractable ulcers	Battery-powered air compressor sequentially inflates and deflates cells	Expensive; more complex; requires charging

Note: Adapted from Braddom’s Physical Medicine and Rehabilitation 5^th Ed. by D.X. Cifu, 2016, p.334, Elsevier

*Product Images from Healing From Home

READ SUGGESTED ARTICLE: CHOOSING A SUITABLE MOBILITY DEVICE (PART 1) - WALKERS, CRUTCHES AND CANES

References

Frontera, W. R., & Delisa, J. A. (2010). DeLisa’s Physical Medicine & Rehabilitation: principles and practice. Lippincott Williams & Wilkins Health.

‌Md, D. C. X. (2015). Braddom’s Physical Medicine and Rehabilitation (5th ed.). Elsevier.

O’Sullivan, S. B., Shmidtz, T.J., Fulk G.D., (2014). Physical Rehabilitation 6^th Ed. FA Davis Company.

Image sources

Alternating air cell inflation [Photograph]. (2015). In Braddom’s Physical Medicine and Rehabilitation (5th ed.) (p. 334).

Carve and assemble foam [Photograph]. (2015). In Braddom’s Physical Medicine and Rehabilitation (5th ed.) (p. 334).

Contour-molded with gel-filled inserts. (n.d.). Retrieved from https://www.healingfromhome.com/collections/seat-cushion

Matrix or air-filled elastic capsules. (n.d.). Retrieved from https://www.healingfromhome.com/collections/seat-cushion

Plain Rectangular foam [Photograph]. (2015). In Braddom’s Physical Medicine and Rehabilitation (5th ed.) (p. 334).