JMIR Publications

ABSTRACT

Background:

Pressure ulcers (PUs) constitute a major healthcare burden, characterized by significant morbidity, diminished quality of life, and elevated treatment costs. Wheelchair users are predisposed to PUs due to sustained ischial and sacral interface pressures resulting from prolonged periods of sitting. Implementation of pressure-relieving interventions, including specialized seating systems engineered to redistribute load and augment the weight-bearing surface area, is critical for mitigating PUs risk.

Objective:

To evaluate a methodology for the custom fabrication of pressure relief cushions, utilizing user-cushion interface pressure mapping to reduce high-pressure areas and increase contact area in wheelchair users.

Methods:

First, a validation study was carried out with seven healthy volunteers. The pressure was determined using an FSA sensor (BodiTrak BT1510), and the cushion profile was obtained through a linear relation with pressure values. In the second phase, ten cushions for wheelchair users were manufactured and tested. The resulting data from buttock pressure using a flat foam, Jay® X2 (gel-foam), ROHO® HP (air), and customed-contoured cushions was analyzed and compared using the following four variables: peak pressure (PP), peak pressure index (PPI), mean pressure (MP), and contact area (CA).

Results:

In the validation study, the statistically significant difference between the flat and the custom-contoured cushion showed a better performance in pressure relief for the custom cushion, MP was 27.3(4.5) mmHg and 34.6(3.5) mmHg (P <0.001). Regarding the study with wheelchair users, custom-contoured cushions had lower PP (91.3 (36.0) mmHg), PPI (69.5 (33.7) mmHg), and MP (34.2 (17.4) mmHg) against flat, Jay® X2, and ROHO® HP cushions (P <0.005). The CA (1457.6 (254.1) cm2) was greater for the contoured cushion (P <0.001) than for flat and ROHO cushions; nevertheless, it was not significantly different from Jay X2 (P=0.595).

Conclusions:

The main finding is that the buttock pressure mapping method produces custom-contoured cushions that, compared to commercial cushions, have good pressure distribution and increased contact area. These results suggest that pressure mapping is a good alternative for manufacturing affordable custom-contoured cushions that can prevent the development of pressure ulcers.