Pressure Sores

What is a pressure sore?

This definition of a pressure ulcer is taken from the wound care communications network. ‘Pressure ulcers are red areas of sores on the skin.’ They are also called bed sores, pressure sores, and decubitus ulcers. They can occur over any bony part of the body, but for people that use a wheelchair, the ischial tuberosities and sacrum are the major risk areas. There are four degrees, or stages, of severity of pressure sores with the most severe causing tissue necrosis, or damage to muscle, bone or supporting structure.

What causes pressure sores?

Pressure sores occur when lying or sitting in one place for too long. The skin needs blood and oxygen to get nutrients. Pressure on the skin blocks the blood supply. If the blood supply is blocked for a long time, a red area may be seen over a bony part of the body. If the pressure is not removed, the red area will turn into a pressure ulcer or sore. Pressure sores can be caused by a lack of blood supply in less than two hours.

Preventing pressure sores

Pressure sores can be prevented by moving or lifting ones self while in the wheelchair. According to physicians, preventing pressure sores is best accomplished by pressure redistribution over the bony area. This means changing the area of concentration of pressure to another area temporarily. Our APK2 changes the areas of concentrated pressure automatically up to 30 times per hour.

A static (non powered) wheelchair cushion cannot change pressure distribution.

For many people in a wheelchair shifting ones weight is a difficult task. Many people simply don’t have the physical ability to lift themselves up to provide this essential pressure relief. For others it may be difficult to remember to perform pressure relief.

This is where the APK2 Cushion system can help.

The APK2 Cushion system will automatically change your pressure distribution so you don’t have to worry about performing pressure lifts if you are not able to do them.

One unique feature of the APK2 is the cycle time control. It gives you complete control over number of times pressure distribution changes.

An interesting fact about pressure sores

Dr. Koziak , who is considered to be the father of modern pressure sore research, found that very high pressure over a short period of time was just as dangerous for developing ulcers as lower pressure over a longer period of time.

Pressure points cannot change on any static cushion unless you can manually move/lift yourself. The APK2 automatically changes the pressure points to simulate manual pressure lifts.  Static cushions can provide pressure reduction, but a sore can still form, it just takes longer to form.  The only way to avoid a sore is to change pressure distribution.. The APK2 changes pressure distribution by automatically alternating pressure points. 

Guidelines for preventing pressure sores

 (This according to a Mayo Clinic community Internal Medicine Division Report)

For individuals that use a wheelchair, doctors have recommended the following steps:

• Inspect skin at least once a day

• Shift weight every 15 minutes

• Use a pressure-reducing device for seating surfaces

• Do not use donut shaped devices

• Consider postural alignment, distribution of weight, balance and stability, and pressure relief when positioning in a wheelchair

The APK2 cushion system is an effective device that will aid the mobility impaired user in following these guidelines. 

Predicting pressure sores

One way of predicting the occurrence of a pressure sore is by using the Brad en scale (1). This scale outlines 6 items, which can be taken into account. The APK addresses 2 of these 6 items, moisture and mobility.

Proper posture in the sitting position is followed by using the 90- degree rule to distribute pressure on the gluteal region to the posterior aspect of the femoral region.

An article written by B.J. Brad en:clinical utility of the Brad en scale for predicting pressure sore risk,Decubitus 2(3):44-51, 1989

If you have ever had a pressure sore you understand the hardships associated with them. We have designed our cushion systems to treat or prevent the occurrence of pressure sores so you will not have to go through those hardships.

We offer a fully automatic system, the APK2, for those people that are at highest risk of developing pressure sores. 

Here is an example of a pressure map taken of a 175 LB male patient while sitting on the APK.  Deflated cells (white area of pressure map) show 0-15 mmHg of pressure. Studies have shown that 32mmHg of pressure or less is required to allow blood flow into compressed tissue. The results achieved with the Airpulse PK are better than the 32mmHg threshold.