Customization Scenarios

The following are six examples that demonstrate Aquila’s ability to customize the Airpulse PK and Defender II cushion systems to meet specific client needs.

Scenario #1 (Developing a Pressure Sore)

Situation: A client is currently developing a pressure sore which severely restricts sitting time.  He is considered high risk for skin breakdown and potentially could develop additional pressure sores using his current cushion.

Solution:  An Airpulse PK system’s cushion is customized such that it isolates the cell directly under the client’s existing pressure sore.  With this configuration, the isolated cell will not inflate when the rest of the cushion is in the inflation cycle.  No upward pressure will be applied to the sore. (See Figure 1 in Pressure Mapping for real case sample.)

To stimulate tissue over the entire posterior in a more frequent cycle, we program the microprocessor for minimal cycle times of 20 seconds rather than the usual one minute minimum.  The client will have 9 cycle time selections to choose from with 20 seconds being the shortest and 3 minutes being the longest.

Result:  The client is able to sit much longer and the existing sore is given a zero pressure environment, which is ideal for healing to take place.  The full dynamics of the rest of the cushion and the more frequent cycle times ensures excellent circulation and helps prevent new sores from forming.  Once the existing sore is healed, the isolated cell can be quickly restored to full system dynamics by snapping a fitting together.

The client can adjust the controller to increase the cycle time as his needs change.

Scenario #2 (Flap Surgery Recovery)

Situation:  A client has recently undergone flap surgery to repair a pressure sore on the right ischial tuberosity.  Recovery is expected to take several weeks during which time the client will only be able to sit for very short periods of time.

Solution:  An Airpulse PK system is configured such that the right ischial cell of the cushion is isolated so it will not apply upward pressure during the inflation cycle.  Once the sore is sufficiently healed, the right ischial cell can easily be connected back into the dynamics for normal operation.   Also, the client can use the controller to adjust cycle times, so that pressure to this area is relieved longer than it is applied.

Result:  The client is able to sit longer while the surgical repair is allowed to heal.  The chance of recurrence of a pressure sore is dramatically reduced because the Airpulse PK gives true pressure relief of less than 32 mmHg and ensures excellent circulation.  This is especially important since the model SCI System Statistical Center recently reported that 40 to 80% of people that had a pressure sore will develop another sore.1

1.  Kierney PC Engrav LH, Isik FF, Esselman PC, Cardenas DD, Rand RP.  Results of 268 Pressure Sores in 158 Patients Managed Jointly by Plastic Surgery and Rehabilitation Medicine.  Plastic Reconstr Surg.  102(3):765-772, 1998.

Scenario #3 (Severe Lean)

Situation:  A client has a severe lean to the left and there is a great deal of pressure to the left ischial tuberosity.

Solution:  Aquila customizes the cushion of an Airpulse PK system which provides full time compensation for the pelvic obliquity and offers firmer support around the left ischial cell with very soft support under the ischial itself.

Result:  This client sits straighter and is no longer in danger of developing a pressure sore.

Scenario #4 (Amputee)

Situation:  A client has an above-the-knee amputation and there is discomfort from his stump resting on the front area of his current cushion.  He is not considered high risk for developing pressure sores.

Solution:  Aquila makes a Defender II manually controlled cushion system with the cells under the stump independent from the rest of the pad so they can be inflated as soft or as firm as desired.

Result:  The client now can control the pressure directly under the stump and can sit much longer with a greater comfort level.

Scenario #5 (Tilt/Recline Pressure)

Situation:  A client has a tilt/recline power chair and has tenderness at the sacral area.  Moving the chair to the tilt position has caused irritation to the coccyx, because, the coccyx bottoms out when the weight is concentrated in such a small area.

Solution:  Aquila custom makes a cushion with firm foam cell inserts to key cells on either side of the coccyx cells.  A remote control is also recommended.

Result:  The client can tilt/recline with no bottoming out of the coccyx.  The cell inserts provide a greater degree of support around the coccyx.  While air will naturally migrate to the front of the cushion during a tilt, this cushion configuration keeps the coccyx supported to prevent bottoming out.  The remote control allows the client the ability to turn the system off if the low pressure alarm should sound as a result of lessening of weight on the pad during the recline.

Scenario #6 (Bariatric Client)

Situation:  A client weighs over 400 lbs and is unable to sit as long as he wants.  Until now, he has not been able to find a cushion that could provide adequate circulation and still support his weight.  His cushion dimensions are 22” wide by 23” deep and he does not currently have a pressure sore.

Solution:  Aquila can provide either an Airpulse PK automatic cushion system or a Defender II manually controlled seating system for the client.  The client’s weight is within limitations for our seating systems.  Aquila also has the capability of custom making a cushion to most any size.

Result:  By utilizing either an automatic or manual Aquila cushion system, the client can sit longer and improve his quality of life.  He can maintain good circulation and minimize tissue compression under the pelvis.