medigraphic.com
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2014, Number S1

<< Back Next >>

Rev Invest Clin 2014; 66 (S1)

Design and evaluation of preventive seats for pressure ulcers associated with spinal injuries

Gayol-Mérida DA, Pérez-Zavala R, Reyes-Aguilar P, Pineda C

Language: Spanish
References: 27
Page: 61-69
PDF size: 317.42 Kb.


ABSTRACT

Introduction. Pressure ulcers are a dominant health problem for people who, for various reasons, must spend most of their time in a seated position. The spinal cord injury patients are the most affected for this situation. One strategy to prevent pressure ulcers is throughthe use of special seats. In the Instituto Nacional de Rehabilitación, contoured special seats have been developed according to anatomical measure of spinal cord injured patients. Objective. To find one or more combinations of test materials that reduced pressure below 60 mmHg, in the ischial area, in order to help to prevent pressure ulcers. Material and methods. The special seats were fabricated using thermoplastic materials and polyurethane foams, following prosthetic fitting technique; and were tests in healthy volunteers. Results. The results were compared with a vinyl seat, because most of wheelchairs have it. All different test combinations were superior to vinyl seat, specially the two polyurethane foam- polypropylene combinations. A group of nine patients with spinal cord injury were recruited to test the designed seats, for a three month period. Discussion. The results showed that pressure values are lower in the special seats than in the vinyl seats. No complications or pressure ulcers were found during follow up.


REFERENCES

  1. Pérez R, Rodríguez E, Escobar A. Frecuencia de úlceras por presión en el paciente lesionado medular, su correlación con el nivel neurológico y escala de ASIA. Rev Mex Med Fis Rehab 2007; 19: 16-23.

  2. Springle S, Chun K, Brubaker C. Reduction of sitting pressures with custom contoured cushions. J Rehabil Res Dev 1990; 27(2): 135-40.

  3. Brienza DM, Kart PF. Seat cushion optimization: a comparison of interface pressure and tissue stiffness characteristics for spinal cord injured and elderly patients. Arch Phys Med Rehabil 1998; 79(4): 388-94.

  4. Pain H. Choosing Assistive Devices: A guide for users and professionals. Philadelphia; Kingsley Publishers; 2002.

  5. Eitzen I. Pressure mapping in seating: A frequency analysis approach. Arch Phys Med Rehabil 2004; 85: 1136-40.

  6. Allen V, Ryan DW, Lomax N, Murray A. Accuracy of interface pressure measurement systems. J Biomedical Engineering 1993; 15(4): 344-8.

  7. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: quick reference guide. Washington DC (United States): National Pressure Ulcer Advisory Panel. Disponible en: http://www. npuap. org/wp-content/uploads/2012/02/Final_Quick_Prevention_for_web_2010.pdf

  8. Springle S, Faisant T, Chung K. Clinical evaluation of customcontoured cushions for the spinal cord injured. Arch Phys Med Rehabil 1990; 71: 655-8.

  9. Vohra RK, McCollum CN. Fortnightly. Review: Pressure Sores. BMJ 1994; 309: 853-7.

  10. Rosenthal M, Felton R, Hileman D. A wheelchair cushions designed to redistribute sites of sitting pressure. Arch Phys Med Rehabil 1996; 77(3): 278-82.

  11. Bar C. Evaluation of cushions using dynamic pressure measurement. Prosthet Orthot Int 1991; 15: 232-40.

  12. Fergason J, Smith D. Socket Considerations for the Patient with a transtibial amputation. Clin Orthop Relat Res 1999; 361: 76- 84.

  13. Knowledge and Application. Technical Report. Otto Bock. Disponible en http://www.ottobock.com.mx/cps/rde/xbcr/ ob_lam_es/646K1_1-GB-01-1103w.pdf.pdf

  14. Yuen HK, Garret D. Comparison of three wheelchair cushions for effectiveness of pressure relief. Am J Occup Ther 2000; 55(4): 76-94.

  15. Henderson J, Price SH, Branstater ME, Mandac B. Efficacy of three measures to relieve pressure in seated persons with spinal cord injury. Arch Phys Med Rehabil 1994; 75: 535-9.

  16. Brienza D, Karg P, Geyer M, Kelsey S, Trefler E. The Relationship between pressure ulcer incidence and buttock-seat cushion interface pressure in at-risk elderly wheelchair users. Arch Phys Med Rehabil 2001; 82: 529-33.

  17. Letechipia J. Los primeros cinco años de la experiencia en México, en Proceedings of the 4tho Latin American Congress on Biomedical Engineering, Bioengineering solutions for Latin American Health 07, Isla Margarita, Venezuela, IFMBE 2007: 1046-8.

  18. Gilsdorf P, Patterson R, Fisher S. Thirty-minute continuous sitting force measurements with different support surfaces in the spinal cord injured and able-bodied. J Rehabil Res Dev 1991; 28(4): 33-8.

  19. Lewko J, Demianiuk M, Krot E, Krajewka-Kutak E, Sierakowska M, Nykelwicz W, Jankowiak B. Assessment of risk for pressure ulcers the Norton scale in nursing practice. Annales Academiae Medicae Biolostocensis 2005; 50(Suppl. 1): 148-51.

  20. Galíndez-Novoa CV, Lobato-Calleros MO, Gayol-Mérida DA. User perception: a further dimension to improve product functionality for users with disabilities. Case: wheelchair cushion to prevent pressure ulcers in spinal cord injured wheelchair users. JCS/D&CB 2013; 26 [En prensa].

  21. Springle S, Chung K, Brubaker C. Factors affecting seat contour characteristics. J Rehabil Res Dev 1990; 27(2): 127-34.

  22. Apatsidis D, Solomonidis S. Pressure distribution at the seating interface of custom-molded wheelchair seats: Effect of various materials. Arch Phys Med Rehabil 2002; 83(8): 1151-6.

  23. Shapcott N, Cooper D, Gonzalez J. A proposed low cost cushion design for individuals with spinal cord injury in developing countries. Proceeding of RESNA’96 Annual Conference, 1996 Jun. 7-12.

  24. Vongpaseuth T, Smitn L, Todd B. Effects of size on mechanical properties of polyurethane foams, Department of mechanical Engineering, The University of Alabama.

  25. Hobson D. Comparative effects of posture on pressure and shear at the body-seat interface. J Rehabil Res Dev 1992; 29(4): 21-31.

  26. Brienza D, Karg P. Seat cushion optimization: A comparison of interface pressure and tissue stiffness characteristics for spinal cord injured and elderly patients. Arch Phys Med Rehabil 1998; 79: 388-94.

  27. Consortium for Spinal Cord Medicine. Directrices de prácticas clínicas. Úlceras por decúbito: Lo que Usted debe saber. Una guía para personas con lesiones medulares. Washington. D.C. (United States). Disponible en http://www.scicpg.org/ cpg_span_pdf/PUC_span.pdf




2020     |     www.medigraphic.com