The wheelchair is an incredible invention. Paraplegic clockmaker Stephan Farfler built the first such device back in the 1600s when he was just 22 years old, and since then, they’ve proved an invaluable aid to the disabled, sick and elderly around the world.
Various degenerative disorders can lead to wheelchair use, including Alzheimer's, Parkinson's, cerebral palsy, and multiple sclerosis. Other conditions such as diabetes, muscular dystrophy, amputations, paralysis, and brain injuries may also result in mobility loss.
Wheelchairs help people regain mobility, enabling many to lead full and satisfying lives. Though wheelchair use may present mental health challenges, these devices ultimately prevent isolation and loneliness for people with disabilities.
While the wheelchair is a relatively simple device, it still presents challenges to those who use it daily. The fact of the matter is, the human body still isn’t used to sitting in one place for such long periods. Without proper care, it will react to areas of high pressure with sores and pain.
What Are Wheelchair Pressure Sores?
Before discussing what causes this problem and some essential wheelchair pressure sore prevention strategies, here is a quick definition.
Pressure sores, also referred to as 'pressure injuries', are an all-too-common result of using a wheelchair. They arise from repeated contact between the body, especially areas where skin and muscle are stretched tightly over bony protuberances, and the surface.
They frequently occur when people cannot shift position frequently enough to distribute the pressure against certain parts of the body, usually when they’re bound to a bed or wheelchair.
Standard pressure sore areas include the heels, backside, elbows, shoulders, and head. For wheelchair users, buttocks make up the majority of pressure-painful injuries, though shoulders, elbows, and the backs of the legs may also suffer.
Unfortunately, sustained pressure on any area of the body puts one at risk of developing pressure sores. Because the higher pressure reduces blood flow, sores develop, and tissue dies where they're left untreated.
Over time, pressure sores that begin at the body's surface can penetrate more deeply, reaching underlayers of skin and even muscle. In later stages of pressure injury, the sores weep and ooze and can become infected. In older people or those with compromised immunity, this infection has severe or even deadly potential.
Causes of Wheelchair Pressure Sores
The leading causes of wheelchair pressure sores include:
- Prolonged Sitting - When people stay in the same place for long periods, the pressure against particular tissue restricts blood flow and creates sore areas.
- Improper Cushioning - People who must be in the same position over long periods need good cushioning. Poor padding increases the chance of injury.
- Poor Posture - Slumping or leaning can dramatically increase pressure areas on a person’s body. Caregivers should encourage correct posture and provide accessories to assist.
- Friction & Shear - Moving sideways along pressure areas also increases their incidence, so ensure the person is snug in their seat and doesn’t need to move around much to get comfortable.
- Medical Conditions - A variety of medical conditions, as well as medications, can make wound healing more complex, so always be on the lookout if you know someone who fits this description.
The Importance of Wheelchair Pressure Sore Prevention
It’s essential to avoid pressure sores because no one deserves unnecessary pain and because they can develop quickly and are challenging to treat once they do. Because pressure tends to repeat in the same places, treating sores after they appear is an uphill battle.
Plus, research shows that pain can actually limit wound repair. Psychological stress (such as pain) slows wound healing time, and “can indirectly modulate the repair process by promoting the adoption of health-damaging behaviors,” such as overeating or lack of activity.
Caregivers should pay special attention to pressure sores and their prevention. That way, the disabled person has as much chance as possible of living a fulfilling life.
Wheelchair Pressure Sore Prevention Strategies
The best way to reduce the impact of bedsores or pressure ulcers if the patient is in a wheelchair, is to ensure they never develop. Prevention can reduce skin loss, keep blood flow normal, and minimize the incidence of adverse health conditions.
Where possible, use the following strategies to prevent wheelchair pressure sores:
- Proper Cushioning - Cushions designed with the individual in mind are vital to minimizing the risk of sores.
- Proper Posture - Good posture is an excellent tactic to avoid sores. With cushions and education, you can make this much more likely.
- Good Hygiene & Skin Maintenance - One of the best ways to prevent a pressure ulcer is by keeping the skin clean and dry.
- Regular Movement & Stretching - Physical therapy is vital for people in wheelchairs, whether they’re there for the short or the long term. Teach people how to move and stretch throughout the day.
- Appropriate Attire - Comfortable, breathable clothing helps increase airflow and decrease friction, both of which will help reduce pressure sore incidence.
- Selecting the Right Wheelchair - Patients require the correct wheelchair for their height, weight, frame, and other unique characteristics. It helps to use a pressure mapping system when choosing the chair.
- Early Detection & Intervention - Knowing when there’s a problem is one of the most important aspects of preventing or reversing pressure sores. If you see raw or red areas appearing, that hints that all is wrong with the wheelchair. Spongy or hard spots are also a red flag that something is wrong.
Treatment for Pressure Sores
Once pressure sores have occurred, your treatment tactics include:
- Proper Wound Care - Cleaning and dressing the wound is paramount once you discover it. If you leave it to suppurate for a short time, it may become infected, which can become systemic if you aren’t careful.
- Pain Management - Pressure sores are painful, and adequate pain relief is necessary to promote healing and mental health.
- Pressure Relief - Whether the pressure sores have just started showing signs or are full-blown, you need to support the person in the wheelchair. The only way to treat and prevent new sores is to relieve pressure on the affected areas.
- Seek Professional Help - With cutting-edge sensors, you can see a map of high and low-pressure areas is crucial to wheelchair pressure sore prevention, but you need to do it.
Sensors & Data to Help Aid in Pressure Sore Prevention
The days of trial and error are gone. No longer must we wait and see if a certain chair or cushion works for a patient; now we can get out in front of pressure sores by using cutting-edge mapping technology. XSENSOR specializes in creating high-quality images, accompanied by actionable, granular data of pressurized areas. Wheelchair seats are no exception. A complete wheelchair pressure mapping system can help you get there.
The ForeSite SS Wheelchair Seat System is a fully realized set of technologies that help clinicians assess patient’s pressure areas, create a map of their imprint on a chair, and then accommodate their unique pressure “footprint.”
You can immediately generate a numerical and 3D picture of where pressure occurs. That allows you to show the patient how to redistribute pressure where needed.
Here's how it works:
- Lay the sensor mat over the base, back, or other wheelchair part where you want to take readings.
- Have the patient sit in the wheelchair as they usually would.
- The pressure mapping system will take pressure readings across the mat in real time, measuring the differential at various points and creating a visual map of pressure—red and orange for high, yellow for medium, and green and blue for low.
- Examine the raw data the system provides to address issues more granularly.
- Adjust the seating as necessary with cushions and inserts, watching to see if the adjustment relieves areas of high pressure.
- Adjust the patient's seating as needed in the current session and later visits.
By educating wheelchair users on effective pressure relief using this system, clinicians not only decrease the number of patients with pressure sores dramatically, but they can also increase the number of assessments overall due to the simple, streamlined nature of the system.
The right equipment, combined with appropriate lifestyle changes, can help to alleviate, reduce and eliminate pressure injuries — especially for wheelchair users.
Ready to give your patients the TLC they deserve and ensure the wheelchair experience is as pleasant as possible? Get in touch for a demo to learn more today!
