The Relationship between Pressure Ulcer Development and Wheelchair Position in the Elderly

Comparison between Lateral and Wheelchair Position

Abstract

Much research has been undertaken concerning the care and prevention of pressure ulcers in spinal cord injuries patients. There are also some studies on sitting posture and pressure management for wheelchair using elderly. However, there is little research related to sitting positions and pressure ulcers in the elderly. Many elderly people have very brittle bones, and are effected by deformation and contracture from skinny body frames.
This research focuses on practices that can prevent of pressure ulcers in the buttocks of the elderly. Skin tissue form was obtained for inquiry into the special shapes and causes of pressure ulcers effected by sitting position. Subjects were sitting position patients (n=59), bedridden patients (n=31), and walking patients (n=23). Views of their buttocks skin were compared, and the shapes of the pressure ulcers obtained. Moreover, ulcers from sitting patients were obtained using a wheelchairs are made from transparent polyvinyl chloride and without any underlining; thus enabling contact areas of the ulcers to be observed. The contact area shapes were compared with lateral and the wheelchair positions.
Pressure ulcer wounds effected by sitting positions are shaped like a circle, a ring, a horse's hoof, butterfly and irregular shapes. The relationship between pressure ulcers and the contact area shapes was determined; circles and rings were related to pressures, while horse's hooves, butterflies and irregular shapes were related to shear forces.
Consequently, early care of pressure ulcers can be aided from the knowledge that the direction of the external force effecting the patient's condition can be determined from the shape of the pressure ulcer.