Prioritizing Pressure Management: Reducing the Risks of Seated Pressure Sores
Why would we develop seated pressure sores, anyway? Here’s a simple physiological fact: as humans, our bodies aren’t designed to sit for long periods. As padded as some of our posteriors may seem, nature didn’t intend for them to handle concentrations of seated body weight indefinitely. And, unfortunately, for those of us with mobility impairments, remaining in a seated position for extended periods can lead to a very serious and debilitating condition called decubitus ulcers – more commonly called pressure sores.
Seated pressure sores occur when bony areas rub away at tissue. Many assume that pressure sores occur from the outside, in. however, it’s in fact bony areas pressing or rubbing against tissue, from the inside, out that causes pressure sores. And, this is among the reasons why they’re so dangerous – by the time we see a pressure sore, serious tissue damage has already occurred, often requiring surgery and months of bed rest.
So, as those often seated, how do we prevent pressure sores? This is where individual practices of pressure management come in.
It Starts With Seat and Back Cushions
It’s natural to think of a seat cushion simply as a padded surface to sit on. However, when it comes to pressure management, a cushion is truly a physiologically-engineered medical necessity. Pressure management cushions serve three foremost roles (and these apply to both seat and backrest cushions):
- Distributing weight as evenly as possible
- Allowing pressure points, such as the sacrum/coccyx, to immerse (sink) into the cushion, reducing pressure
- Reducing shearing (pulling of the skin and tissue
The more evenly pressure is distributed across the seating surface, the less pressure is on any one point, thus decreasing the risk of a seated pressure sores developing. A cushion with immersion characteristics – commonly made of air cells, gel, or layers of memory foam – allow pressure points to sink in and reduce pressure. And, a low-shear (slick) cover reduces pulling on skin and tissue. When the three are combined, optimal pressure management occurs.
There are a range of seat and backrest cushions on the market, but looking for these three characteristics is key to pressure management.
You Must Shift Your Weight
A pressure management cushion and backrest is only half of the equation to preventing seated pressure sores. The other half is weight shifts. Weight shifts are just as they say – it’s shifting your weight off of pressure management areas. For example, lateral weight shifts involve leaning to each side to temporarily relieve pressure on areas of your posterior. Similarly, a forward lean takes pressure off of your back and tailbone region. For those wheelchair users who can’t perform manual pressure shifts, there is tilt and recline seating that shifts one’s weight. There are additional pressure relief methods, and all should be approved as safe and effective by your clinician or healthcare professional. Regardless of the method used, the clinical community recommends that those at risk of pressure sores perform weight shifts every 15 to 20 minutes. And, when our schedules allow, lying on our side on a bed for a bit to eliminate pressure altogether can be among the best forms of pressure management.
Shifting Our Priorities
For those of us who rely on mobility products, in seated positions, it’s vital that we make pressure management a priority. However, when done right – getting a pressure management seat and back cushion, as well as performing weight shifts – we can focus less on our posterior and more on our everyday lives with health and comfort.