Pressure Sore Healing Progress in Nursing Home Setting

3-01-18

The following is a summary of information received from the reporting nurse, Christopher F. from Rose of Sharon nursing home in Roseville MN regarding a patient using the Aquila SofTech Basic cushion.
The cushion used is the SofTech Basic which is the cushion designed for the nursing home, LTC, managed care centers and hospital environments. The SofTech basic features a simple one button control. It cannot be damaged if left on with no weight on the cushion or if the battery becomes very low, so it is ideal for settings such as nursing homes. All system components (pump, electronics, battery etc) are incorporated inside the seat cushion so there is no external control box, only a remote control.
This report will illustrate that this standard configured cushion is also able to treat severe pressure ulcers while the patient is sitting.
The nurse that is writing a case report has provided periodic measurements of the wound, so the following is an abbreviation of data over time.
The patient started this clinical case study with a stage 4 pressure ulcer at the left ischial. Prior to using the Aquila SofTech basic cushion, he had been using a Roho static air cushion. The patient sits for up to 12 hours per day and sleeps in his chair in a reclined position.
Stage 4 or unstageable pressure ulcers are very difficult to heal and typically require bedrest for long periods of time to heal. In this case, there has been significant healing while the patient has been up and sitting for over 12 hours per day using the Aquila SofTech basic cushion. The nurse comments at the end of the summary about the improvement to the sores being directly related to the SofTech Basic cushion.
Before using the Aquila SofTech basic cushion
12/06/16 The patient had a stage 4 pressure ulcer on the left ischial with measurements of 3.5 x 5.2x 1.2 cm (21.8 cubic centimeters) while using a Roho static air cushion

Patient began using the Aquila SofTech Basic cushion
On 12/07/16 Patient begins sitting on the Aquila cushion.
On 1/04/17 The sore improved to 2 x 4.8 x 1.2cm, (11.52 cubic centimeters almost 50 % improved)
On about 1/18/17 the nurse reports an abrasion measuring 10 x 9 cm over the sacral area. The nurse reports the abrasion is from the patient transferring with new leg rests on his wheelchair.
On 2/17 the battery of the Aquila needs to be evaluated and possibly replaced so the patient reverted to a Roho static air cushion while the SofTech was sent to Aquila for battery replacement. While using the Roho air cushion the nurse reports that the roho cushion went flat and staff was unaware when this happened because there is no warning device on the flat Roho cushion.

2/23/17 The SofTech alternating cushion is again being used by the patient and working fine. During the time the patient was using the Roho cushion, the original pressure sore degraded to 5 x 4.5 x 3cm, (67 cubic centimeters) and the sacral abrasion has turned into an unstageable pressure ulcer. 

The sacral wound when staged was 11 x 8 x 4.3 cm.

4/02/17 The left ischial wound is now improving to 3.5 x 4 x 2.2 cm (30 cubic centimeters)
6/23/17 left ischial wound measures 3.3 x 3.2 x 0.9cm (9.5 cubic centimeters) and the sacral wound measures 3.4 x 1.6 x 1.3 cm, (7.02 cubic centimeters). The nurse reports the patient was gone from late morning to midnight 4 days previous week and now most every day he is gone and sitting in his wheelchair for over 12 hours per day. The report state that “During this time the wounds have continued to show slow improvement which is directly related to the cushion”.
The patient is a smoker too which makes healing a sore much more difficult.
Summary
To summarize: The original pressure sore improved from 21 cubic cm to 11 cubic cm in 4 weeks while using the Aquila.
The sore degraded to 67 cubic cm while using a Roho cushion that went flat.
When back on the Aquila cushion the sore improved to 9.5 cubic cm while sitting over 12 hours per day.
The entire duration was a span of 6 months.

The sacral sore improved from 378.4 cubic cm to 7.07 cubic cm during the same 6 months while sitting on the Aquila SofTech Basic cushion. The sore is 98.2% healed.