Advice on Sitting While Experiencing a Pressure Injury
A common question arises when a wheelchair user develops a pressure injury. They want to know if it is advisable to sit before the pressure injury is completely healed. The answer will depend on many things including the type of cushion they intend to sit on and their ability to do pressure relief if using a static cushion.
The Aquila custom fabricated wheelchair cushion is specifically designed to help treat and improve pressure injuries by virtue of the automatic pressure relief and offloading capabilities under a current pressure injury. Static cushions do not have that capability, so it is very risky to sit on them when you have a pressure injury and your ability to provide your own pressure relief is questionable.
The experts at Permobil address this exact scenario on their website. They pose the following question and answer pertaining to a ROHO static air wheelchair cushion.
The following paragraph is taken directly from the Permobil website regarding the ROHO static air cushion.
“If I have pressure injuries, can I sit on my DRY FLOTATION cushion?”
Permobil says…”Yes, DRY FLOTATION cushions and mattresses are designed to both prevent and heal pressure injuries. If you have a Stage 1, 2 or 3 injury, you can sit directly on a DRY FLOTATION cushion, provided you (or a caregiver) frequently monitor the wound. Always discuss your care with your clinician, but along with proper care and nutrition, it has been proven that an injury can heal on a ROHO cushion or mattress.”
“Our DRY FLOTATION products have a unique ability to redistribute pressure, minimize the tissue deformations that cause deep tissue injury, sustain blood flow, and potentially decrease edema, which all enhance healing. A Stage 4 injury usually requires surgery and presents additional complications”.
Steve Kohlman, President of Aquila Corporation responds to the above paragraph.
“I am not sure how the people at Permobil believe a static air cushion is designed to prevent and heal pressure injury. The fact is, a static cushion of any design, applies a constant pressure to the posterior which is the primary cause of pressure injury. A static cushion lacks the ability to change pressure points by itself which is precisely why the client must perform their own pressure relief at least every 20 minutes as recommended by physicians.”
“Sitting on a static cushion when you have a pressure injury is very dangerous. The injury site must have pressure relief, or it will certainly get worse. Applying constant pressure to the injury is very bad advice.”
“A ROHO cushion sits completely motionless and does not have the ability to change pressure points or relieve pressure on its own.”
“If a static cushion does nothing but sit motionless exerting constant pressure (the primary cause of pressure injuries) the manufacturer of that static cushion cannot say it is designed to heal a pressure injury. Rather, the static cushion by nature of its motionless state, is a contributing factor to pressure injuries.”
“Also, a ROHO cushion could lose all its protection if it were to leak and lose all air leaving absolutely no protection between the posterior and a metal seat pan. This makes it potentially the most dangerous cushion on the market because the ROHO does not have any type of low- pressure alarm system.”
“There is no valid clinical data to indicate that a ROHO cushion ever healed a pressure injury. Valid clinical data is that which was not written by an employee of ROHO or a division of ROHO. Any case study written by Cynthia Fleck of Crown therapeutic, a division of ROHO, must be questioned as invalid.”
“Logic dictates sitting on a static cushion such as a ROHO is a risk and requires extreme vigilance in performing pressure relief and in making sure the cushion has not gone flat.”
“If you want a wheelchair cushion that changes pressure points by itself and has been clinically proven to improve pressure injuries, even heal them, the Aquila cushion is for you. Upgrade to the best, Aquila.”