Pressure Ulcers Part Four : Support Surfaces

Support surfaces reduce the risk of pressure ulcers by minimizing pressure in vulnerable areas.

A support surface is any bed, mattress, mattress overlay, or seat cushion that is intended to reduce pressure, especially to areas vulnerable to pressure ulcer development. It is important to remember that a wheelchair is a part of the support surface.

The regular use of support surfaces can reduce the risk of pressure ulcers by minimizing pressure in vulnerable areas. Although support surfaces do not heal pressure ulcers, they are essential to prevention, treatment and allowing for healing.

All equipment should meet your individual needs. The equipment that was recommended for you during rehabilitation, or shortly thereafter, may not be appropriate later as you increase the amounts and types of activities you participate in.

Additionally, equipment should be in good repair. Over time, bed and chair surfaces are compressed and flattened (also known as “bottoming out”), at which point they no longer provide adequate protection against the effects of pressure.

Financial coverage (reimbursement) for support surfaces differs among insurance companies and other third-party payers. Before purchasing anything, check your policy to see what your insurer covers. If you encounter problems with your reimbursement, contact your social worker or case manager or ask your health-care provider to refer you to an appropriate person.

A number of factors, other than those associated with your SCI, determine the type of pressure-reducing equipment that may be recommended for you, including:

• Daily routines and lifestyle activities (work, school, leisure, sports)

• Your specific preferences regarding your equipment

• Who you live with and who assists you on a daily basis

• Whether you have access to all areas in your residence (doorways, carpet vs. hard flooring)

 • How you get around in your community

• What resources are available to you for replacement and repair of your equipment

Similarly, a number of important factors must be considered before a wheelchair cushion or seating system is recommended:

• Height, weight and body build

• Posture (do you slouch or have any curvature?)

• Your ability to shift your weight

• Your level of comfort

• The length of time you sit in the wheelchair

• The frequency and types of daily activities

• Your financial and social resources

Factors that pertain to your wheelchair and cushion:

• The type of wheelchair that meets your mobility needs (manual versus motorized, tilt-in-space versus recliner, solid seat versus sling)

• The cushion’s ability to support your body and promote good posture

• The cushion’s cost, care and maintenance

The result should be equipment that works well for you and those who assist in your care. If not, let your health-care provider know so you can explore other options.

Remember, what is right today may not be right later in life.

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