Pressure Relief, Part I

If you ask any health-care professional or paralyzed patient what’s one issue to be most concerned and vigilant about they’ll all tell you the same thing, pressure sores. The statistics of this health concern are staggering. Every year more than 2.5 million people, in the United States alone, develop pressure sores. Of those, approximately 60,000 die from complications from pressure ulcers. A large population of these patients are paralyzed patients, diabetic patients and nursing home residents. Unfortunately, the mortality rate among individuals with stage 4 bedsores is quite high, with nearly 70 percent of individuals diagnosed with stage 4 bedsores dying within 180 days. Overall, the average lifespan of individuals with stage 4 bedsores is less than 50 days.

After going through six different muscle flap surgeries for stage 4 pressure sores and one leg amputation from infection, over the past 15 years, it’s safe to say that I’m familiar with pressure sores and everything that goes with them. Spending months upon months in bed, the constant sweating and chills, osteomyelitis (bone infection), sepsis. Then there’s the surgery, the six weeks of recovery in a Clinitron tub bed (affectionately known as the coffin) and rehabilitation to try and get back to your life.

Once everything is healed then you have to be vigilant about the fact that the wound site will never be 100% of what it was originally so you become even more susceptible to recurring issues. So how do we stop this from happening and get the proper pressure relief surface to both sit on all day and sleep on all night?

Anyone who’s ever had a stage 4 pressure sore is probably familiar with the Clinitron line of air-fluidized beds.

In simple terms, its a bed of synthetic sand with air forced through it to produce a bouyancy that causes the patient to “float” on the sand and thus reduce the pressure on the contact surface of the skin. This works exceptionally well to relieve pressure and reduce or eliminate the risk of getting ulcers. I’ll address my philosophy on patient access to this equipment in my next post.

For now I want to address pressure relief surfaces for daily use in your wheelchair. For the past 40 years the gold standard for pressure relieving seating cushions has been the ROHO.

History tells us that the ROHO does a very good job of pressure relief if used and maintained properly. Maintaining proper air pressure in the bladder is the key to optimum performance; however many patients, especially new one, have a tendency to overinflate the cushion producing a harder than necessary seating surface. Temperature also has an effect on the air pressure in the cushion. In particular the cold weather causes it to deflate too much. A little vigilance can overcome these issues and you’ll have a good seating solution. We need better. We need great. We need something along the same performance lines of the Clinitron bed.

So here’s my question. Why can’t there be a seating cushion with the same pressure relieving capabilities as a Clinitron by using the same or similar technology? I think there can be and there should be. It shouldn’t be difficult to develop.

The Clinitron is electrically operated to get the sand to flow so obviously that’s not going to work for a device that needs to be mobile. We need something lightweight and portable and preferably without any moving parts. My concept is to utilize a fluid to accomplish the pressure relief. Something along the same lines of the gel cushions that are already on the market but provide higher level of pressure relief. My preliminary solution is the use of a Non-Newtonian fluid (one where the viscosity of the fluid changes with the shear stress imparted on the fluid) to provide the pressure distribution. There appears to be some work in this arena based on this patent application from General Electric in 2018. This seems to be a promising start to this solution.

I’ll be doing my part to try and track down someone at General Electric who is familiar with this research to see if there is any interest in my proposal.  At the same time, if there is anyone in this community that another idea please offer it and pursue it as well.  Another path could be research project for a graduate student at the university level, another healthcare equipment corporation or even just an individual who has the technical expertise in the necessary fields to move this idea forward.

I think this could be a game-changer in the health and well-being of millions of people who annually suffer and die from pressure sores and their related symptoms.  I don’t think we can sit by and just try to survive with what equipment is available to us, or someone we care about, without pursuing something better.  I know I can’t afford to.  I’ve beaten the odds six times so far.  I’m not interested in waiting until I end up on the wrong side of the statistics and then it’s too late.  I’ll be actively pursuing this and I will provide updates as progress warrants because…

…that’s how I roll…