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Comparison of Shower Chair Seat Modules by Pressure Mapping The aim of these case studies is to establish, by using the modelling capabilities of a digital pressure sensing and mapping tool, which shower chair and seat combination offers patients the most protection from tissue injury through pressure. Our focus in these trials is on users that have a spinal injury; this subset of users tend to present with the highest requirement for pressure relief. Experience tells us that a user with a spinal injury often presents with some or all of the following characteristics when using a commode chair: • Paralysis and sensory impairment - you can’t tell if something is irritating your skin • They may not have the ability to move themselves to relieve any discomfort or pain • Particularly prominent ischial tuberosities and other bony prominences as a result of muscle atrophy • Altered circulation can reduce blood supply to tissues, which increases the risk of skin problems, but slows the healing process • They often have the requirement to transfer sideways to and from their wheelchair We have undertaken two separate trials so far. For both trials we used a FSA and Boditrak unit with a standard seat sensor, 455mm x 455mm with 256 sensor points, calibrated to a maximum of 300mmHg and connected to a laptop pc. Prior experience has shown that whilst most pressure mapping systems are calibrated to a maximum of 200mmHg, this is not sufficient for the purposes of mapping a seat where a large portion of the surface is removed (as in the case of a shower chair/commode seat). Trial 1 - Hospital Ward, male user, approx 50 years old The ward standard chair at the time of the trial is Freeway T70. The user was able to transfer himself from his wheelchair to the shower chairs, and then bridge to enable the pressure map cushion to be placed in the right way. Trial 2 - Home setting, male user, 29 years old Currently using a Chiltern chair. The user was able to transfer himself from his wheelchair to the shower chairs, and then bridge to enable the pressure map cushion to be placed in the right way. The purpose of this evaluation is to measure the pressure imposed by the seats of popular shower commode chairs currently in circulation in the UK. These trials have included products from Prism/Freeway, Invacare and Raz. Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalisations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients’ education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Abstract from article published by US National Library of Medicine, ‘Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends’, Nov 2013 Trial 1 In this trial the patient was using a Prism T70 on the ward. The Senior Outpatient OT was specifically searching for a chair which could provide pressure relief whilst maintaining usability for the patient. The patient was mapped on the T70 with a Medium Horseshoe seat module, on the RAZ AT with a 19” deep moulded seat module, and on the Raz AT with a 19” deep visco seat module. He also transferred to the Aquatec Ocean VIP which was equipped with an ergonomic soft seat. However he could not tolerate the seat for long enough to have mapping done, and the OT advised him to move off the chair to prevent tissue damage. Freeway Seat Module RAZ Seat Module Trial 2 In this trial, the patient offered to assist us with research into seat pressures. As a spinal injury patient advocate, he was interested in accumulating knowledge around seat pressures in shower and wheel chairs. The patient was mapped on the Prism T80 with a medium horseshoe seat module, the Aquatec Ocean VIP with a regular soft seat, and the RAZ AT with 19” deep visco seat module. Aquatec Freeway T80 RAZ AT Aquatec Freeway T80 RAZ AT