Why Pressure Sores Are Serious
Pressure sores (also called pressure ulcers or decubitus ulcers) are one of the most common and dangerous complications for wheelchair users. They occur when sustained pressure on skin — especially over bony areas — cuts off blood flow, causing tissue damage.
Key facts:
- Up to 80% of people with spinal cord injuries will develop a pressure sore in their lifetime
- Severe pressure sores can take months to heal and may require surgery
- They can become life-threatening if infected
- Prevention is far easier and cheaper than treatment
High-Risk Areas for Wheelchair Users
- Ischial tuberosities (sit bones) — the #1 location for wheelchair users
- Sacrum/tailbone — especially when sliding forward in the chair
- Shoulder blades — from leaning against the backrest
- Heels — from resting on footplates
- Elbows — from armrests
Prevention Strategies
1. Use the Right Wheelchair Cushion
Your cushion is your most important defense against pressure sores. Types include:
Foam Cushions
Most affordable. Memory foam contours to your body shape. Good for low-to-moderate risk. Replace every 1-2 years as foam breaks down.
Gel Cushions
Gel layer distributes pressure evenly. Stays cooler than foam. Good for moderate risk. Heavier than foam but excellent pressure relief.
Air Cushions
Interconnected air cells that you inflate to the right pressure. Best pressure distribution available. Used by high-risk individuals. Brands: ROHO, Star Cushion. Requires maintenance (checking air pressure regularly).
Hybrid Cushions
Combine foam + gel, foam + air, or all three. Balance comfort, weight, and pressure relief. Popular choices: Jay, Varilite.
2. Pressure Reliefs
Every 15-30 minutes, perform a pressure relief:
- Wheelchair push-up: Push down on armrests to lift your buttocks off the seat for 30-60 seconds
- Forward lean: Lean your chest toward your knees for 1-2 minutes
- Side lean: Lean to each side for 30-60 seconds
- Tilt: If your chair has tilt-in-space, tilt back 45-65° for 1-2 minutes
3. Proper Wheelchair Fit
- Seat width: 1-2 inches wider than your hips
- Seat depth: 1-2 inches shorter than your thigh length
- Footrests: Adjusted so thighs are parallel to the ground
- Backrest: Supports without forcing you forward or back
4. Daily Skin Checks
Check your skin every day, especially:
- Sit bones, tailbone, hips
- Any area that contacts the chair
- Use a mirror or phone camera for hard-to-see areas
- Look for redness that doesn’t fade after 20 minutes of pressure relief
5. Keep Skin Clean and Dry
- Shower or bathe daily
- Use moisture barrier cream on areas prone to sweating
- Change clothing if wet from perspiration or incontinence
- Use absorbent cushion covers
6. Nutrition
Good nutrition is essential for skin health:
- Protein: Aim for 1.2-1.5g per kg of body weight daily
- Vitamin C: Supports collagen production and healing
- Zinc: Essential for cell repair
- Hydration: 8+ glasses of water daily
Stages of Pressure Sores
| Stage | Description | Action |
|---|---|---|
| Stage 1 | Red area that doesn’t blanch (turn white) when pressed | Relieve pressure immediately. Monitor closely. |
| Stage 2 | Broken skin, blister, or shallow open wound | See healthcare provider. Keep clean and covered. |
| Stage 3 | Deep wound extending into fat layer | Medical treatment required. May need wound care nurse. |
| Stage 4 | Deep wound exposing muscle, bone, or tendon | Urgent medical attention. May require surgery. |
Shop Wheelchair Cushions at FinalMedic
We carry 34 wheelchair cushions including ROHO air cushions, Jay hybrids, gel cushions, and foam options. Plus wheelchair backs, positioning accessories, and skin care products.
Free shipping across Canada. Need help choosing? Contact info@finalmedic.ca.