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The ability of three pressure-ulcer prevention support-surfaces to maintain physiological transcutaneous gas tensions in the seated patient

The ability of three pressure-ulcer prevention support-surfaces to maintain physiological transcutaneous gas tensions in the seated patient
The ability of three pressure-ulcer prevention support-surfaces to maintain physiological transcutaneous gas tensions in the seated patient

Aims: this study evaluates the effectiveness of three seating interventions-static foam (SF), alternating pressure (AP) cushion, and lateral pressure (LP) device-in reducing pressure ulcer (PU) risk among seated individuals by maintaining tissue perfusion levels in buttocks tissue.

Methods: eight healthy participants were seated on each intervention for 30 min, followed by a 10-min standing recovery period. Transcutaneous tissue oxygen (TcPO 2) and carbon dioxide (TcPCO 2) were measured at the right ischial tuberosity to monitor tissue perfusion. Responses were recorded as a percentage change relative to each participant's unloaded baseline gas tensions and categorised into three levels of risk. Statistical analysis included paired, one-tailed t-tests to compare the impact of each seating intervention on transcutaneous gas tensions.

Results: both AP and LP devices revealed a lower magnitude of ischemic carbon dioxide compared to the SF cushion, with mean TcPCO 2 increases of 13.8 % ± 12.0 % and 14.3 % ± 12.0 %, respectively, versus 96.5 % ± 106.5 % for SF. The corresponding TcPO 2 decrease was significantly less for AP (-29.2 % ± 15.7 %) and LP (-28.3 % ± 32.6 %) than for SF (-67.8 % ± 29.0 %). Participants spent significantly more time in the lowest risk category on the AP (17.5 min) and LP (18.2 min) devices than on the SF (2.2 min).

Conclusion: the AP and LP devices maintained favourable buttocks tissue perfusion more effectively compared to the SF, indicating their potential benefit in reducing PU risk for seated patients. These findings support the need for further research to confirm the efficacy of interventions across large sample sizes and longer durations.

0965-206X
Spiteri, Maegan
98d2e3f7-2e3d-409d-a2d6-68c8d9883180
Christou, Alexandros
9a11de08-a8c6-439d-b86e-4fd62eb4966a
Boyle, Colin
c5ce4507-21e3-432e-8c9a-f266636a87f8
Savine, Louise
dbbe57d6-0222-47df-b502-74b244aaebbe
Worsley, Peter R.
6d33aee3-ef43-468d-aef6-86d190de6756
Masouros, Spyros
102270a4-11c6-428f-81d4-608b833c3147
Spiteri, Maegan
98d2e3f7-2e3d-409d-a2d6-68c8d9883180
Christou, Alexandros
9a11de08-a8c6-439d-b86e-4fd62eb4966a
Boyle, Colin
c5ce4507-21e3-432e-8c9a-f266636a87f8
Savine, Louise
dbbe57d6-0222-47df-b502-74b244aaebbe
Worsley, Peter R.
6d33aee3-ef43-468d-aef6-86d190de6756
Masouros, Spyros
102270a4-11c6-428f-81d4-608b833c3147

Spiteri, Maegan, Christou, Alexandros, Boyle, Colin, Savine, Louise, Worsley, Peter R. and Masouros, Spyros (2025) The ability of three pressure-ulcer prevention support-surfaces to maintain physiological transcutaneous gas tensions in the seated patient. Journal of Tissue Viability, 34 (3), [100920]. (doi:10.1016/j.jtv.2025.100920).

Record type: Article

Abstract

Aims: this study evaluates the effectiveness of three seating interventions-static foam (SF), alternating pressure (AP) cushion, and lateral pressure (LP) device-in reducing pressure ulcer (PU) risk among seated individuals by maintaining tissue perfusion levels in buttocks tissue.

Methods: eight healthy participants were seated on each intervention for 30 min, followed by a 10-min standing recovery period. Transcutaneous tissue oxygen (TcPO 2) and carbon dioxide (TcPCO 2) were measured at the right ischial tuberosity to monitor tissue perfusion. Responses were recorded as a percentage change relative to each participant's unloaded baseline gas tensions and categorised into three levels of risk. Statistical analysis included paired, one-tailed t-tests to compare the impact of each seating intervention on transcutaneous gas tensions.

Results: both AP and LP devices revealed a lower magnitude of ischemic carbon dioxide compared to the SF cushion, with mean TcPCO 2 increases of 13.8 % ± 12.0 % and 14.3 % ± 12.0 %, respectively, versus 96.5 % ± 106.5 % for SF. The corresponding TcPO 2 decrease was significantly less for AP (-29.2 % ± 15.7 %) and LP (-28.3 % ± 32.6 %) than for SF (-67.8 % ± 29.0 %). Participants spent significantly more time in the lowest risk category on the AP (17.5 min) and LP (18.2 min) devices than on the SF (2.2 min).

Conclusion: the AP and LP devices maintained favourable buttocks tissue perfusion more effectively compared to the SF, indicating their potential benefit in reducing PU risk for seated patients. These findings support the need for further research to confirm the efficacy of interventions across large sample sizes and longer durations.

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Accepted/In Press date: 26 April 2025
e-pub ahead of print date: 3 May 2025
Published date: 11 May 2025

Identifiers

Local EPrints ID: 502530
URI: http://eprints.soton.ac.uk/id/eprint/502530
ISSN: 0965-206X
PURE UUID: d4b71f61-5b0e-45b6-a508-73c82f7fff50
ORCID for Peter R. Worsley: ORCID iD orcid.org/0000-0003-0145-5042

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Date deposited: 30 Jun 2025 17:34
Last modified: 03 Jul 2025 01:53

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Contributors

Author: Maegan Spiteri
Author: Alexandros Christou
Author: Colin Boyle
Author: Louise Savine
Author: Spyros Masouros

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