Clinical trial of foam cushions in the prevention of decubitis ulcers in elderly patients.

Polyurethane foam cushions in a slab form or a customized contoured form are commonly used in wheelchairs to prevent the development of decubitus ulcers (DU) in elderly chronically ill persons. Sixty-two consenting subjects, 60 years or older, were randomly assigned to sit on one of the two types of cushions for 3 or more hours daily for 5 months. A total of 72 DU developed in the 52 subjects who completed the study. These were mostly in the areas of ischial tuberosities, buttocks, and thighs; were of persistent erythema level in severity; and took an average of 6 to 8 weeks to heal. No statistically significant differences were found in the incidence, location, severity, or healing time of the sores that developed in the subjects who used the slab (N = 26) and those who used the contoured (N = 26) cushions. But, more severe sores did develop among the slab cushion group in the area of ischial tuberosities. It appears that foam customization for elderly persons could be justified only if DU have been a particular problem in this region. Incontinence as a contributory factor to DU formation should receive careful attention with respect to prevention. The trials described are being continued, using a larger number of subjects.