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Skin Integrity and Pressure Injuries

SCI vs. Elderly Participants

The elderly have been identified as an at-risk group for skin integrity issues due to the normal changes in skin as it ages. This, in combination with decreased ambulation and more time spent in sitting, results in increased pressure related skin integrity issues. There are many similarities in potential contributing factors in pressure related skin issues of the elderly population and the SCI population. Brienza and Karg (1998) compared sitting pressures between these two groups.

Author Year Country Research Design Sample Size

Methods Outcome

Brienza & Karg 1998; USA
Prospective Controlled Trial
N=12

Population: Age=21-52 yr; BMI range: 17-32.3 kg/m2.
Treatment: Assessed forces for 3 different surfaces (flat foam, the initial contour and final optimized contour) with the force sensing array pad between the cushion and buttocks. Compared SCI to seniors group.
Outcome Measures: Electronic Shape Sensor; Computer Automated Seating System.

  1. There was no difference in tissue stiffness between SCI and senior group on any of the surfaces.
  2. There was a significant difference in pressure for the initial contour condition between SCI and seniors (p=0.027, p=0.017, respectively), but not within other conditions.
  3. The mean maximum depth was significantly deeper for the final contour as opposed to the initial contour (p<0.0001). Also, the mean maximum depth was deeper in the SCI group than the senior group within the final contour condition (p=0.016, p=0.052, respectively).
  4. Significant differences in interface pressure were found between flat and initial contour (p=0.023) and flat and final contour (p=0.006). No difference was found between the initial and final contour condition.

Discussion

Brienza and Karg (1998) found differences in interface pressure mapping between participants with SCI and elderly adults. Elderly adults are also often at risk of skin integrity issues due to pressure but not across as many parameters as people with SCI. This study identified significant differences between these two groups across most parameters measured, suggesting that data from pressure mapping should not be generalized between groups.

Conclusion

There is level 4 evidence (from one prospective controlled trial: Brienza & Karg 1998) to support not generalizing pressure mapping data from the elderly population to the SCI population.

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