Ian's pressure ulcer improved in only 2 weeks using the StarLock air cell cushion

This case report, with Ian Lamb and his struggle with a pressure ulcer that wouldn't heal, until he started to sit on the StarLock Air cell cushion, was prepared by Jo McConnell Occupational Therapist and Education manager for Etac, in December 2020.

"I have been suffering with pressure ulcers for around eight years before I started to use the StarLock cushion.

You need to know what your goal is with any cushion. My goal is always to be healthy, which means healthy skin and no pressure ulcers that limit my quality of life.

My bum (bottom) is like my feet and the cushion is like my shoes, the cushion has to work.

– Ian Lamb"

Purpose and goal of this case report

To document the selected air cell cushion’s properties regarding positioning, pressure redistribution, sitting tolerance and its influence on the healing of a grade 4 pressure ulcer using a pressure free zone.

Method

Interview, pictures, cushion set up and adjustments.

An assessment of the user’s posture and seating needs was carried out and his current needs were identified via assessment and through discussions about what difficulties he was experiencing with his current wheelchair pressure redistribution cushion. One face to face assessment took place, then a follow up virtual meeting was arranged a month later to check the set up and advise on the offload.

Background

The user Mr Lamb was struggling to cope on his existing air cell cushion due to discomfort. He was experiencing pain when sitting and needed his posture adjusting by his carers.

He was having to spend hours every day on bed rest due to a grade 4 pressure ulcer which was not healing. Mr Lamb had not found a successful solution for his wheelchair pressure redistribution cushion, his pressure ulcer was being monitored and treated with dressings via visits from a community nurse.

Ian Lamb

Mr Lamb lives at home in the UK in an adapted property with his wife and he has carers who visit daily to assist with his personal care needs. He is hoisted for all transfers.

Medical background

Mr Lamb is a 58-year-old man who had a spinal cord injury eight years ago. The injury left him with a C5/6 level incomplete spinal cord injury. His carers and his wife assist him throughout the day with all activities of daily living due to his paralysis and level of spinal cord injury.

Mr Lamb had been suffering with grade 3 and 4 pressure ulcers for the past eight years and the ulcers had been constant even with treatment from the specialist nursing team. Mr Lamb had two pressure ulcers near his left ischial tuberosity.

Wheelchair

Mr lamb is a full time powered wheelchair user. The powered wheelchair has powered tilt and recline, and powered elevating leg supports. This enables him to independently change his position throughout the day to relieve pressure. Mr Lamb also has a lightweight rigid active wheelchair that he uses when he goes
out and about to visit friends’ houses and when he goes on holiday. Mr Lamb is pushed by an attendant in his manual wheelchair, due to his level of paralysis he is unable to self-propel.

Cushion history

Mr Lamb was using a Vicair Adjuster 10 cm cushion and he had previously been using Jay pressure redistribution cushions. Initially he had felt that the other cushions seemed to be working but his pressure ulcers remained and never showed any signs of improving.

Mr Lamb reported that “it took around two weeks from starting to use the StarLock cushion for the pressure ulcer to improve”.

Assessment

The OT/education manager Jo McConnell was invited by a specialist dealer from Bromakin wheelchairs to carry out an assessment on a StarLock cushion for Mr Lamb.

The assessment took place at his home in November 2019 with the dealer, his carers and wife present. Mr Lamb explained that he had suffered from pressure ulcers for almost eight years and wanted a cushion that he could have better protection and comfort so that he could sit in his wheelchairs for longer without worrying about the risk to his pressure ulcer.

The assessment was carried out and it was agreed that the best solution would be to trail the StarLock 13cm cell height and set it up with a pressure free zone where his pressure ulcer were located. The cushion was easily set up and the process was explained and demonstrated to Mr Lamb, his carers and the dealer who would provide back up support.

Result

The dealer kept me updated on the success of the StarLock. A review via video call was arranged when he was with Mr Lamb in January. During the review, the set up and the offload area were checked. It was reported that all involved were managing the cushion well.

Conclusion

The StarLock has been very successful for Mr Lamb. He has now been using the cushion for a year and he is happy to say that his pressure ulcers have recovered to a stage 1 and there is no longer an open wound. This is a great relief to him and his family. He found the cushion easy to use and monitor. He noticed a difference in just two weeks after starting to use the StarLock cushion; the pressure ulcers started to heal. The StarLock was used in conjunction with his ongoing pressure ulcer treatment of dressings. The combination of the 13 cm air cell technology and being able to provide a pressure free zone had a positive impact on his skin integrity and Mr Lamb is now protecting his vulnerable skin and continues to use the StarLock cushion in both of his wheelchairs.

Mr Lamb has agreed for us to use his own words and name to endorse the StarLock cushion. He would like to share his experience with other users from around the world who have struggled to find a solution to their long-term pressure ulcers.

Follow up review - May 2021

A follow up visit took place with Jo McConnell, Etac Education manager. It had been so long since the initial assessment so it is good practice to review the set up and how the cushion is performing. Jo attended with Steve from Bromakin who provides all of Mr Lamb’s wheelchair needs.

The Starlock has been very successful and Jo asked Mr Lamb:
– What has made such a difference compared to other cushions?

Mr Lamb answered:
– Being able to lock off the cells under my pressure ulcer has made all the difference and the pressure ulcer has remained healed, I feel that I don’t have to worry about my skin now, but it is regularly checked anyway.

Mr Lamb said that he felt less wobbly on the Starlock and he didn’t have to worry about feeling unstable, he said the cushions worked so well with his powered wheelchair and he sits from 10.00 am to roughly 8.30 pm every day on the StarLock, and longer at weekends, He couldn’t sit that long on any other cushion.

He has excellent carers who are an integral part of the cushion being a success
“the carers have to buy into the cushion and have to fully understand it, then its straightforward.”

During the review visit, Jo checked the cushion set up and went over the mechanism again, with a different carer who had not been present, the carer said it’s an easy cushion to monitor and easy to clean and maintain.