A patient who is wheelchair bound is at risk for skin breakdown and pressure ulceration. The risk can be minimized by scrupulous attention to preventive measures. The author is from the Shriners Hospitals for Children in Houston, Texas.


Periodic pressure relief - one of the following:

(1) "push ups" on armrest every hour

(2) wiggle and lifting of buttocks at least hourly

(3) movement by caregiver


Hygiene, especially if incontinent in feces or urine:

(1) cleanliness and need to report soiling

(2) wash cushion and covers if soiled

(3) keep clothing, cushion and cover dry



(1) cushion for signs of excessive wear

(2) points of abrasion or excessive friction

(3) correct wheelchair size for growing children and obese patients

(4) proper placement of the cushion in the wheelchair

(5) skin for early signs of abrasion. maceration or excessive pressure


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