Wound Care Q&A: Justine Kohlman, Aquila Corp.

Q: How should a client’s pressure injury history impact the seating team’s equipment strategy?

Justine Kohlman: The most important part of a seating strategy is the cushion, as pressure injuries are predominantly developed on the posterior, where the majority of weight is applied and [where it’s] not easy to relieve pressure.

When building a custom automatic-alternating wheelchair cushion, such as the Aquila Seating System, it is critical to know the client’s pressure injury history to properly offload under previously compromised skin and tissue. It is well known that previously injured skin loses flexibility and can be easily and quickly reinjured with the constant, unrelieved pressure from a static wheelchair cushion. When ordering a custom automatic-alternating Aquila Seating System, clients are required to indicate the location and size of current and past pressure injuries, as well as surgical repair sites, to create offloads that will eliminate upward pressure on past and present pressure injuries.

Q: Can someone with a pressure injury still use their wheelchair while healing?

Kohlman: Every client, along with their care team, should consult their physician to discuss possible seating protocols.

It is possible for someone with a pressure injury to still use their wheelchair. However, not all wheelchair cushions are created equal. If an individual is not fully capable of performing an effective weight shift or pressure lift and uses a static cushion, they will experience constant, unrelieved pressure, which is the number-one leading cause of pressure injuries. Aquila Seating Systems automatically alternate to relieve pressure, are custom fabricated to offload under each client’s current and previous pressure injuries, and inflate and deflate to a client-specific PSI to allow clients to use their wheelchair while healing.

Being seated upright and using the mobility device helps prevent additional healing complications, such as wounds in additional areas, pneumonia, mental health concerns, and more.

Q: What’s the strategy for dealing with a pressure injury if the client wants to continue to use the wheelchair while healing?

Kohlman: Each client should consult with their physician to establish a seating protocol. Acknowledge that the most important part of a wheelchair is the cushion, to which a majority of the body weight is applied (the posterior). Then, choose an automatic-alternating wheelchair cushion, like the Aquila Seating System, to relieve the constant pressure that is the number one cause of pressure injuries.

Justine Kohlman is the VP of Aquila Corp., manufacturer of seat cushions that can be custom made per each client’s needs.

This article originally appeared in the Jul/Aug 2022 issue of Mobility Management.

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