title: Sacral Peak Pressure in Healthy Volunteers and Patients With Spinal Cord Injury: With and Without Liquid-Based Pad.
abstract: BACKGROUND
  The prevalence of sacral pressure ulcers in patients with spinal cord injuries is high. The sacral area is vulnerable to compressive pressure because of immobility and because the sacrum and posterior superior iliac prominence lie closely under the skin with no muscle layer in between.
  
  
  OBJECTIVE
  The aim of this study was to assess peak sacral pressure before and after use of PURAP, a liquid-based pad that covers only the sacral area and can be applied on any bed surface.
  
  
  METHODS
  Healthy volunteers (n = 12) and patients with spinal cord injuries (n = 10) took part; the patients had undergone spine surgery within 7 days before data collection. Participants were in bed, pretest pressure maps were generated, PURAP was placed for 15 minutes, and then posttest pressure maps were generated. Peak pressure was obtained every second and averaged over the entire period. Patients rated whether their comfort had improved when PURAP was in use.
  
  
  RESULTS
  For healthy volunteers, mean pretest peak sacral pressure was 74.7 (SD = 16.2) mmHg; the posttest mean was 49.1 (SD = 7.5) mmHg (p < .001, Wilcoxon signed-rank test). For patients with spinal cord injuries, mean pretest peak sacral pressure was 105.7 (SD = 22.4) mmHg; the posttest mean was 81.4 (SD = 18.3) mmHg (p < .001, Wilcoxon signed-rank test). The pad reduced the peak sacral pressure in the patient group by 23% (range = 11%-42%) and in the volunteers by 32% (range = 19%-46%). Overall, 70% of the patients reported increased comfort with PURAP.
  
  
  CONCLUSIONS
  Peak sacral pressure was reduced when PURAP was used. It covers only the sacral area but could help many patients with spinal cord injury because the prevalence of sacral pressure ulcers is high in this group. PURAP may be economically advantageous in countries and hospitals with limited financial resources needed for more expensive mattresses and cushions.
authors.affiliation: Stephan Duetzmann, MD, MSc, is Clinical Fellow, Department of Neurosurgery, Stanford University, California, and Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany. Lynn M. Forsey, RN, PhD, is Director, Center for Clinical Excellence & Practice Innovation, Mills Peninsula Health Services, Burlingame, California. Christian Senft, MD, PhD, is Vice Chair; and Volker Seifert, MD, PhD, is Chair, Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany. John Ratliff, MD, is Vice Chair for Operations and Development, Department of Neurosurgery, Stanford University, California. Jon Park, MD, is Director, Comprehensive Spine Neurosurgery, Department of Neurosurgery, Stanford University, California.
authors.forename: Stephan
authors.initials: S
authors.lastname: Duetzmann
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Forsey
authors.forename: Christian
authors.initials: C
authors.lastname: Senft
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.forename: John
authors.initials: J
authors.lastname: Ratliff
authors.forename: Jon
authors.initials: J
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001512:Bedding and Linens; D001513:Beds; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011312:Pressure; D003668:Pressure Ulcer / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D012447:Sacrum; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
chemical_list: D005782:Gels