Film star Christopher "Reeve went into cardiac arrest Saturday at his home in Westchester County, New York, after developing a serious systemic infection during treatment for a pressure wound."
- CNN News report today, October 11, 2004
Obviously, even given the very best care money can buy, pressure wounds remain a very serious concern for people who are disabled or ill.
So, I want to suggest what may be a novel method for avoiding pressure wounds, improving on previous techniques, and I offer it here for lack of alternatives (no copyright is claimed on this article, it may be freely reproduced):
Also known as bedsores, pressure sores form when blood circulation is somewhat impaired at the points where our weight is supported - on the bottom when sitting in a wheelchair, or wherever body meets bed. Individuals who are well and able-bodied can and do shift their positions frequently, even while sleeping so pressure sores never form. Change is what's needed, so that some other part of the body can experience slightly less circulation instead, as would happen soon enough if the patient were active. So, standard advice involves shifting the body on the bed or chair, with assistance if necessary, periodically.
But maybe there's a better way.
One advance in recent decades has been "pimpled" cushions with bumps a bit more than an inch across. These limit the size of any given area under extreme pressure, allowing some blood circulation around those areas. Often, for comfort, the bumps are air-filled and the air pressure can be adjusted. It's a bit like sitting on an egg crate. Another advantage to such cushions is that even a very slight shift of position, will change the position of nearly all those bumps, creating the needed change in position. Unfortunately, some patients, such as Mr. Reeve, have no mobility at all, and get less advantage from such cushioning.
So how's this: imagine a matrix of such air-filled bumps divided, as it were, into a checkerboard or chessboard, so that the air pressure of the cells corresponding to the "black squares" can be controlled entirely separately from those of the "white squares". Now imagine these two interlaced matrices of air-filled bumps (the "white" matrix and the "black" matrix of cells) alternating pressure - at first all the "white" bumps inflate and take the body's pressure while the "black" bumps entirely deflate. Then, in a minute or two, the process, and the air pressure inflating the bumps, is reversed. The "white" bumps deflate entirely, or largely, and the "black" bumps inflate fully. This cycle repeats indefinitely. Therefore, no area of the skin or body is under pressure for longer than a minute or so, ever, under any circumstance. Pressure wounds could not form, as no area of the body or skin] would be under constant pressure, however slight, for any significant length of time - not even a minute or two.
To be tendentious, by "black" bumps, and "white" bumps, I don't of course mean that you have to color the bumps or cells differently, or should, but only to selectively refer to those bumps or cells corresponding, by virtue of their location, to the black and white squares of a chessboard or checkerboard.
It would probably be best to expand the size of the cells or bumps at least somewhat, perhaps even doubling to two inches, or even more, for best results. As well, it may be that three or four interlaced matrices would be better than two, with only one matrix being inflated at a time. As well, a hexagonal matrix] and interlaced matrices together composing a hexagonal matrix, could be employed, rather than a square checker board matrix, if desired. Or two or more superimposed-but-offset hexagonal matrices.
A bed could be surfaced entirely with such a cushion, and seats as well. Air could be moved between the two matrices, and a very small, therefore quiet pump could be at work constantly, even when the pressure in the matrices was static, particularly if a tank or two tanks "in between" provided a reservoir that could be filled or emptied while the pressure in at least one of the matrices remained at maximum, or nearly.
Needless to say, other mechanical methods of alternating pressure points using interlaced matrices could be used, not necessarily using air pressure. A mechanical system which interlaced at least two matrices of bumps of whatever shape and raised each matrix alternately, to take the patients weight, would work as well. Each point could be actuated to move up and down separately if desired, but this probably isn't the most economical method.
A still more advanced system can be imagined in which the movement of individual “bumps” up and down, by air pressure or otherwise was organized so as to create virtual or apparent “waves” of pressure that would tend to push blood along both in capilleries and larger vessels, improving or even forcing more circulation of blood through the skin and even underlying muscles. Such waves could come from all directions, just one most beneficial direction, or some of both. In this case the bumps should probably be smaller.