Page 20 - Mobility Management, July 2019

ATP Series
Cushion Covers
“A newer development in cover technology is the use of specialized materials made to decrease friction and shear.”
A cover can also impact how fully the wheelchair user sinks into the seat cushion. That’s where a cover’s ability to stretch comes into play.
“The stretch of the cover is important to allow the cushion
to function optimally for skin protection with envelopment
and immersion,” Cwiertnia said. “If the cover material does not adequately stretch, it could impact the immersion and decrease the envelopment because the fabric doesn’t ‘give.’ This effect is sometimes called hammocking and could cause increased pres- sure to develop in critical areas.”
Incontinence Cover Pros & Cons
Moisture resistance is a common and popular option for seat cushion covers, which can be exposed to rain and snow, bodily fluids, and food spills that can damage the cushions themselves. But there are advantages and disadvantages to choosing an incontinence cover.
“Typically,” Cwiertnia said, “incontinence covers use fabrics coated for moisture resistance or to make them water proof to protect the cushion inside. Sometimes, moisture from a spill or incontinence episode can lead to a pooling of fluid on top of the cushion.”
When that happens, she noted, “It is important to clean up the moisture and make sure that the skin surface is dried as soon as possible to prevent skin maceration from the moisture, which could lead to skin injuries.”
The properties that enable a cover to protect against occa- sional accidents or apple juice spills can also present other chal- lenges and benefits, Cwiertnia added.
“The benefit of the incontinence cover can sometimes be a trade-off because the water-proof fabrics often don’t breathe as well as mesh or spacer knit fabrics and could have increased heat buildup,” she said. “In some cases, because the fabric weave of the incontinence covers is tighter to assist with moisture control, it might be easier for wheelchair users to scoot and transfer due to lower friction.”
Embracing Cover Variety
With so many cover choices available (see sidebar), what’s the best way for a clinician or ATP to select a cover for a particular client? “The cover choice should be based on the individual’s priori- tized needs for skin protection, incontinence and consideration
for the environments the seating will be used in,” Cwiertnia said. And you might consider a “more can be better” approach to
covers as well.
“Sometimes one cover style won’t meet all needs all of the
time,” Cwiertnia said. “Most people have different coats and jackets for different types of weather, such as a raincoat, light spring coat and a heavier winter coat. Many cushions have inter- changeable covers, and investing in extra covers can be a good idea. Having a spare cover also means that the client can still use their cushion while they wash the cover.” m
Custom-Molded Seating: A Cover Conundrum?
Custom-molded seating can be a great option for wheel- chair users with very complex or fixed postural needs. But due to their highly supportive designs, custom-molded systems can also trap heat and moisture, which can
raise wheelchair clients’ risk
of pressure injuries and skin breakdown.
Fortunately, the newest generation of custom-molded seating now offers options that are sensitive to these dilemmas.
Sam Hannah, ATP, Executive VP at Symmetric Designs, recently announced just such an option for the company’s Free Form Seating system.
“Free Form Back Kits now have the option for a Stimulite cover,” Hannah said. “Each Free Form Back Kit always includes a foam pad/cover, but clients now have the option to upgrade to a Stimulite cover for their custom moldable backrest. The Stimulite cover is 3/4" thick, covered in
air mesh. It provides a soft but supportive interface between the custom-contoured Free Form shell and the client. The entire
cover and pad can be machine washed and hung to dry.” Stimulite is Supracor’s
popular honeycomb, designed and manufactured to be anti- bacterial, antifungal and odor resistant, in addition to being lightweight and easy to clean.
“Free Form and Stimulite are very complementary seating materials that give
the client a fully ventilated, contoured backrest,” Hannah said. “There is air flow and moisture dissipation through the shell, padding and cover. This is very important, as it allows air flow, which reduces heat and moisture buildup, two potential causes of poor skin integrity or skin breakdown. When combined with proper contouring, a Free Form
Back with Stimulite achieves
Symmetric Designs and Supracor have teamed up to offer more breathable, yet very supportive solutions for wheel- chair users who need aggres- sive and complex support.
a balance of proper pres- sure distribution, offloading, support, moisture dissipation and temperature control.” m
18 JULY2019|MOBILITYMANAGEMENT MobilityMgmt.com