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Preventing Recurrent Pressure-Related Furuncles With an Alternating Air Cushion

Farr, Barry M. MD, MSc

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e3182699226
Original Articles

Background: The value of alternating air mattresses and chair cushions for preventing pressure ulcers on the buttocks of a patient with paralysis or paresis has been studied in randomized trials since the 1980s but is still being studied and debated. This study sought to determine whether an alternating air cushion could prevent recurrent pressure-related Staphylococcus aureus furuncules in an increasingly paretic leg of a patient with multiple sclerosis.

Methods: An n-of-1 trial involving a patient with recurrent pressure-related furuncules repeatedly switching from sitting on an alternating air cushion made by Aquila to an alternating air cushion made by Ease.

Results: Sitting on an Ease cushion was associated with development of 7 new furuncles during 18 patient-days, all in different locations on the left buttock; by contrast, sitting on an Aquila cushion for 170 patient-days was associated with no new infections (P = 1.47 × 10−7), suggesting a relative risk greater than 66. After the study ended, the patient sat on an Aquila cushion for the next 6 months with no new furuncles.

Conclusions: The results of this study suggest that a properly functioning alternating air cushion can prevent pressure-related S. aureus furuncules in the paretic leg of a patient with multiple sclerosis. The furunculosis had not only recurred for 9 years on the left buttock but was getting worse when the trial began. It did not recur while sitting on an Aquila alternating air cushion for 6 months after the study ended.

Author Information

From the Department of Medicine, University of Virginia Health System, Charlottesville, VA.

Correspondence to: Barry M. Farr, MD, MSc, Department of Medicine, P.O. Box 800473, University of Virginia Health System, Charlottesville, VA 22908. E-mail address:

The author has no funding or conflicts of interest to disclose.

© 2013 Lippincott Williams & Wilkins, Inc.