OBJECTIVE: To investigate the relation between pressure ulcer incidence and buttock-wheelchair seat cushion interface pressure measurements. DESIGN: Secondary analysis of data from a randomized clinical trial. SETTING: Skilled nursing facility. PATIENTS: Thirty-two elderly patients (age >= 65 yr), with Braden score <= 18 and Braden mobility and activity subscale score <= 5, who used wheelchairs >= 6 hr/d, were free of existing sitting-induced pressure ulcers, and weighed <= 250 lb. INTERVENTIONS: Generic foam seat cushion or pressure-reducing seat cushion. MAIN OUTCOME MEASURES: The incidence of sitting-induced pressure ulcers over a 1- to 12-month period was compared with pressure measured between patients' buttocks and wheelchair seat cushions. A flexible pad with a 15x15 pressure sensor array was used to measure interface pressure. RESULTS: Interface pressure measured on wheelchair seat cushions was higher (p <= 0.01 for both peak pressure and average of highest 4 pressures) for patients who developed sitting-acquired pressure ulcers compared with those patients who did not. CONCLUSIONS: Results indicated that higher interface pressure measurements are associated with a higher incidence of sitting-acquired pressure ulcers for high-risk elderly people who use wheelchairs.

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