How to Prevent Pressure Sores While Using a Transport Wheelchair

Disclaimer: This guide is for educational purposes only and does not replace personalized medical advice. Individual assessment by a clinician is recommended.

Introduction

Transport wheelchairs are essential mobility aids, but prolonged sitting increases the risk of pressure sores—localized injuries to skin and underlying tissue caused by sustained pressure, shear, or friction (NPIAP, 2023). Pressure sores can reduce comfort, limit mobility, and, if untreated, lead to serious complications.

This guide combines current clinical guidance with practical experience to help wheelchair users prevent pressure injuries safely and effectively. If you’re newer to mobility aids or want a deeper understanding of how transport wheelchairs support different user needs, you may also find our guide on understanding seniors and transport wheelchairs helpful—it provides useful context for recognizing early signs of discomfort and mobility-related risks.

understanding seniors transport wheelchair

Understanding Pressure Sores

Definition: Pressure sores (pressure injuries) are localized damage to the skin and underlying tissue due to sustained pressure or shear (WHO, 2022).

Common risk areas:

Ischial tuberosities (sit bones)
Sacrum/coccyx
Greater trochanters

Key risk factors:

Limited mobility or inability to shift weight (PubMed, 2002)
Poorly fitted seating
Shear and friction
Moisture from sweat or incontinence
Poor nutrition or dehydration

Evidence-Based Prevention Strategies

Seating & Cushion Selection

Assessment: Have an occupational therapist assess seat width, depth, and posture support (NPIAP, 2023).
Posture: Hips and knees should be approximately 90° to reduce sliding and shear.
Cushion choice: Use pressure-redistributing cushions (foam, gel, or air). Avoid donut cushions, which can increase localized pressure (PMC, 2002).
Pressure guidance: While older studies suggest ~40 mmHg as a peak pressure reference, individualized clinical assessment is recommended.

Pressure Relief & Weight Shifting

Perform pressure relief every 15–30 minutes using arm push-ups, forward leans, or side leans (Sunrise Medical, 2016).
Tilt-in-space or recline wheelchairs can offload pressure for 1–2 minutes if safely tolerated.
Adjust frequency based on ability, comfort, and clinician guidance.

Skin Care & Inspection

Inspect skin daily for redness or non-blanching areas. Use a mirror or photograph hard-to-see areas.
Keep skin clean, dry, and moisturized. Use barrier creams if necessary (NHS, 2022).
Consult a clinician promptly if persistent redness or breakdown occurs.

Nutrition & Hydration

Adequate protein and hydration support skin resilience (ECCH, 2023).

Practical Daily Routine & Checklist

Sample routine:

Morning: Inspect skin; adjust cushion and footrests.
Every 15–30 minutes during sitting: Perform pressure relief maneuvers.
Evening: Inspect skin and document any redness.
Maintain hydration and protein intake throughout the day.

Checklist:

Proper seat depth, width, and posture support
Pressure-redistributing cushion in place
Footrests adjusted; hips/knees ~90°
Pressure relief reminders set
Daily skin inspection
Moisture management & barrier creams
Adequate hydration and protein
Reassessment with a clinician every 1–3 months

Real-Life Examples

Example 1:

John, 62, used side leans every 20 minutes and a gel cushion. Over three months, no skin breakdown occurred.

Example 2:

Maria, 55, incorporated tilt-in-space relief every 30 minutes. Combined with daily skin inspections, she maintained healthy skin and avoided pressure injuries.

Common Challenges & Solutions

Challenge	Solution
Wheelchair lacks tilt/recline	Perform manual relief more frequently; consider cushion upgrade
Forgetting reliefs	Use alarms, phone reminders, or routine-linked cues
Redness or skin breakdown	Temporarily limit sitting, reassess cushion, consult wound-care specialist
Donut cushions in use	Replace with high-spec foam, gel, or air cushions
Moisture/incontinence	Use breathable covers, barrier creams, and frequent inspections

Frequently Asked Questions (FAQs)

Are transport wheelchairs good for preventing pressure sores?

Transport wheelchairs can help users stay mobile, but the wheelchair alone does not prevent pressure sores. Prevention mainly depends on the seat cushion, posture, and how often the user can relieve pressure by shifting weight or standing. Adding a pressure-relief cushion, keeping the skin dry, and following a routine of regular repositioning can significantly reduce risks. For people with a history of skin breakdown, a clinician can help recommend the safest seating setup.

How often should I perform pressure relief?

Every 15–30 minutes, or as advised by a clinician (NPIAP, 2023).

Which cushions are most effective?

Foam, gel, or air cushions; avoid donut-shaped cushions.

What if I notice skin redness?

Reduce sitting time, perform more frequent reliefs, and consult a clinician.

Can nutrition impact pressure sore risk?

Absolutely—adequate protein and hydration improve skin resilience (ECCH, 2023).

What is the best wheelchair to avoid pressure sores?

The best wheelchair for preventing pressure sores is one that provides proper pressure redistribution, good posture support, and allows regular weight shifting. Features such as a pressure-relief cushion (gel, air, or high-density foam), adjustable seat width and depth, and supportive backrests help reduce pressure on the skin. For people who spend long periods seated, a lightweight wheelchair with a high-quality pressure-relieving cushion is more important than the chair frame itself. A clinician or seating specialist can help recommend the right setup based on individual needs.

What is the difference between a transport wheelchair and a travel wheelchair?

A transport wheelchair and a travel wheelchair are often similar, but they serve slightly different purposes. Transport wheelchairs are designed for short-term trips, medical appointments, and indoor/outdoor mobility with a caregiver pushing from behind. They usually feature small rear wheels and a lightweight frame.

Travel wheelchairs, on the other hand, focus on portability, with ultra-light frames, quick-fold mechanisms, and compact storage for cars or flights. In other words, all travel wheelchairs are built for convenience, while transport wheelchairs prioritize smooth, caregiver-assisted mobility and comfort during short outings. If you’d like a deeper comparison of mobility options—including how manual wheelchairs differ from transport models—you can also refer to our detailed guide on manual vs. transport wheelchairs, which helps clarify which type best fits different mobility needs.