Seat Cushion Review-Overview
Having worked with patients after their rectal surgeries and undergoing abdominoperineal resection surgery (aka barbie butt surgery) myself, I know first-hand the importance of using a quality seat cushion during surgery recovery.
If you get nothing else out of this post, I hope you come away understanding why you should NOT use a donut cushion. There is a line of thinking out there that leads many to believe that a donut cushion is ideal after anal/rectal surgery because pressure is not being directed at the anus/rectum. However, donut cushions have actually been found to increase swelling in the tissues and decrease blood flow to the area ‘inside’ the donut1. This is bad. It can increase your risk for pressure injury and impede healing.
When I had my most recent surgery, in back to back discussions, I actually had a resident surgeon recommend that I use a donut cushion while my surgeon told me not to use a donut cushion. I’m lucky to work as an OT because I already know how cushions and proper seating systems impact healing. But this could be very confusing for many people. Bottom line, don’t use a donut cushion. Even if it feels comfortable, it’s not worth it.
Okay, let’s move on to some other options…
By the way, I’m only going to talk about cushions that I’ve actually tried out myself or used with patients. I also am not being paid to recommend cushions. I’m doing this review independently. I utilized a hospital air cushion for the first month after surgery, and then started trying out other cushions for a more long-term solution. There are many options out there that are similar, so shop around until you find what works for you. I have not found any supported research on most of these cushions, so this is all anecdotal evidence based on my rehabilitation background, pressure injury prevention training, and personal opinion.
And I’ll let you know ahead of time that the Cushion Lab Pressure Relief Cushion and the hospital air cushions are my top picks (so far). I’m continuing to test their extended use.
Foam Cushions
1.Cushion Lab – Pressure Relief Cushion
From the manufacturer: “Patented shaped by in-house ergonomists, the Ergonomic Seat Cushion is scientifically designed to relieve sitting and hip pressure while improving sitting posture on any chair. Proprietary extra-dense charcoal memory foam is odor resistant and provides velvet support for all day sitting comfort.”
My Opinion: This ended up being my top pick for cushions. Like I said, I didn’t use it until I was a month out from surgery after I stopped using the cushion I acquired in the hospital. This was the top pick because of the support and decreased pressure around the tailbone. Because of spending so much time in a reclined position, I ended up with quite a bit of tailbone pain initially after surgery which caused me to seek out a cushion that would relieve that pressure.
Pros: The foam in this cushion is very supportive which leads me to believe that it will last quite a while. The anti-slip rubber works. The opening in the back is small enough and has a cutout, so I’m not concerned about tissue swelling or decreased blood flow to the perineum. In most positions, the pressure is well distributed over the backs of the legs and the buttocks, rather than concentrated around the perineum.
Cons: This cushion is quite expensive. It doesn’t have a handle, so it can be a little cumbersome to carry around. It also doesn’t pack down well. It is not water proof, so I put a trash bag over it if I’m boating or on the water, so that it doesn’t get wet. I imagine it would dry okay though.
2. CushZone – Gel Seat Cushion
From the manufacturer: “Ergonomic U shape design perfectly fits curve of hip and improves blood circulation. Effectively relieves back pain, low back pain, sciatica and other issues caused by sitting for long periods of time.”
My Opinion: This cushion was comfortable at first, but the more I sat on it, the less I liked it. It felt pretty cheap. And I ended up feeling most of the pressure around my perineum. I’m wondering if the wider cutout contributed to the increased perineal pressure similar to a donut cushion, but that’s just a theory.
Pros: Soft and comfortable at first. It does pack down well. Good price point. The anti-slip rubber on the bottom does work.
Cons: Material may break down more quickly. Appears to increase pressure around the perineum.
Gel (rubber) Cushions
From the manufacturer: “The gel Kayak seat cushion is Special U shape ergonomic design and made your hips naturally relaxed. This seat cushion can effectively protect your tailbone…The gel seat cushion is made of 100% high quality gel material, feeling soft and supportive.”
My Opinion: This was another cushion that I liked at first, but the more I used, I didn’t like it. I ultimately felt too hard, as did all the “gel” cushions. Most of the pressure felt concentrated around the perineum. And again, maybe this was from the cutout or from the material itself.
Pros: Very packable. Washable. Anti-slip surface works well. Good price point.
Cons: Cheap cover material. Too much pressure at the perineum. Quite hard feeling.
2. KYSMOTIC – Gel Seat Cushion
From the manufacturer: “This gel seat cushion for hip pain has no pressure points, and can effectively relieves hip pain…This gel seat cushion for long sitting is specially designed large and thick, which is larger and thicker than most other gel cushions.”
My Opinion: I did not like this cushion at all. It is a knock-off of Purple brand cushions and you can definitely tell. The cushion cover was the cheapest of all the ones I tried. It moved around the most, so the anti-slip material didn’t work, and I felt a lot of pressure on my perineum.
Pros: None
Cons: All mentioned above.
3. Purple – Simply Seat Cushion
Product Description: “The Grid cradles your tailbone while cushioning the rest of your seat….Hundreds of air channels paired with a temperature-neutral material mean you’re not stuck with a sweaty seat.”
My Opinion: In was uncertain of this cushion at first. It initially felt hard, but I found it useful in certain scenarios, such as in the car or in a reclined position. It would have come in handy earlier on in my recover, when I was spending more time reclined. I didn’t like it as much in an upright position because again, it felt too hard, and there was too much pressure on my perineum.
Pros: Easy to clean and wash. Quality materials. Nice handles for carrying (this was a major plus for me).
Cons: Quite expensive. Too hard for my preference.
Air Cushions
EHOB -Waffle Cushion (i.e. what was provided in the hospital)
From the Manufacturer: The WAFFLE Cushion helps reduce your risk of pressure injuries and helps improve comfort when sitting. Lifts sit bones and tailbone off the surface when properly inflated. Allows your body to sink into the product, helping increase comfort. Unique venting holes provide airflow to keep you comfortable.
My Opinion: I didn’t really have an alternative for the first month after surgery, so I definitely appreciated this cushion. I do continue to use it in certain circumstances even at almost 3 months out from surgery. This cushion appears to not have enough air when you look at it, but it does and has to be used in a specific way. In order to use it properly, you have to be sitting evenly and upright on it. Otherwise, you’ll sink to the bottom. That’s why it doesn’t work as well if you’re reclined too far back. I ran into the issue of my tailbone sitting on the deflated portion while the rest of my bottom was supported. I find that I just have to pay more attention to how I’m sitting. Of note, this cushion does come with specific weight limits. This is the Medium valveless cushion. It has a 300 pound weight limit with a 90 day warranty (according to the manufacturer website). It does come in larger sizes with an increased weight limit, so make sure you select the correct option. And don’t use the larger one if you’re under 300 pounds because you will bottom-out the cushion.
Pros: lightweight, usually provided in the hospital, cost effective, easy to travel (I was able to take this hiking by folding it and putting it in my backpack, so that I could sit if I needed to take a break. I also brought along a Crazy Creek type chair to provide increased support while sitting).
Cons: I haven’t been able to find detailed information on how long the valveless cushions last. I’m sure I’ll be able to tell as it loses air over time. This is why the option with the valve may be better.
2. Stryker – Sof.Care Chair Cushion
I’m going to briefly mention the Stryker cushion because it’s essentially the same as the WAFFLE cushion. The hospital I work at happens to use the Stryker ones, so it definitely will depend on which vendor your hospital has a contract with or chooses to stock. The standard size of the Stryker has a 350 pound weight limit, but it does come in a larger size. There is a 30 day warranty. Pros and cons would be similar to the WAFFLE. I will say that the WAFFLe may provide better airflow due to the cutouts.
ROHO is another cushion I will briefly mention. I primarily use these cushions with my Spinal Cord Injury patients. They are a gold standard for decreasing the risk of pressure injury. They are quite expensive though, so if you can get away with using another cushion, I’d recommend that. Unless you are having a lot of difficulty with wound healing. If that’s the case, you may want to look into a ROHO. And ask your medical team about writing a letter of medical necessity to see if insurance will cover this cushion.
Summary:
I hope you find this resource helpful! It has been very challenging to find reputable evidence regarding cushion use after surgery. All I know is that anecdotally, cushions do make a world of difference from a comfort perspective. As I find more evidence, I will either update this post or write another post. Hopefully more research can be done in this area!
I currently use my cushions any time I’m sitting directly on my butt, so at a dinner table, upright in a lounge chair, out at a restaurant, in the car, etc. Otherwise, I prop myself on my side. Even when I’m using the cushion, I do make sure to perform a 2 min pressure relief every 30 minutes (I give my patients this protocol as well). Getting up off your butt will do wonders for incision healing.
References
1Berlowitz, D. Prevention of pressure-induced skin and soft tissue injury. Post TW, ed. Waltham, MA: UpToDate Inc. http://www.uptodate.com. (Accessed on July 6, 2023)
