Indentation marks, skin temperature and comfort of two cervical collars

Authors Jobbe Leenen, Wietske Blom-Ham, Luke Leenen
Published in International emergency nursing
Publication date 2020
Research groups Innovation of Movement Care
Type Article


Background: Collar-related pressure ulcers (CRPU) are a problem in trauma patients with a suspicion of cervical cord injury patients. Indentation marks (IM), skin temperature (Tsk) and comfort could play a role in the development of CRPU. Two comparable cervical collars are the Stifneck® and Philadelphia®. However, the differences between them remain unclear. Aim: To determine and compare occurrence and severity of IM, Tsk and comfort of the Stifneck® and Philadelphia® in immobilized healthy adults. Methods: This single-blinded randomized controlled trial compared two groups of immobilized participants in supine position for 20 min. Results: All participants (n = 60) generated IM in at least one location in the observed area. Total occurrence was higher in the Stifneck®-group (n = 95 versus n = 69; p = .002). Tsk increased significantly with 1.0 °C in the Stifneck®-group and 1.3 °C in the Philadelphia®-group (p = .024). Comfort was rated 3 on a scale of 5 (p = .506). Conclusion: The occurrence of IM in both groups was high. In comparison to the Stifneck®, fewer and less severe IM were observed from the Philadelphia®. The Tsk increased significantly with both collars; however, no clinical difference in increase of Tsk between them was found. The results emphasize the need for a better design of cervical collars regarding CRPU.

On this publication contributed

  • Wietske Blom-Ham
    • Professor
    • Research group: Proactive care for older people living at home

Language English
Published in International emergency nursing
Key words cervical collars, Cervical cord, Collar related pressure ulcers, indentation marks, spinal cord injuries
Digital Object Identifier 10.1016/j.ienj.2020.100878

Innovation of Movement Care