Indentation marks, skin temperature and comfort of two cervical collars: A single-blinded randomized controlled trial in healthy volunteers

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 (T_sk) 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, T_sk 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). T_sk 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 T_sk increased significantly with both collars; however, no clinical difference in increase of T_sk between them was found. The results emphasize the need for a better design of cervical collars regarding CRPU.