CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-14). The draft was written by AI, the existence of all 2 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2519 · Search date 2026-08-14 · Methodology v0.7

Donut-shaped cushion,
does it really help with Prevention of pressure injuries?

30-Second Summary
D
Evidence Grade D · 34 · Safety caution
The donut arm had no injuries in this cardiac-surgery trial, but only three total events left prevention unproven.
Ring edges can concentrate pressure, so prolonged unsupervised use in bed or a wheelchair warrants caution. Skin checks, repositioning, and an appropriate pressure-redistributing support surface should be planned with clinicians.
What the
research shows
The grade is D. In 45 patients undergoing cardiac surgery for more than three hours, pressure injury occurred in 0/22 with a donut cushion versus 3/23 (13.0%) with hydrophilic foam, P=.083. The direction favored the donut but was not significant, and the sample was too small to distinguish benefit from harm precisely. The actual event and noncommercial independence yield D with 34 points.
What the
ads claim
Saying pressure is distributed describes a change in contact mechanics, not proof of prevention. Relieving the center can transfer load to the ring edge, so actual skin-injury events must establish benefit.
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Useful facts when choosing a product

  • The tested cushion was 35 cm wide and 6 cm high with a 10-cm central opening and polystyrene-bead filling.
  • The sacrum avoided direct table contact, while the cushion ring supported surrounding tissue.
  • Verdict 2483 concerns foam-dressing prevention, a different intervention; no duplicate PMID, DOI, or KCT record was found.
Gap Measurement · Verdict 2519 · D 34
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

The KCT0003138 trial enrolled ASA III-IV patients lying supine for more than three hours during open-heart surgery. The donut was 35 cm wide, 6 cm high, with a 10-cm central opening and polystyrene-bead filling; control was 20 by 20 by 0.5 cm hydrophilic foam. All 45 were reported by assigned group and assessment was masked. Limitations were the sample below 200 and comparison only with another preventive device rather than a no-device group.

02

Why this is classified as D (34)

This registered, unfunded study measured actual pressure injuries, but included only 45 patients and three events, found no significant preventive effect, and lacked a no-device control. These features yield D with 34 points.

Counterpoint. D does not mean donut cushions were proven to cause ulcers. The specific cardiac-surgery product showed a favorable but highly imprecise direction.

Rejudgment record. Cross-check applied — We cross-checked product dimensions, allocation and masking, analyzed sample, timed injury events, comparator, registration, and funding against the primary paper and KCT record.

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE0Null
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
A donut-shaped cushion prevents sacral pressure injury during cardiac surgery.DThe direction was favorable at zero versus three events, but P=.083 with too few events.
Donut cushions prevent pressure injuries in general bed or wheelchair use.?The trial assessed one sacral product during cardiac surgery, not general bed or wheelchair use.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Prospectively registered randomized double-blind controlled trial23Financial support and sponsorship: Nil; conflicts reported as noneNPUAP stage I or higher sacral pressure injury immediately, at 48 hours, and at seven days0/22 (0%) versus 3/23 (13.0%), P=.083Only registered trial directly measuring actual injury events
Study 2Systematic review of pressure-injury prevention studies in cardiac surgery45Review funding was not verified in the accessible recordPressure-injury prevention associated with cardiac surgeryConfirmed 0/22 versus 3/23, P=.083, with no additional independent donut-cushion trialConfirms lack of replication and comparator context
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Receipt — 2 References

All 2 cited sources were verified for existence at the original page (as of 2026-08-14).

Heo MH, Kim JY, Park BI, et al. Prophylactic use of donut-shaped cushion to reduce sacral pressure injuries during open heart surgery. Saudi J Anaesth. 2022;16(1):17-23. PMID: 35261583. PMCID: PMC8846244. DOI: 10.4103/sja.sja_415_21. KCT0003138.
checked
Taghiloo H, Ebadi A, Saeid Y, Jalali Farahni A, Davoudian A. Preventing pressure injury in open-heart surgical patients: a systematic review. Health Sci Rep. 2023;6(3):e1148. PMID: 36938142. PMCID: PMC10022652. DOI: 10.1002/hsr2.1148.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none

Cite this verdict

Donut-shaped cushion x pressure-injury prevention Evidence Grade D card
[Chamgap] Donut-shaped cushion x pressure-injury prevention — Evidence Grade D·34. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/skin-hair/donut-cushion-pressure-injury-prevention/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.