Semi-Fowler Retraction Wedge - Pressure Relieving Support for Heels and Sacrum.
- Resists Forward Sliding in the Semi-Fowler Position - the Semi-Fowler Retraction Wedge is placed under the thighs and lower body in the semi-Fowler position to provide a wedged support surface that physically resists the forward gravitational slide of the resident's body down the inclined bed; forward sliding in semi-Fowler creates the sacral shear forces that are the primary mechanism of sacral pressure injury in this position, and removing or reducing the slide is the most direct intervention for sacral shear reduction; the wedge's position under the thighs transfers the body's load to the thigh muscles rather than allowing the sacrum to bear the shear force generated by the incline.
- Sacrum and Heel Offloading by Load Redistribution - the wedge redistributes the body's weight from the sacrum and heels - both primary pressure ulcer sites - to the calf and thigh musculature, which have greater tissue volume and vascularity to withstand interface loading; this redistribution is achieved by the wedge's profile elevating the thighs and lifting the sacrum and heel off or away from the mattress contact surface, placing the load where the tissue tolerance is higher and the pressure ulcer risk is lower per NICE CG179.
- High-Resiliency Foam for Sustained Positioning Support - the high-resiliency foam construction maintains the wedge profile under the resident's body weight for extended positioning periods without compression set that would reduce the wedge's effective height and therefore its ability to elevate and offload the targeted zones; HR foam's recovery rate after compression is high enough to maintain the positioning function across a full repositioning interval without requiring the wedge to be replaced or adjusted between nursing turns.
- Clearly Marked - Compatible with Heel Supports - NCL-P905T1HW - clear usage labels support correct placement orientation in care settings where multiple positioning aids are in use simultaneously; the wedge is compatible with specialist heel supports for enhanced heel protection at the distal end while the wedge addresses the sacral and thigh zones; dimensions 620 x 700 x 75mm; MDR 2017/745 Class I positioning device; assessed per NICE CG179; product code NCL-P905T1HW.
Semi-Fowler Retraction Wedge - HR Foam - Sacrum and Heel Offloading - Anti-Slide - 620x700x75mm
The Semi-Fowler Retraction Wedge is placed under the thighs and lower body in the semi-Fowler position to resist forward body sliding and offload the sacrum and heels by redistributing load to the calf and thigh musculature. High-resiliency foam maintains the wedge profile under body weight across full repositioning intervals. Clearly marked for correct placement. Compatible with specialist heel supports. Dimensions: 620 x 700 x 75mm. MDR 2017/745 Class I positioning device. NICE CG179. NCL-P905T1HW.
Specifications
| Specification | Detail |
|---|---|
| Construction | High-resiliency foam |
| Dimensions | 620 x 700 x 75mm |
| Clinical Position | Semi-Fowler - under thighs and lower body |
| Function | Anti-slide; sacrum offloading; heel offloading; load redistribution to thigh and calf |
| Usage Aid | Clearly marked label for correct orientation |
| Accessory Compatibility | Compatible with specialist heel supports |
| Reference | NCL-P905T1HW |
| Regulatory Status | MDR 2017/745 Class I medical device |
Regulatory Compliance
The Semi-Fowler Retraction Wedge is a Class I medical device under MDR 2017/745. Clinical selection requires occupational therapist or tissue viability assessment per NICE CG179. The wedge placement and any combined heel support configuration must be documented in the care plan with the positioning schedule and skin inspection protocol. Equipment register records and MDR conformity documentation must be maintained for CQC Regulation 12 compliance.
Frequently Asked Questions
What is a retraction wedge and how does it differ from a standard positioning wedge?
A retraction wedge is specifically designed to resist the retraction of the resident's body down the incline of a raised backrest - that is, it provides physical resistance to the forward sliding that gravity imposes on the body in the semi-Fowler position. A standard positioning wedge may be placed under various body zones for elevation or angle adjustment without a specific anti-slide function. The retraction wedge's geometry and placement are calibrated so that its presence under the thighs creates a support surface that the body rests against rather than sliding over, maintaining the resident in the intended position for the full repositioning interval. This anti-slide function directly addresses one of the two primary mechanisms of sacral pressure injury in semi-Fowler - the shear force generated at the sacrum when the body slides toward the foot of the bed. The complementary mechanism, the contact pressure at the sacrum, is addressed by the elevation that the wedge provides, lifting the sacrum away from the mattress surface when correctly positioned.
Why is load redistribution to the calf and thigh considered safer than maintaining load at the sacrum and heel?
The sacrum and heel have distinctly different tissue characteristics from the calf and thigh musculature. At the sacrum, the bone is covered by relatively thin tissue with limited subcutaneous fat and muscle mass; the blood supply to the sacral skin is concentrated in a network that is vulnerable to compression ischaemia even at moderate interface pressures sustained over 2-3 hours. At the heel, the calcaneus is similarly prominent with a thin tissue layer and a blood supply at risk from sustained contact pressure. The calf and thigh, by contrast, have substantial muscle mass overlying the bone (the gastrocnemius and soleus in the calf; the quadriceps and hamstrings in the thigh), providing a much larger and more vascular tissue buffer between the bone and the contact surface; the same contact pressure distributed across the calf or thigh creates lower interface pressure per unit area and encounters tissue that is significantly more tolerant of sustained loading. NICE CG179 explicitly recognises this distinction in directing clinicians to offload bony prominences to lower-risk areas; the retraction wedge mechanically implements this principle by making the calf and thigh the primary contact surfaces in the semi-Fowler position.
NCL-P905T1HW
- Resists Forward Sliding in the Semi-Fowler Position - the Semi-Fowler Retraction Wedge is placed under the thighs and lower body in the semi-Fowler position to provide a wedged support surface that physically resists the forward gravitational slide of the resident's body down the inclined bed; forward sliding in semi-Fowler creates the sacral shear forces that are the primary mechanism of sacral pressure injury in this position, and removing or reducing the slide is the most direct intervention for sacral shear reduction; the wedge's position under the thighs transfers the body's load to the thigh muscles rather than allowing the sacrum to bear the shear force generated by the incline.
- Sacrum and Heel Offloading by Load Redistribution - the wedge redistributes the body's weight from the sacrum and heels - both primary pressure ulcer sites - to the calf and thigh musculature, which have greater tissue volume and vascularity to withstand interface loading; this redistribution is achieved by the wedge's profile elevating the thighs and lifting the sacrum and heel off or away from the mattress contact surface, placing the load where the tissue tolerance is higher and the pressure ulcer risk is lower per NICE CG179.
- High-Resiliency Foam for Sustained Positioning Support - the high-resiliency foam construction maintains the wedge profile under the resident's body weight for extended positioning periods without compression set that would reduce the wedge's effective height and therefore its ability to elevate and offload the targeted zones; HR foam's recovery rate after compression is high enough to maintain the positioning function across a full repositioning interval without requiring the wedge to be replaced or adjusted between nursing turns.
- Clearly Marked - Compatible with Heel Supports - NCL-P905T1HW - clear usage labels support correct placement orientation in care settings where multiple positioning aids are in use simultaneously; the wedge is compatible with specialist heel supports for enhanced heel protection at the distal end while the wedge addresses the sacral and thigh zones; dimensions 620 x 700 x 75mm; MDR 2017/745 Class I positioning device; assessed per NICE CG179; product code NCL-P905T1HW.