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The importance of prevention utilising appropriate pressure reducing/ relieving equipment should not be under-estimated. Studies show that caring for people who are vulnerable to developing pressure ulcers, on high-specification foam mattresses compared with standard hospital mattresses, significantly reduced their risk of developing a pressure ulcer (Legood & Mc Innes 2005). Pressure ulcer prevention guidelines (NICE 2005) advocates the use of high-specification foam mattresses as the minimum provision in patients vulnerable to pressure in all in-patient areas and identifies the need for the availability of appropriate equipment, including mattresses and cushions. (audit report WH&CT)
Specialist Mattresses broadly fall into two main categories
Pressure-redistributing support surfaces are designed to either increase the body surface area that comes in contact with the support surface (to reduce interface pressure) or to sequentially alter the parts of the body that bear the load, thus reducing the duration of loading at any given anatomical site allowing pressure relief. (EPUAP, 2014)
Pressure redistribution can be achieved in one of two primary methods: immersion/envelopment or redirection/off-loading. (EPUAP, 2014)
Types of Pressure Redistribution Mattresses are:
Pressure-relieving mattresses aim to completely relieve the pressure on a localised area of skin by frequently alternating or cycling to offer pressure relief to the skin while supporting the users weight, providing assistance to the entire contact area during each full cycle, as in the case of alternating-pressure air mattresses (APAMs)
Types of Pressure Relieving Mattresses are:
Support surfaces should be chosen on an individual basis depending on the needs of the individual for pressure redistribution and other therapeutic functions. In all cases, the manufacturer’s recommendations for the use and maintenance should be followed. (EPUAP, 2014)
Shelden Healthcare UK will be happy to talk through the options with you before purchase and also recommend that you seek professional advice from your Nurse, General Practitioner or Occupational therapist.
Ensure pressure redistributing equipment is clean, intact and safe for use by following manufacturer’s guidelines for correct setup, cleaning and service.
The need for all the surfaces being used by the patient
Static pressure mattresses maximise the areas of the patient’s body in contact with the mattress surface thus reducing interface pressure and reducing pressure on areas vulnerable to pressure damage e.g. bony prominences. Static pressure mattresses are available in a range of specifications from a basic comfort foam to a higher specification, visco-elastic foam which allows more protection and higher degrees of comfort. A range of sizes are also available from standard width 90cm to bariatric widths of 120cm.
Alternating Pressure mechanically varies the pressure beneath the individual by inflating and deflating alternate air-filled sacs. The depth of air cells, mechanical robustness, duration and sequence varies between manufacturers. There are a range of mattresses which offer alternating pressure including standard alternating mattresses and low air loss mattresses which offers exceptional patient comfort. These mattresses are available in a range of sizes including the standard width 90cm to bariatric width 120cm.
Hybrid Pressure Mattresses combine the benefits of both a static pressure mattress and an alternating pressure mattress. It allows optimum patient comfort whilst offering the ability to step-up the therapy, simply by connecting the pump. There are a range of hybrid pressure mattresses available including foam on top of air cells and foam inside of air cells. A range of sizes are also available including the standard width 90cm to bariatric width 120cm.
Are designed to either increase the body surface area that comes in contact with the support surface (to reduce interface pressure) or to sequentially alter the parts of the body that bear the load, thus reducing the duration of loading at any given anatomical site allowing pressure relief. (EPUAP, 2014).
Similarly, to the Alternating pressure mattress, the alternating pressure cushion mechanically varies the pressure beneath the individual by inflating and deflating alternate air-filled sacs to relieve the pressure. This allows pressure relief and protection for patients who are sitting out of bed.
The Alternating Battery Operated Pressure Cushion allows alternating therapy to be portable. The cushion is powered by a battery operated pump which is ideal for wheelchair users as it allows the patient to receive mobile pressure relief.
Hybrid Pressure cushions combine the benefits of both a static pressure cushion and an alternating pressure cushion. It allows optimum patient comfort whilst offering the ability to step-up the therapy, simply by connecting the pump. There are a range of hybrid pressure cushions including foam on top of air cells and foam inside of air cells. A range of sizes are also available from standard to bariatric bigger sizes.
Poor seating and posture can greatly increase the risk of pressure ulcer development. Shear forces are increased when a ‘slouched’ position is adopted. All of our covers are multi-stretch which reduced the shear forces
Consider choosing a pressure redistributing mattress that is suitable for patients with high pain levels. Repositioning is required to ensure effective therapy for pressure ulcer prevention, which needs to accommodate the patients’ wishes, comfort and tolerance.
Select support surfaces that adequately support the weight of the individual and will encourage independence, mobility and all transfers. Ensure mattresses and cushions are sufficiently wide enough to ensure skin folds do not come into contact with the sides of the bed or chair.
Sitting is important to reducing the hazards of immobility, facilitating eating and breathing, and promoting rehabilitation. While sitting is important for overall health, every effort should be made to avoid or minimize pressure on the ulcer. (EPUAP, 2014) Modify sitting time schedules and re-evaluate the seating surface and the individual’s posture if the ulcer worsens or fails to improve. Seating time should always be restricted to less than 4 hours per session for those with intact skin and 2 hours with broken skin.