Adjustability and Adaptability Are Critical Characteristics of Pediatric Support Surfaces

Sodium pyruvate pre‐treatment prevents cell death due to localised, damaging mechanical strains in the context of pressure ulcers

“…In that case, we have recently shown that pre‐exposure to NaPy would accelerate gap closure by cell migration (repair), even if the exogenous pyruvate reservoir had already been depleted, as long as compensatory low‐level, non‐damaging, sustained strains are applied as a combined treatment . This is especially critical for patients whose skin is more fragile, leading to the rapid formation of PUs on the skin, for example, because of contact with medical devices of various types, utilised in life‐saving procedures that inadvertently cause damaging‐level mechanical loading on skin and deeper tissues . For those patients, one can envision preventative pre‐treatment with NaPy to avert PU formation at susceptible sites on the skin by facilitating the fibroblasts' dynamic adaptation to avoid damage concurrently by accelerating their ability to repair small‐scale damage in the form of micro‐scale gaps (resulting from the death of hundreds of cells) before the development of a PU.…”

“…For example, at bony prominences, damage can initiate at bone‐muscle interfaces and then spread towards the skin; that is termed a deep tissue injury (DTI). Damage can also initiate at the skin, from contact with clothing, support and other surfaces, or medical and other devices, for example, in paediatric care . Prevention is the only cost‐effective approach to avert the dangers of PU formation in temporarily/permanently immobilised individuals or patients who often have other underlying medical conditions.…”

Preventing pressure injuries in the emergency department: Current evidence and practice considerations

“…In addition, potentially, there could also be small objects, including plastics (eg, needle covers), consumables, or pieces of packaging of sterile equipment, that may have fallen or have been forgotten on the bed and may come into contact with the patient. Rigid equipment, devices, and any objects that are misplaced between the body and support surface act like an “external bony prominence” and can inflict localised, aggressive soft tissue distortions in addition to those caused near the bony prominences because of bodyweight . Procedures to thoroughly check the correct placement of catheter tubing and wiring, as well as careful collection of all packaging and plastics/consumables so that they do not become trapped under the weight‐bearing body, is critically important for the prevention of PIs in the ED.…”

“…Rigid equipment, devices, and any objects that are misplaced between the body and support surface act like an "external bony prominence" and can inflict localised, aggressive soft tissue distortions in addition to those caused near the bony prominences because of bodyweight. [28][29][30] Procedures to thoroughly check the correct placement of catheter tubing and wiring, as well as careful collection of all packaging and plastics/consumables so that they do not become trapped under the weight-bearing body, is critically important for the prevention of PIs in the ED. One should consider that the ED, unlike other clinical settings, is particularly rich with such equipment and is also typically busy and hectic, which can make the staff more prone to human errors.…”

Neonatal pressure ulcers: prevention and treatment

“…This zone is the one that maintains more pressure in children between the neonatal age and 2 years in all the mattresses studied. [92][93][94] The viscoelastic and gel surfaces are equally effective in preventing PUs. However, the viscoelastic ones have a better circumference and biparietal index and maintain the temperature better.…”