Support surfaces for pressure ulcer prevention

Abstract

Background Pressure ulcers (also known as bedsores, pressure sores, decubitus ulcers) are areas of localised damage to the skin and underlying tissue due to pressure, shear or friction. They are common in the elderly and immobile and costly in financial and human terms. Pressurerelieving beds, mattresses and seat cushions are widely used as aids to prevention in both institutional and non-institutional settings. Objectives This systematic review seeks to answer the following questions: (1) to what extent do pressure-relieving cushions, beds, mattress overlays and mattress replacements reduce the incidence of pressure ulcers compared with standard support surfaces? (2) how effective are different pressure-relieving surfaces in preventing pressure ulcers, compared to one another? Search strategy For this second update the Cochrane Wounds Group Specialised Register was searched (28/2/08), The Cochrane Central Register of

Pressure Ulcers and Prolonged Hospital Stay in Hip Fracture Patients Affected by Time-to-Surgery

“…In view of the complex nature of the process of pressure ulcer development, a great number of potential risk factors have been identified [32] and this has led to difficulties in developing a simple and reliable risk assessment model [33]. To reduce the incidence of pressure ulcers, patients at risk should be placed on low-pressure support systems from arrival at hospital until mobility is restored [8,34,35] However, the clinical and economic effect of these support systems has yet to be proven in properly designed clinical trials [36]. Nutrition plays an important role in the wound-healing process.…”

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

“…In their systematic review focused on randomiz ed controlled trials with PU development as an outcome, Cullum et al used the term "constant low-pressure support surfaces" to describe the myriad foam, air , water, and elastomeric mattresses, overlays, and cushions [12]. Their review of the literature concluded that these surfaces outperform standard hospital mattresses in preventing PU formation.…”

“…Two recent systematic reviews do a very thorough job of covering the literature on alternating pressure mattresses so the details will not be repeated here [12,24]. Cullum et al focused exclusively on direct outcomes (PU development), while Vanderwee et al extended their review to include studies with indirect outcome measurements and a lternative study designs.…”

“…Ample evidence has show n that standard ma ttresses are inadequate to prevent PU s. Even relati vely "low tech" mattresses and overlays offer better prevention [12].…”

Effects of Mattress Material on Body Pressure Profiles in Different Sleeping Postures

“…17,18 However, if the mattress is not suited for the person, pressure sores may develop at body regions where the pressure is concentrated. 19 The regions affected by higher pressure often include the buttocks, shoulder, and back, 17,20 which may consequently affect the quality of sleep and result in lethargy or body stiffness throughout the day. 21 A recent study by Bae and Ko 22 compared the bed positions of hospital mattresses and found that the head-foot angle of 30°was the best position to mitigate the possibility of decubitus ulcers occurring in patients at the high-pressure-risk regions.…”