Evaluation of pressure-redistributing replacement mattresses

The role of pressure-redistributing equipment in the prevention and management of pressure ulcers

In response to a focus on education and research in pressure ulcer prevention, this paper reviews the evolution of pressure-redistributing mattresses and explores the effectiveness of interface pressure measurement in mattress development.

An instrument for in-service testing of mattresses

It is widely recognised that mattresses have a finite life-span. In particular, hospital mattresses, typically made from polymer foam materials, are known to degrade over a period of years. Fatigue of a mattress in this way leads to a phenomenon known as 'bottoming'. This refers to the yielding of the mattress to such an extent that the occupant comes into close contact with the hard base of the bed: an important condition to avoid as it is thought to represent an aggravated risk factor for pressure ulcers. The authors have developed a portable, easy--to use, interactive device that quickly gives accurate information as to the condition of a mattress in a clinical setting. The device is validated against accelerated fatigue, pressure mapping of bottoming with healthy volunteers, and service life of 150 mattresses. The QUINCE SUPPORT SCORE provides an objective and valid basis for a mattress replacement programme.

Relieving the pressure in the radiology department

Interventional radiological procedures can be complex, requiring patients, many of whom already have compromised arterial circulation, to lie immobile for significant periods. X-ray table mattresses are designed to avoid radiation attenuation, which could degrade image quality or increase patient dose. Consequently, most mattresses do not have pressure redistribution properties. Skin changes, noted after lengthy radiological procedures, would appear to indicate that this unrelieved pressure places vulnerable patients at risk of sustaining pressure damage that could potentially initiate pressure ulcer development. This article examines the biomedical basis of pressure ulcer development, and discusses the suitability of alternative support devices for radiological examinations in an apparently under-researched environment.

Review of interface pressure measurement to establish a protocol for their use in the assessment of patient support surfaces

The interface pressure (IP) between a body and support surface is one objective measure used in the evaluation of the wide variety of pressure relieving equipment that exists for the prevention and treatment of pressure sores. We present a review of the literature associated with making these measurements and discuss the acute need to be able to use them to choose the most effective 'anti-pressure sore devices' for patient care, as well as discussing the difficulties associated with this decision making. We focus on interface pressure monitors describing their development and discussing the questions that remain about the accuracy and relevance of their measurements. An outline of the strengths and limitations of the most commonly used pressure sensors is given. There remains a gap in research in this area that is clinically specific and the need to be able to assess these anti-pressure sore devices with patients in a hospital environment is highlighted. The variants involved in assessing patients on various mattresses and the difficulties associated with this are described. A protocol is suggested in an attempt to improve the use of such devices and establish a better method for quantifying the clinical effectiveness of different support surfaces.