Effectiveness Of Support Surfaces Research Articles

The effect of support surface on the prevention of pressure injury in acute care settings: A multi-center prospective observational study

PurposeThis study aimed to analyze if a multi-foam core mattress with a laminated cover can reduce the incidence of pressure injuries, compared to an alternating air mattress overlay among critically ill patients in acute settings. DesignProspective observational study. Participantsand setting: Patients with a Braden scale score ≤16 on intensive care unit admission at five general hospitals in Korea were included in this study between February 2022 and March 2022. MethodsOne hundred and twenty patients in acute settings were enrolled and categorized into two groups: a multi-form core mattress with a laminated cover group (n = 60) and an alternating air mattress overlay group (n = 60). Data were collected for 7 days by wound care nurses. ResultsPressure injury developed at a significantly lower rate in the multi-form core mattress with a laminated cover group (n = 4/60, 6.7 %) than in the alternating air mattress overlay group (n = 25/60, 25.0 %) (P = 0.011). Using a multi-foam core mattress with a laminated cover demonstrated a protective effect against pressure injuries (odds ratio 0.123, 95 % confidence interval 0.024–0.620, P = 0.011). ConclusionsA multi-foam core mattress with a laminated cover was significantly more effective than an alternating air mattress overlay in preventing pressure injury in critically ill patients.

Support Surfaces for Pressure Ulcer Prevention in Intensive Care Patients: A Short Review Article

Objective: This short review seeks to present the effectiveness of support surfaces for pressure ulcer prevention in intensive care patients. Methods: A literature search was undertaken of international databases (PubMed, CINAHL, and Cochrane Library). A time limited criteria was applied with respect to articles publication; articles published in the last decade (2010-2020). As key words, the following terms were used: “pressure ulcers”, “support surfaces”, “intensive care unit”, “prevention”, “mattresses”. Randomized controlled trials (RCTs), which assessed the effectiveness of mattresses for the prevention of pressure ulcers, in intensive care unit (ICU) patients were included in this review. Results: Many researchers have compared support surfaces and revealed the effectiveness between different types of support surfaces. From the present short review of the literature, researchers made an effort to compare the standard hospital mattress with viscoelastic mattress. It was found that the viscoelastic type of mattress reduced the incidence of PUs in critical ill patients. Moreover, some researchers underline the need for systematic and ongoing assessment of the patient’s skin as well as implementation of prevention measures. Conclusions: Viscoelastic mattress seems to be more effective compared to standard foam mattresses in prevention of PUs, in ICU patients. Coping strategies can be developed through an organized intensive care team for PUs prevention.

The effect of support surface and footwear condition on postural sway and lower limb muscle action of the older women.

Diminished somatosensory function is a critical age-related change which is related to postural instability in the older population. Footwear is a cost-effective way to modulate the postural stability by altering sensorimotor inputs via mechanoreceptors on the plantar surface of the feet. Compared to insoles with indentions in the entire surface, we innovatively developed a textured insole with site-specific nodulous protrudous. This study thus aimed to investigate the immediate effect of the nodulous insole and supporting surface condition on static postural stability and lower limb muscle activation for healthy older women. This is a single-session study with repeated measurements. Twenty-three healthy older women stood on the firm (i.e., concrete floor) and foam surfaces with their eyes open in the three footwear conditions, namely barefoot, plain shoes and shoes with an innovative textured insole, for 30 seconds. Static postural sway and muscle activation of biceps femoris (BF), vastus lateralis (VL), tibialis anterior (TA), and lateral gastrocnemius (LG) of the dominant leg were measured during each testing condition. Compared to a firm surface, standing on the foam could significantly increase the body sway and lower limb muscle activation (p<0.05). When standing on the foam, compared to barefoot, wearing footwear significantly decreased the VL and TA muscle activation and minimize the postural sway in medial-lateral and anterior-posterior direction, while the influence is larger for the shoes with nodulous insloe compared to the plain shoes. No significant differences between the footwear conditions for static stability and muscle activation were observed on firm surface condition. For older women, footwear could improve the postural stability in the unstable surface, particularly the footwear with nodulous insole, with the underlying mechanism as enhancing the mechanoreceptors on the plantar surface of the feet.

What are the effects of support surfaces for people with pressure ulcers?

What are the effects of support surfaces for people with pressure ulcers?

Management of Pressure Ulcers and Pressure-Related Injury

Pressure ulcers, or pressure-related injuries, result from localized injury to the skin and underlying tissues due to unrelieved pressure, usually over a bony prominence, resulting in ischemia, cell death, and tissue necrosis. Pressure injuries are increasing in incidence due to an aging population with increasing rates of obesity, diabetes, and cardiovascular disease. A rapidly expanding geriatric population with impaired mobility, diminished sensation, and poor nutrition—factors exacerbated by the end-stage effects of dementia, obesity, osteoarthritis, and diabetes as well as cardiovascular and cerebrovascular disease—have a greater propensity toward, and a higher prevalence of, pressure injury. Our aim in this paper is to determine through a review of the literature whether any new literature exists, indicating greater effectiveness in pressure ulcer prevention or treatment as compared to standard of care. We examined which studies of available support surfaces, new and currently utilized wound dressings or any other treatment modalities have provided evidence of any greater effectiveness than standard of care in the prevention of pressure injury and in promotion of pressure ulcer healing. Our objective is to provide healthcare providers with an assessment of the relative efficacy of the various interventions available to facilitate their decision-making in the healing of their patient’s pressure ulcers. Goals for pressure injury prevention or treatment, especially in the geriatric population, address repositioning for pressure redistribution and accurate diagnosis of wound etiology, including comorbidities in aging, cognition, care of aging skin, and patient or family goals in care (healing versus palliation). We performed a literature search of the Cochrane Database of Systematic Reviews, Ovid Medline, and PubMed for published studies, reviews, and meta-analyses using the keywords pressure ulcer, pressure injury, wound care, bedsore, decubitus ulcers, and support surfaces. We also examined the reference lists of included studies to identify additional trials, position statements, guidelines, and reviews. We limited our review to English language publications between January 2008 and November 2018. We identified 36 studies for review. Despite this relatively large number of studies, there remains a disturbing lack of good-quality evidence regarding the effectiveness of support surfaces or repositioning for pressure ulcer prevention or treatment, for any class of dressing or topical therapy for promotion of wound healing, or for nutritional supplementation to facilitate wound healing. These studies yielded little evidence to warrant an update to the current standard of care for pressure ulcer prevention or management. The prevention and management of pressure ulcers requires a varied approach including assessment of risk, institution of preventive measures, and interventions to promote wound healing. Several tools for pressure injury risk assessment have been developed; a comparative description of these scales is provided. Understanding comorbidities (e.g., cardiovascular disease, diabetes, and neurodegenerative disorders) as well as complicating issues common to the elderly population that can impact pressure injury treatment (e.g., malnutrition, polypharmacy, incontinence, frailty, and disability) helps tailor wound care to this population.

The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial.

Purpose To analyze whether a viscoelastic mattress support surface can reduce the incidence of stage 2 pressure injuries compared to a standard hospital mattress with pyramidal overlay in critically ill patients. Method A randomized clinical trial with intention-to-treat analysis was carried out recruiting patients with Braden scale ≤14 on intensive care unit admission from April 2016 to April 2017. Patients were allocated into two groups: intervention group (viscoelastic mattress) and control group (standard mattress with pyramidal overlay). The level of significance adopted was 5%. Results A total of 62 patients were included in the study. There was a predominance of males (53%) and the mean age was 67.9 (SD 18.8) years. There were no differences in clinical or severity characteristics between the patients in the control group and the intervention group. Pressure injuries occurred in 35 patients, with a median time of 7 days (ITQ 4–10) from admission. The frequency of pressure injuries was higher in the control group (80.6%) compared to the intervention group (32.2%; p < 0.001). Conclusions Viscoelastic support surfaces reduced the incidence of pressure injuries in moderate or higher risk critically ill patients when compared to pyramidal support surfaces.

Effect of support surface on methane dry-reforming catalyst preparation

Present investigation shows the different catalytic behavior of Ni-supported catalysts in the dry-reforming of methane. Highly ordered Silicalite-1, highly defective pure silica MCM-41 and pure silica delaminated zeolite ITQ-6 have been prepared and used as support for nickel deposition.The heterogeneity of the support surface strongly affects the nickel particles deposition. Delaminated surface of ITQ-6 material permits to obtain high nickel particles dispersion and high metal sintering resistance. The particles of Ni remain free from coke formation since they are very well dispersed and strongly linked to the support.Good overall catalytic performances was achieved by Ni-ITQ-6 catalyst, after 30h of reaction: ≅80% of CH4 conversion, ≅90% of CO2 conversion, H2/CO molar ratio >1.3 and very low coke deposition, <4wt.%.

Effect of Support Surface on Catalyst Activity and Stability under Potential Cycling

not Available.

A Quantitative Analysis of Pressure and Shear in the Effectiveness of Support Surfaces

A Quantitative Analysis of Pressure and Shear in the Effectiveness of Support Surfaces

A quantitative analysis of pressure and shear in the effectiveness of support surfaces

Purpose: We compared pressure and shear among 3 support surfaces in a controlled laboratory setting. Methods: In this comparative study, interface pressure and shear were measured in 11 healthy subjects with use of 3 different Medicare-approved, group 2 therapeutic support surfaces. Each surface was placed on 1 of 3 identical platforms, allowing for a fixed, 45-degree head-of-bed (HOB) elevation. Multiple pressure readings were taken at each test site and each HOB position until a measurement that was determined to be reliable was obtained. A shear force measurement was obtained using a noninvasive instrument of proprietary design, and a formula linking the effects of shear force and pressure was calculated. Data were then compared using analysis of variance; specific differences were identified using the post hoc Duncan test. Findings: Pressure readings on the nonpowered fluid overlay device were lower at the trochanter than when compared with the powered, air-filled overlay (23.7 mm Hg vs 36.7 mm Hg; P = .017). Both the nonpowered fluid overlay and the powered air-filled mattress provided pressure readings at the sacrum with HOB elevation that were lower than those recorded on the powered air-filled overlay (16.2 mm Hg and 19.6 mm Hg vs 27.5 mm Hg, respectively; P < .001). Pressure measurements taken at the heels, supine sacrum, and scapula were not significantly different for any of the surfaces. Shear force readings were significantly lower on the nonpowered fluid overlay when compared with the powered air-filled overlay and powered air-filled mattress (79.3 g vs 257.82 g and 231.38 g, respectively; P = .015). Conclusions: Measurements of shear obtained on the nonpowered fluid overlay support surface were significantly lower than those obtained on either of the powered support surfaces. Reduction in shear force might explain the accelerated healing observed in patients being treated with the nonpowered support surface. Randomized clinical trials to validate perceptions of enhanced healing rates are required.