Hospital Mattresses Research Articles

Enhancing pressure ulcer prevention through optimized design of a multi-cellular foam mattress

Sustained mechanical loading on skeletal muscle tissue can lead to degeneration and cell damage over time, resulting in the development of pressure ulcers, particularly in hospital mattresses or for wheelchair-bound users. The primary risk factors for this damage are tissue ischemia caused by pressure in the contact area and tissue compressive strain. In this study, a multi-cell, multi-material foam mattress for the upper comfort layer was developed, with the aim of simultaneously minimizing soft tissue compressive strain and maximum surface pressure on the human buttocks zone. The levels of these factors were estimated using the finite element method (FEM). A multi-objective optimization (MOO) approach was employed, coupling the non-dominated sorting genetic algorithm (NSGA-II) with FEM. This algorithm helped determine the required compressive strength and the optimal cell configurations to achieve the desired outcomes. The majority of the optimal solutions exhibited contact pressures (Cpresss) below the recommended threshold to avoid local tissue ischemia. The optimized cellular material configurations resulted in soft tissue compressive strain of 12% and Cpress of 3.4 kPa, indicating longer safety times for supine support on the foam mattress without the need for repositioning. The optimization process utilized 5 softer foam materials out of the 9 firmness levels tested to achieve these results. The proposed multi-cell, multi-material foam mattress model shows promise for the prevention of pressure sores, as suggested by the optimization findings.

Large-scale acute hospital bed and mattress implementations: insights and recommendations

Background/Aims Hospital-wide replacement of beds and mattresses, often referred to as an ‘implementation’, can be an efficient way of ensuring that these products are up to date. However, large-scale implementations can be daunting for healthcare managers, with a lack of guidance to support them through this process. This service evaluation aimed to provide practical suggestions to NHS managers who are planning a hospital-wide acute hospital bed and mattress implementation from peers who have completed similar projects. Methods Interviews were conducted with a purposive sample of seven NHS staff members, all of whom had held a leading role in managing and executing an implementation project with the provider Medstrom. Exploratory, qualitative, semi-structured interviews were conducted, with data analysed through content-driven narrative analysis, using NVivo software. Results Four themes relating to large-scale bed and mattress implementation were identified: drivers; specification process; financial process; and physical implementation and training. Communication and planning were considered crucial, as was selecting a provider that could offer support throughout the implementation. Participants had been able to successfully implement a large volume of products, but all felt that a resource allowing healthcare managers to draw on the experiences of others who had previously completed a large-scale implementation project would be beneficial. Conclusions Large-scale mattress implementations are achievable with the right input and support. Learning from the experiences and knowledge of peers who have previously been involved in implementations can be very useful for healthcare managers embarking on this kind of project.

Improving Best Practices in Assessing the Usage Conditions of Hospital and Long-Term Care Mattresses

Background: Inadequate mattresses can pose risks to users, and the routine inspection of mattresses often falls short in various healthcare settings. Objectives: To evaluate the physical condition of mattresses in hospitals and long-term care facilities and to explore the association with management practices regarding procurement, handling, and maintenance. Methods: This analytical descriptive cross-sectional study was conducted in 13 hospitals and 5 long-term care facilities, examining a total of 278 mattresses through proportional stratified sampling. The Mann-Whitney U test, Kruskal-Wallis test, and Multiple Regression Analysis were utilized for data analysis. Results: A mere 9.9% of the mattresses met the physical evaluation criteria, revealing a significant gap in mattress management standardization. The highest compliance was noted in the utilization of waterproof coverings, whereas the lowest was in mattress labeling. Factors significantly influencing the scores included the involvement of nurses in the evaluation process, periodic replacement of coverings, type of administration, assessment of mattress and covering integrity during bed making, and the nature of the institution. Conclusions: Due to inadequate physical conditions in both hospital and long-term care settings, the low approval rate of mattresses underscores the urgent need for standardized mattress management practices. Descriptors: Beds, Hospital Infection, Disinfection, Long-Term Care Facilities for the Elderly, Patient Safety.

Using the paired T-Test to compare suppliers

The manufacture of industrial products requires rigorous quality, which is why they need to be in compliance. It is therefore essential that two different suppliers present products within the same specifications. The aim of this article is to show a case study carried out in a company in the south of the state of Rio de Janeiro, which used the Paired T Test to compare two types of foam for hospital mattresses. The results showed that supplier 1 produces a foam below the specified thickness of 11 cm while supplier 2 produces a foam within the specified value, so supplier 1 would be rejected and supplier 2's service would be used.

Hospital mattresses: Thermal disinfection against bacteria, fungi and virus

Disinfection protocols for medical items play an important role in the prevention and con-trol of healthcare-associated infections. Regarding mattresses, disinfection with chemical products only cleans the surface, leading to failures in the execution of final processes of cleaning. This study aims to evaluate the antimicrobial activity of ECOSTOVE Thermal Chamber for the disinfection of hospital mattresses. Microbiological analyses were carried out under different experimental con-ditions, considering microbial viability, treatment time and position of inoculum on mattress. Staphylococcus aureus, Klebsiella pneumoniae, Candida albicans and Chikungunya virus were in-oculated at five pre-defined positions on the external and internal areas of hospital mattresses. Im-prints were done using RODAC plates, before and after heat treatment to evaluate colony-forming unit and microbial viability. The percentage of microbial inhibition obtained by heat treatment of the ECOSTOVE varied between 83.1 to 100%. The best results were observed for the enveloped Chikungunya (100% inhibition) and C. albicans (between 97.6 and 100%), followed by K. pneu-moniae (85.4-100%) and S. aureus (83.1-99.1%). Due to the significant antimicrobial activity of ECOSTOVE, it can be integrated into standard hospital hygiene and cleaning procedures as a prom-ising strategy in the control of healthcare-associated infections.

Healthcare-Associated Infections and the Hospital Bed.

Bedframes are a potential source of bacterial contamination, fomites, and healthcare-associated infections for patients with active skin wounds and other underlying conditions. Bedframes also differ in their design, materials, texture, and ease of disassembly for cleaning. In this study, the authors evaluated five hospital bedframes in terms of retained soil and ease of cleaning as rated by volunteers. Hospital mattresses were placed on five different bedframes and soiled with mock bodily fluids containing Geobacillus stearothermophilus endospores as an indicator organism for contamination. In a second set of experiments, volunteers evaluated the bedframes for ease of cleaning; fewer than 30% of the volunteers had experience cleaning in hospitals or had previously received infection-control training. Questionnaires evaluated subjective measures such as ease of cleaning and texture. Researchers observed a strong correlation between the initial amount of soil retained, the most probable number calculations of endospore counts, and the number of washes to reach extinction (no detectable endospores). Although volunteers' rankings for ease of cleaning were independent of the amount of soil retained, their rankings correlated with the actual washes to reach undetectable limits and bedframe materials that were perceived as harder to clean. This study demonstrates the importance of both bedframe design and user cleaning experience in reducing bedframes as a source of healthcare-associated infections.

Impact of a new clinical mattress solution on interface pressure and comfort during supine lying.

Effective pressure management for individuals is critical for hospital and community-based care, to prevent the occurrence of pressure ulcers. This study explores the impact of a new mattress and topper solution on interface pressure and comfort during supine lying. In this quantitative, healthy cohort study, patient-surface interface pressures were calculated for three mattresses (a standard hospital mattress, a new mattress solution (Levitex Foams Ltd., UK) and a dynamic air flow mattress) with and without an innovative topper solution (Levitex Foams Ltd., UK). Subjective comfort, contact surface area, peak and mean pressure and peak pressure index (head, sacrum, heels) were calculated for all mattress conditions for a 21-minute period. A total of 27 healthy volunteers took part in this study. The new mattress solution decreased peak pressure significantly compared with the hospital and air mattresses (p<0.04). Lower peak pressures were observed for the hospital mattress compared with the dynamic air flow mattress. The new mattress solution improved comfort and significantly lowered (>30%; p≤0.005) heel and head pressure compared with the other surfaces. Both hospital and air mattresses significantly reduced pressure and improved comfort with the addition of the new topper solution (p<0.05). The new mattress solution used in this study offers a potentially improved pressure management solution for individuals. Implementation of the topper may also help to improve pressure management when used with existing standard or dynamic air flow mattresses.

Pressure injury prevention measures: overview of systematic reviews.

Summarizing the evidence from systematic reviews regarding the comparison the effectiveness of interventions to prevent pressure injuries. Overview of systematic reviews conducted in accordance with Cochrane guidelines. A search was performed in databases, repositories and systematic review registration sites. 15 reviews were included in this overview. The sensitivity analysis showed a reduction in the incidence of pressure injuries with nutritional supplementation compared to the standard hospital diet (Relative Risk (RR) = 0.83; 95% Confidence Interval (CI): 0.72-0.95). There was evidence of the superiority of constant low-pressure surfaces (RR = 0.38; 95% CI;0.24-0.61), alternating pressure devices (RR = 0.31; 95% CI:0.17-0.58) and alternative foams (RR = 0.40; 95% CI:0.21-0.74) when compared to the standard hospital mattress or standard foam. The use of a silicone cover reduced the incidence of pressure injuries by 75% (RR = 0.25; 95%CI:0.16-0.41) when compared to no cover. Although some interventions have been shown to be effective in reducing the incidence of pressure injury, the evidence is limited or very limited and subject to change. Registration CRD42017064586.

Predicting the cut‐off point for interface pressure in pressure injury according to the standard hospital mattress and polyurethane foam mattress as support surfaces

This study aimed to investigate the interface pressure (IP) of patients using a standard hospital mattress and polyurethane foam mattress as support surfaces and present cut‐off points for IP in patients who exhibited skin changes. A total of 189 inpatients enrolled from six general wards and three intensive care units at a Korean University Hospital. Skin changes were classified, and peak IP at the sacral and occipital regions was measured using a pressure scanner. Differences in IPs according to mattress type were analysed using independent t‐tests. The receiver operating characteristic curve was constructed to determine the cut‐off point, and the area under the curve with a 95% confidence interval was obtained using the Stata 15.1.program. The IP for a standard hospital mattress was significantly higher than that of a polyurethane foam mattress. The cut‐off points for IP at the sacral region were 52.90 and 30.15 mm Hg for a standard hospital mattress and polyurethane foam mattress, respectively. The cut‐off point for IP at the occipital region was 36.40 mm Hg for a polyurethane foam mattress. Using IP measurements to prevent pressure injuries is important and employ individualised interventions based on the cut‐off points for different support surfaces.

A firm recommendation: measuring the softness of infant sleep surfaces

BackgroundApproximately 3600 sudden unexpected infant deaths (SUID) occur annually in the United States, and a quarter of SUIDs are caused by unintentional suffocation and strangulation in bed, with soft bedding use being a significant risk factor. Therefore, The American Academy of Pediatrics (AAP) recommends infants sleep on a “firm” surface, though neither an objective definition nor national standard has been established. The purpose of this study is to report on the performance of a device that measures mattress softness and to provide quantitative values of softness for various infant sleep surfaces.MethodsIn collaboration with the authors and a national child product safety organization (Kids in Danger), University of Michigan engineering students designed and validated a device that measures the vertical depression (softness) of a simulated 2-month-old’s head on a sleep surface. A total of 17 infant sleep surfaces − 14 household surfaces and 3 hospital mattresses - were measured between April 2019 and January 2020. The average softness of each surface was calculated. Surfaces were also measured with soft bedding, which included an infant fleece blanket, and firm and soft pillows.ResultsThe average softness for the 14 household sleep surfaces ranged from 7.4–36.9 mm. The 2019 cribette playard and the 2018 infant spring had similar softness (21 mm) as the 2018 and 2019 adult foam and 2015 sofa. An infant’s fleece blanket folded once added an additional 2.3–6.5 mm of softness, folded twice added 4.8–11.6 mm, and folded three times added 11–21.8 mm. Using a firm pillow added 4.0–20.9 mm of softness while using a soft pillow added 24.5–46.4 mm. The softness for the 3 hospital sleep surfaces ranged from 14 to 36.9 mm, with the infant bassinet being the firmest and the pediatrics mattress being the softest.ConclusionsWe found a wide range of softness among sleep surfaces, with some infant mattresses as soft as some adult mattresses. Adding blankets and pillows to mattresses measurably increased softness. Quantifying sleep surface softness will advance our understanding of how softness relates to SUID risk. We hope this new information will further inform safe infant sleep recommendations and improve mattress safety standards nationally.

Effectiveness and real-world materials compatibility of a novel hydrogen peroxide disinfectant cleaner

A novel 4% hydrogen peroxide disinfectant was effective against methicillin-resistant Staphylococcus aureus (MRSA), Clostridioides difficile spores, carbapenem-resistant Escherichia coli, and 2 strains of Candida auris. In laboratory testing, a sodium hypochlorite disinfectant caused fading and loss of pliability of a hospital mattress, but the hydrogen peroxide disinfectant did not. These findings suggest that the hydrogen peroxide-based disinfectant may be a useful addition to the sporicidal disinfectant products available for use in healthcare settings.

Damaged Hospital Mattresses and Bed Frames Are Common in Acute-Care Hospitals

Background: Hospital beds are now high-tech, reprocessable, medical devices. The surface of the mattress (cover) is manufactured using polyurethane-coated fabric to ensure moisture-vapor transmission to prevent pressure ulcers. In recent years, due to multidrug-resistant organisms, healthcare organizations have used increasingly harsh chemicals to clean these mattresses. None of these chemicals are approved for use on polyurethane-coated fabric. Previous research has shown that many mattresses in hospitals are damaged. The US Food and Drug Administration, Centers for Disease Control and Prevention, ECRI, and manufacturers recommend routine mattress inspection and replacement of mattresses with any visible signs of stains, wear, or damage. Damaged mattresses have been linked to fluid leakage, resulting in patient exposure and outbreaks of healthcare-acquired infections. Methods: Four hospitals of a midwestern hospital system had all of their mattresses inspected for damage and staining to the mattress. After external examination, each mattress was opened, and the mattress core was evaluated for damage. The cover of each mattress was examined using the naked eye and then using an LED light to demonstrate smaller holes. Each bed frame was examined for evidence of rust, and the amount of rust was recorded. If available, the age of the mattress was determined based on a label on the mattress. Results: In total, 727 beds and mattresses were inspected. Of these mattresses, 523 (72%) were damaged. Also, 340 (47%) required replacement of the mattress cover, and 183 (25%) required replacement of the entire mattress (cover and core). For the 209 damaged mattresses (40%) with the date of manufacture label, 156 (75%) were &lt;4 years old. Damage to the mattress included 428 (59%) with holes in the cover: 113 (16%) were visible to the naked eye and 315 (43%) small holes only detected by using an LED light. Also 173 mattresses (24%) had stains on the exterior cover, 215 (30%) had stains on the interior of the top cover, and 192 (26%) had stains on the interior of the bottom cover. Bed-frame rust was identified on 175 (24%) beds, of which 65 (9%) had widespread rust. Conclusions: These findings confirm previous reports that damaged mattresses are common in hospitals and potentially place patients at risk. Most of these failed mattresses are &lt;4 years old, which is much less than the expected life of a mattress and bed deck.Funding: NoDisclosures: None

Effects of loading and prophylactic dressings on the sacral and heel skin: An exploratory cross-over trial.

Pressure ulcers/injuries are caused by sustained loading and deformation of skin and underlying soft tissues. Prophylactic dressings are recommended as an adjunct to other preventive measures such as repositioning and offloading. The aim of this study was to investigate the effects of prophylactic soft silicone multi‐layered foam dressings on the skin structure and function of the two most common pressure areas, sacrum and heel, with and without loading. An exploratory randomised cross‐over trial using intra‐individual comparisons was conducted. Eight healthy volunteers (mean age 27.5 years) were assigned to three groups and either spent 2.5 hours on a standard hospital mattress lying in supine position with and without dressings or spent 2.5 hours with dressings applied but without loading. Skin temperature, stratum corneum, and epidermal hydration increased in all groups irrespective of wearing a dressing and/or loading. Mean roughness decreased at the heels. Reactive hyperaemia and the release of interleukin 1 alpha were associated with loading only. Results suggest that the occlusive effects of dressings are similar or only slightly greater than those observed with non‐loading or loading without dressings. Thus, a dressing does not cause additional irritation or skin changes during loading but it may reduce the inflammatory response.

Skin Viability and Microvascular Function Under Localised Applications of Heat and Pressure

Soft tissue pressure injuries are localised injuries to surface and deep tissue, caused by sustained compression of skin and muscle between a bony area of the body, and for example, a hospital mattress or medical device. Prolonged cell deformation is known to reduce the structural integrity of the cell cytoskeleton, leading to cascade of cell death, inflammation, oedema and oxidative stress, factors that are likely exacerbated by inadequate blood flow and oxygen delivery. Numerous secondary factors are thought to accelerate this cascade, including systemic hypoxia and changes in tissue temperature. By examining the responses of various skin viability markers, both during and after the application of temperature and pressure stimuli, the present study aims to expand understanding of the secondary factors affecting pressure ulcer onset and progression. In the present study, a custom skin deformation device, with an area of 33cm2, was used to apply a combination of pressures (6, 20 and 40mmHg) and temperatures (23, 33, 38°C) at the sacrum of four healthy volunteers (data collection ongoing). A laser doppler flowmetry probe, embedded into the skin deformation device, was used to measure baseline skin blood flow, skin blood flow under pressure, and reactive hyperaemia (RH) on pressure release. All measurements were calculated as a percentage of heat-induced maximal cutaneous vascular conductance (%CVCmax). Changes in stratum corneum and epidermal hydration were calculated using the difference in tissue electrical capacitance (corneometry) measurements before and after skin deformation. The results indicated a significant difference in loaded skin blood flow between the pressures of 6-20mmHg (p=0.045), and 6-40mmHg (p=0.018), decreasing from 30.5 ± 9.1 %CVCmax to 21.8 ± 9.0 %CVCmax and 17.5 ± 6.7 %CVCmax respectively. Furthermore, there was a significant increase (p=0.030) from 16.9 ± 8.2 %CVCmax to 29.8 ± 5.4 %CVCmax in loaded skin blood flow, between the temperatures of 28-38°C. Finally, blood flow saw a significant (p=0.005) increase on pressure release, from a loaded average of 19.7 ± 8.2 %CVCmax to an unloaded average of 29.0 ± 12.0 %CVCmax, however there was no significant effect of pressure level or temperature on reactive hyperemia. Changes in stratum corneum hydration between 28-33°C (p=0.044), and 28-38°C (p=0.019), increased from 20.8 ± 11.3% to 38.8 ± 12.7% and 48.5 ± 15.5% respectively. Differing pressures and temperatures had no significant effect on epidermal hydration. Initial indications from the present study suggest low local tissue temperature reduces tissue blood flow under pressure, thereby potentially reducing oxygen transport to, and metabolites away from, areas of loaded tissue. However, increased local temperature results in greater moisture accumulation on the surface layer of the cutaneous tissues, potentially resulting in a lower structural integrity. On balance, a neutral skin temperature may be best to balance the harmful effects pressure on tissue viability, but further investigation is required to fully understand the influence of temperature on each aspect of the pressure injury cascade, including cell cytoskeleton integrity, inflammation, and oedema, as well as blood flow dynamics, oxygen delivery, cell metabolism and oxidative stress.

Computational modelling of hospital mattresses made from spacer fabrics

The appearance of pressure ulcers is a very common occurrence, especially for people with limited mobility who are obliged to spend a long time prone on a support surface. Pressure ulcers in severe cases can cause damage to underlying muscle and bone. Damage to deeper tissues, tendons and joints may also occur. Serious complications, such as infection of the bone (osteomyelitis) or blood (sepsis), can occur if pressure sores progress. While the main strategy for dealing with pressure ulcers is centred around the interaction of patient and care-giver (manually changing the position of the patient every two hours in order to relieve pressure on critical body areas, examination of patient for signs of pressure ulcer formation) there are auxiliary approaches, such as the choice of a pressure relieving support surface. Currently, a variety of support surfaces exists. The criteria of choice are dependent on factors such as the medical history of the patient and economic. The emergence of 3D spacer fabrics as textile materials with good compression behaviour makes them suitable candidates for the production of support surfaces that contribute to the prevention of pressure ulcers. In order to decide on their suitability, extended clinical trials involving actual patients must be performed. In the present paper, a computational methodology utilizing a tool, widely used in the area of engineering namely Finite Element (FE) Method, is proposed as a supporting tool for the preliminary evaluation of the suitability in terms of mechanical behaviour of certain 3D spacer fabrics, providing an insight of the deformation, stress and strain developed on the bodies (human body – mattress) as well as on their interface.

Comparing the effects of three different multilayer dressings for pressure ulcer prevention on sacral skin after prolonged loading: An exploratory crossover trial.

Evidence suggests that preventive dressings applied on sacral skin help to prevent pressure ulcers. However, possible performance differences of different dressing types are unclear. An exploratory randomized crossover trial with intra-individual comparisons was conducted to compare the effects of three different multi-layer foam dressings (Mepilex Border Sacrum, ALLEVYN Life Sacrum and Optifoam Gentle Sacrum) compared to no dressing on the sacral skin. Healthy female volunteers (n = 12, mean age 72 years) wore three different dressings on their sacral skin for 3.5 hours while lying supine on a standard hospital mattress. At regular intervals, subjects performed standardized movements to enhance shear loads. Skin surface temperature, stratum corneum hydration, erythema, skin roughness and the interleukin 1 alpha (IL-1α) concentration per total protein were measured at baseline and after the lying periods. After 3.5 hours, the median skin temperature increased in all four groups between 3.0°C and 3.8°C with only minor differences between the no dressing and the dressing groups. Median stratum corneum hydration increased during the lying period in all groups with highest increases in the Optifoam Gentle Sacrum (7.3 arbitrary units) and no dressing group (7.0 arbitrary units). There was a median decrease of the mean roughness (Rz) in the Optifoam Gentle Sacrum group of -6.3 μm but no relevant changes in the other groups. After loading, the erythema index was highest in the ALLEVYN Life Sacrum and no dressing groups. Highest releases of IL-1α were observed in the ALLEVYN Life Sacrum and Optifoam Gentle Sacrum groups, in the Mepilex Border Sacrum group changes were minor. Study results indicate, that the application of preventive dressings on sacral skin during loading do not cause additional occlusion compared to loading without dressings when lying supine. Different dressings cause different cutaneous responses during loading.

Interface Pressures of New and Worn Standard and Viscoelastic Hospital Mattresses: A Comparative Study

This descriptive comparative study investigated interface pressures in a sample of 5 new and worn standard and viscoelastic hospital mattresses and compared their comfort and mobility ratings. Using convenience sampling methods, 20 healthy individuals (75% female, average age 41.3 years [SD ± 12.25]) volunteered to lay supine for 10 minutes on 5 different mattresses. Mattresses had been in use for up to 7 years (since 2011). Using a bed-size pressure mapping system, interface pressures (mm Hg) were obtained after 10 minutes. Comfort and ease of turning oneself (very poor to very good) were evaluated after the pressure mapping was completed. Differences were found between viscoelastic mattresses and standard mattresses, with mean interface pressures ranging from 30.28 to 38.37 mm Hg (P = .011), and for the mean number of cells 60 mm Hg or above (P = .025) and 80 mm Hg or above (P = .046) between the different mattresses after 10 minutes. One standard mattress from 2014 had the highest mean interface pressure (38.37 ± 7.43 mm Hg). Viscoelastic foam mattresses had the highest comfort, and standard mattresses had the highest ease of mobility scores; however, the differences were not significant. The mean interface pressures differed between participants weighing > 100 kg and those weighing < 100 kg on the standard mattress from 2011 (46.50 ± 4.83 vs. 33.86 ± 5.83; P = .012). Similarly, the values were 41.25 ± 7.70 versus 29.78 ± 5.99 on the new viscoelastic mattress (P = .040) and 42.87 ± 4.09 versus 28.05 ± 6.16 (P = .012) on the old viscoelastic mattress. Older standard mattresses were found to be less comfortable and had higher interface pressures compared to the new standard and viscoelastic foam mattresses.

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.

Skin Blood Flow in Relation to External Pressure and Temperature in the Supine Position on a Standard Hospital Mattress

The purpose of this investigation was to study the relationship between skin blood flow, external pressure and temperature in the skin over bony prominences and muscle padded areas, when healthy individuals and patients with hemiplegia were lying in the supine position on a standard hospital mattress. The pressure values under the gluteus maximus muscle and the sacrum increased significantly in the supine position with bent knees. The heels resting on the mattress gave very high pressure values. Some patients had no observable skin blood flow in the skin over the sacrum and the gluteus maximus muscle. In many individuals there was no observable blood flow in the skin over the heel among both healthy individuals and patients, which was confirmed by very high post-ischemic reactive hyperaemia. There is also a heat accumulation when lying on the mattress which increases the requirement for skin blood flow.

Functional textiles for prevention of pressure ulcers – a review

Purpose This paper aims to summarize researches conducted related to functional textiles for prevention of pressure ulcers and critical analysis of the outcomes to pave path for the future research in this area for benefit of the patients. Pressure ulcers, also known as bed sores, pressure sores and decubitus ulcers, are localized areas of tissue damage that develop due to pressure usually over a bony prominence. A standard hospital mattress has an interface pressure of 100 mmHg which can result in pressure ulcers unless repositioning occurs at regular intervals. Moisture accumulation on the skin is an important physical factor predisposing a patient to the occurrence of pressure ulcers and tissue breakdown. The disability leads to several requirements of functional clothing and textile products. The textiles play a variety of roles in this concern, from simply having good aesthetic appearance to preventing life threatening risks. An ideal support surface prevents pressure ulcers by providing pressure redistribution and maintaining a healthy skin microenvironment. The use of the textiles for the care of elderly disabled and bedridden persons can play an important role, as their quality of life can be improved by making use of functional and good-looking textiles. Design/methodology/approach This review paper aims to summarize researches conducted related to functional textiles for prevention of pressure ulcers and critical analysis of the outcomes to pave path for the future research in this area for benefit of the patients. Findings In the past years, there have been several functional textiles developed for the prevention of pressure ulcer. They are designed to maintain proper microclimate around patient skin. Sheepskin is one of the oldest used bed overlays which prevent pressure ulcer but its prolonged use leads to uneasy feeling for the patient. A sensor in bed for pressure detection is one of the good alternatives as it provides proper indication on when to change the position of the patient so that the pressure can be shifted and ulcers is prevented. These sensors are costly and complex to setup so for common man they are not easily available. Multilayer textiles on the other hand are complex to make as the properties are dependent upon the fiber content, yarn structure, fabric structure and technique of layering them together. Spacer fabric provides good air and moisture permeability, but there is a scope to study this type of fabric by varying the fibers type and thickness of the spacer fabric. A bedding material which is not much complex and can be easily purchased and used by common man for in-house usage is the need of the hour. Originality/value There is no comprehensive review available regarding research in this area with critical analysis of the outcomes for future study.