Effects of position and mattress overlay on sacral and heel pressures in a clinical population

Abstract

A comparison of pressure reducing properties of alternating air, static air, and water mattress overlays was conducted with 57 patients in a surgical intensive care unit. Sacral and heel pressures in both recumbent and semi-Fowler's positions were tested for each surface using a repeated measures design. Mean pressures for the alternating air mattress were significantly higher than pressures with other surfaces, regardless of position or site. There were significant main effects for position and site, with higher pressures in the semi-Fowler's position and at the sacral site. A significant interaction between surface, site, and position was found. Pressure sores developed in eight patients, but the incidence was not significantly different across groups. A pressure measuring device constructed from available clinical materials proved to be both sensitive and reliable. The findings suggest alternating air overlays should be avoided, and that positioning and periodic position change to reduce sacral pressures for patients requiring prolonged upper body elevation is important.

Effects of elevating the head of bed on interface pressure in volunteers

“…Greater muscle mass can elevate the sacrum above the support surface and aid in pressure relief (25). Consequently, higher peak interface pressures could be expected in at-risk patients (21). Patients are more likely to have bare skin against the bed as opposed to the hospital scrubs worn by our volunteers.…”

“…Sideranko et al (21) measured interface pressures over the sacrum on three mattress overlays. Sacral interface pressures were significantly higher in the semi-Fowler (45°HOB elevation) compared to the supine position, by a factor of 1.5, with the alternating air mattress overlay.…”

Pressure relief, cold foam or static air? A single center, prospective, controlled randomized clinical trial in a Dutch nursing home

“…Siderenko et al looked at the effects of using a static air overlay on sacral and heel pressure ulcers in a clinical population [12]. One of the conclusions was a 5% development of pressure ulcers, when patients were laying on a static air mattress contrary to a standard hospital mattress (15% on a water mattress and 25% on an alternating mattress).…”

Fortnightly Review: Pressure sores

“…In a comparison of alternating air, static air, and water mattress overlays on sacral and heel pressures in a surgical intensive care unit, mean pressures were significantly higher for the alternating air mattress than the other surfaces; they should therefore be avoided 51. Further prospective studies are necessary before these beds become even more widely used for long term treatment of nursing home patients with severe pressure sores.…”