Alternating Pressure Mattress
Selecting a good pressure reducing mattress is often one of the many things to consider for those who spend a lot of time in bed and are unable to change position. Bed sores are primarily caused by pressure against the skin over a prolonged period but can also result from heat/moisture causing maceration, tears from shearing against rough surfaces and burns.
Medical mattresses, therapeutic to stage IV wounds are necessary when our clients are unable to turn from side to side promoting pressure relief thought the night. Bed sores are primarily caused by pressure over time, a good pressure relieving mattress will reduce pressure against the skin.
Alternating pressure mattresses (Auralis) provide both sustained sequential low pressure and by alternating the pressures in each segment it causes increased blood flow to the skin. Along with good nutrition, a good alternating pressure mattress will heal sores for most patients. Older and more highly debilitated clients with friable skin and poor blood circulation will require more complex care. For those at risk a good mattress will very often prevent injury by promoting good circulation.
Low Air Loss
Although most sores are caused by prolonged pressure against the skin sometimes the injury is the result of maceration which can occur when moisture is trapped between the body and the mattress surface. This can cause a microclimate which heats the skin and this will result in breakdown. In this case a Low Pressure Air Mattress can be very beneficial as this type of mattress provides both a lower pressure against the skin and also ventilates via a multitude of openings in the mattress top blowing air directly onto the skin dissipating excess moisture. Some manufactures use a combination of an alternating pressure mattress (APM) with a topper sheet with a small vacuum and internal tubing which wicks moisture.
Gel or Fluid Mattress
Sometimes a sore is the result of shear forces or tearing of the skin against a rough surface. For patients who are immobile transfers and turning can cause abrasions and without the appropriate intervention the skin can tear resulting in serious injury. As transfers and turning happen often through the day caretakers need to alter the transfer protocol and to choose surfaces with low shear. (RIK) In serious injuries a fluid cushion and mattress are recommended. The cover is a low shear fabric and the gel/fluid moves with the skin and decreasing shear and tearing.
Hybrid Mattress
Several manufacturers combine low air loss and alternating pressure in the same mattress. Also there are several models of mattresses with a lower pressure foam surface with internal valves which self adjust pressures as the user moves reducing pressures on the bodies low spots. These self adjusting mattresses, SAM are healing to stage 2 and the Arjo model (Atmos Air) can be fitted with an alternating pressure pump and may heal to stage 3 sores. Another type of multi function mattress (APM2) combines alternating pressure and lateral turning. Turning from side to side both offloads tissue and can increase fluid motility, ease congestion and promote better bowel and bladder hygiene.