Understanding Pressure Relieving Equipment
Pressure ulcers, also known as bed sores or pressure injuries, are areas of skin damage that result from prolonged pressure on the skin. This often occurs in individuals with limited mobility who spend long periods in a bed or wheelchair. The right equipment can help redistribute pressure, improve blood flow, and protect vulnerable areas of the body.
Types of Pressure Relieving Equipment
Pressure-relieving devices are broadly categorized into static (non-powered) and dynamic (powered) systems. The choice of equipment depends on factors such as the individual's mobility, risk level, and the severity and location of any existing pressure ulcers.
Static or Reactive Support Surfaces
Static surfaces work by conforming to the shape of the body, increasing the contact area and reducing peak pressure points. They are often referred to as Constant Low Pressure (CLP) devices.
- Foam Mattresses and Overlays: High-specification foam mattresses and overlays are a common choice. They can be standard foam or have convoluted or cubed shapes to help with pressure distribution. Alternative foam types can offer enhanced pressure reduction compared to standard hospital mattresses.
- Gel-Filled Mattresses and Overlays: These devices use gel to conform to the body's contours, providing an immersive effect that spreads pressure more evenly. They are effective for individuals at risk of developing ulcers.
- Water-Filled Mattresses and Overlays: Similar to gel, these use water to support the body. The fluid nature helps redistribute pressure over a wider area.
- Air-Filled Mattresses and Overlays (Non-Powered): These feature interconnected, air-filled cells that contour to the body's shape, distributing pressure over a larger surface area. The ROHO Mosaic cushion is a well-known example of this technology.
Dynamic or Active Support Surfaces
Dynamic systems actively change pressure distribution over time, either through alternating inflation/deflation cycles or fluidizing support media. These are typically powered and are used for higher-risk individuals or those with existing pressure ulcers.
- Alternating Pressure Mattresses and Overlays: These systems use an electric pump to sequentially inflate and deflate air cells, constantly shifting pressure points. This promotes blood circulation and prevents sustained pressure on any single area.
- Low-Air-Loss Beds: These beds use a series of air sacs to circulate warmed air, which helps to distribute body weight and manage moisture, a key factor in skin maceration. They provide constant low pressure and are often used in acute care settings.
- Air-Fluidized Beds: This advanced technology uses warmed air circulating through fine, ceramic beads covered by a permeable sheet. This creates a fluid-like environment that provides maximum pressure redistribution.
Specialized Cushions and Positioners
For those who spend time seated, or to protect specific body parts, there are a variety of smaller, targeted devices.
- Wheelchair Cushions: These are available in various materials, including foam, gel, and air-filled cells, to redistribute pressure and reduce shear forces during prolonged sitting. Some are dynamic, offering alternating pressure relief.
- Riser Recliner Chairs: These chairs provide adjustable seating positions to shift weight and relieve pressure points for individuals with limited mobility.
- Limb and Heel Protectors: Specifically designed booties, pads, and cushions protect bony prominences like heels and elbows, which are highly susceptible to pressure injuries. Some use foam or gel, while off-loading devices use props to completely suspend the heel off the surface.
Comparison of Different Pressure Relieving Equipment
| Feature | Static (Reactive) Surfaces | Dynamic (Active) Surfaces | Specialized Cushions/Aids |
|---|---|---|---|
| Mechanism | Redistributes pressure over a larger area by conforming to the body. | Actively changes pressure points over time via inflation/deflation cycles or fluidization. | Targets and offloads pressure from specific, high-risk body parts. |
| Power Required? | No | Yes | No (mostly) |
| Risk Level | Low to moderate risk | High risk, or for treatment of existing ulcers | High risk areas (e.g., heels, elbows) |
| Primary Use | Prevention | Prevention and treatment | Targeted prevention and treatment |
| Examples | High-spec foam mattress, gel overlay, static air cushion | Alternating pressure mattress, air-fluidized bed | Heel protectors, wheelchair cushions, riser chairs |
| Pros | Cost-effective, simple, quiet, good for lower-risk patients. | Highly effective for high-risk patients, promotes blood flow. | Targeted relief for specific areas, portable. |
| Cons | Less effective for high-risk patients, requires proper patient positioning. | Requires power, can be noisy, higher cost, may not be tolerated by all patients. | Limited to specific areas, may require correct application to be effective. |
Choosing the Right Equipment
The selection of appropriate pressure-relieving equipment should always be guided by a healthcare professional, such as a doctor, physical therapist, or wound care nurse. They will assess the individual's specific needs, including mobility level, skin condition, and overall health. Regular skin assessments and proper repositioning remain essential in conjunction with any equipment.
For more information on the clinical evidence and comparisons of different support surfaces, the National Institutes of Health provides detailed resources on its website: https://www.ncbi.nlm.nih.gov/books/NBK333141/.
Conclusion
Pressure-relieving equipment is a critical component of care for preventing and treating pressure ulcers. From simple static foam cushions to advanced dynamic air systems and specialized positioners, a wide range of devices is available to suit different levels of risk and care needs. By understanding the options and consulting with a healthcare provider, individuals can choose the most effective solution to protect their skin and promote healing.
