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Care Beds, Pressure Care Mattresses and Cushions
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Pressure care mattresses are designed for individuals that are susceptible to, or have developed, pressure ulcers. Pressure ulcers (also known as bed sores) result from sustained pressure applied to the skin, often occurring when a person spends long periods of time in the same position. Individuals most at risk of developing sores are those with restricted mobility and/or poor skin integrity.
In this guide, you will learn more about the different types of pressure care mattress and how they apply to different patient needs and risk levels. You will learn how to specify the correct mattress from the comprehensive Opera® range and we will point out the key considerations when buying a mattress system.
Pressure ulcers and categorising risk
Pressure ulcers (known also as pressure sores, bed sores, and decubitus ulcers) are areas of skin that have been subjected to sustained amounts of pressure, resulting in the skin and tissue becoming damaged. Constant pressure on a vulnerable area of the body results in the circulation of blood being cut off, which leads to the decay of the affected area. Extended pressure occurs when a person is sat or laid in a particular position on a static surface for a long period of time. There are four grades of ulcer, each denoting the severity of the wound:
Reddening of the skin
Superficial ‘blister-like’ wound
Full thickness skin loss
Deep wound and tissue damage
As a sore is allowed to develop, it moves through the four grades. Different patients have different levels of risk in developing ulcers, factors include mobility, skin integrity and nutrition/wellness. There are three risk categories that denote how at risk the patient is: at risk; high risk; and very high risk. The risk level is determined by measuring the patient’s mobility, skin integrity etc, through assessment tools such as the Waterlow Score.
The different types of pressure relieving surfaces
Static mattresses are made up of a single or multiple pressure relieving foam/s. They are are static surface and relieve pressure over time by responding to body shape, movement and heat. Castellations and shaped surfaces as well as air pockets are often used to offer additional pressure relief.
For immobile users, it is essential that a carer repositions them regularly on the mattress surface (once every two to three hours). A static surface can only relieve so much pressure and sores will develop if the patient is not moved regularly.
Static mattresses are designed to prevent ulcers rather than treat them, however the more sophisticated layered foam mattress can be used to heal grade 1 ulcers as long as there is a turning plan for the user.
Alternating pressure mattresses, commonly referred to as air-flow mattresses, relieve and redistribute pressure through a dynamic lying surface. These mattresses are constructed from a row of lateral air cells that constantly alternate, whilst some cells are inflated the others are deflated. Air flow is controlled through a pump unit which connects to the mattress and is usually hooked onto the footboard of the bed the mattress is being used with.
The air cells that are inflated support the user whilst the deflated air cells provide total pressure relief to the skin above them. The air pump then inflates the deflated cells and deflates the inflated cells, ensuring the user’s skin is subjected to movement as well as periods of no pressure.
Alternating pressure mattresses are typically used to help treat developed pressure ulcers and also to prevent ulcers for users that aren’t able to move themselves. They reduce the need for manual repositioning and provide consistent pressure relief. However, they do present comfort considerations, namely with the moving lying surface and also compressor noise.
Hybrid pressure mattresses combine both alternating and static mattress systems into one mattress. This is usually in the form of alternating air cells inset in a foam mattress surround with a soft foam topper. Hybrid pressure mattresses provide advanced pressure relief that an alternating air pressure mattress brings, whilst still maintaining the high level of comfort found in a static foam pressure mattress.
The majority of hybrid pressure mattresses require a mains-powered air pump to operate the integral alternating air cells. New, innovative technology has also led to non-powered hybrid mattresses that relieve pressure by responding intelligently to body shape and movement. Air cells are self-adjusting through valves that inhale and exhale naturally as pressure is exerted on the mattress surface. See the Opera® Synergy Hybrid.
Hybrid mattresses are designed for users who are at high or very high risk of developing sores but still have some mobility.
Key purchasing/specifying considerations
Aside from the risk category and type of pressure relieving surface, there are some other key considerations to bear in mind when specifying an Opera® pressure care mattress.
Pressure care mattress are available in two different forms; an overlay system, or a full replacement system.
An overlay system is a shallow depth mattress that is designed to be used on existing mattresses. They are usually about 2-5” in depth, and are laid on top of an existing mattress or underlay.
Overlay vs Full replacement
A full replacement system is a pressure care mattress that is only to be used as a single unit. They have deep air cells that are 6”+ in depth and their more sophisticated construction means they provide greater levels of pressure relief.
As standard, Opera® pressure care mattresses are 2m (6ft 6″) in length and 90cm (3ft) in width. Some of the models are available in an extra wide version of 120cm (4ft).
All Opera® pressure care mattresses have a wipe-clean PU cover. They are two-way stretch and vapour-permeable to prevent moisture as well as allow for better microclimate control. On some models, the cover is impregnated with antimicrobial agents ensuring the mattress covers are resistant to bacterial growth including MRSA, fungal growth and house dust mite.
Opera® mattress covers are durable and manufactured to withstand rigorous cleaning practices. 50,000ppm Chlorine resistance resists damage even where Chlorine builds up through multiple cleaning cycles.
Bases on the static mattresses are designed for lighter use and are usually non-slip to minimise mattress movement. For alternating and hybrid systems, the bases are constructed from a tough nylon material that prevents damage to air cells. They also have securing straps to limit movement and/or handling loops to ease transfer of the mattress.
The Opera® range
The Opera® range of pressure care mattresses is split into the three types of pressure relieving surface: static; alternating; and hybrid.
Opera® Static Mattresses
Opera® static mattresses are high-quality everyday pressure care mattresses designed for users who are at risk of developing sores but are able to move themselves or be regularly tuned by a carer. Key benefits include:
Single or layered foam options.
Castellations ease profiling and relieve pressure.
High density edging foam eases transfer.
Firmness ratings help to ensure user comfort.
The update to the MHRA bed rail regulations in 2013 is a topic of conversation that has been well covered in the healthcare sector in recent years. So, I’m not going to waste your time with that right now! The impact of those regulations affect us every day because they are important and, in many instances, quite literally a matter of life and death. But, in all seriousness, do we really need extension side rails?
The answer to this question depends on whom you talk to. It’s a fact that full replacement alternating pressure mattresses don’t comply with bed rail regulations when fitted onto most profiling beds (link ‘profiling beds’ to https://alpinehc.co.uk/beds-and-overbed-tables/beds/profiling) in the marketplace.
Common sense has been failing to prevail as manufacturers have been prescribing makeshift bolted on extension side rails for inadequate beds. A lack of innovation in the care equipment marketplace has resulted in temporary fixes to what is, in all likelihood, going to be a long-term issue.
As a manufacturer, Alpine HC has taken a step back from this issue and asked, ‘why do we even need extension side rails?’ Dave Maude from Alpine HC said:
Alpine HC kept this in mind when developing the Opera® bed range, and the new Opera®bed can now take up to a 10” mattress without the need for extension side rails. See the video below.