How is pressure reduction achieved in the treatment of pressure injuries (pressure ulcers)?

Updated: Mar 26, 2020
  • Author: Christian N Kirman, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

Pressure reduction may be achieved through the use of specialized support surfaces for bedding and wheelchairs that can keep tissue pressures below 32 mm Hg (the standard threshold value for evaluating support surfaces). [84, 85, 86, 87, 88] In theory, reduction of tissue pressures below capillary filling pressures should allow adequate tissue perfusion. Various different types of specialized support surfaces are available (see Table 1 below).

Table 1. Advantages and Disadvantages of Specialized Support Surfaces (Open Table in a new window)

Surface

Advantages

Disadvantages

Air

Low maintenance; inexpensive; multipatient use; durable

Can be punctured; requires proper inflation

Gel

Low maintenance; easy to clean; multipatient use; resists puncture

Heavy; expensive; little research

Foam

Lightweight; resists puncture; no maintenance

Retains heat and moisture; limited life

Water

Readily available in community; easy to clean

Requires heater; transfers are difficult; can leak; heavy; difficult to maintain; procedures difficult

Dynamic overlays

Easy to clean; moisture control; deflates for transfers; reusable pump

Noisy; can be damaged by sharp objects; requires assembly; requires power

Replacement mattresses

Reduced staff time; multipatient use; easy to clean; low maintenance

High initial cost; may not control moisture; loses effectiveness

Low air loss

Head and foot of bed can be raised; less frequent turning required; relieves pressure; reduces shear and friction; moisture control

Noisy; expensive; transfers are difficult; requires energy source; restricts mobility; requires skilled setup; rental charge

Air fluidized

Reduces shear and friction; lowest interface pressure; low moisture; less frequent turning required

Expensive; noisy; heavy; dehydration and electrolyte imbalances can occur; may cause disorientation; transfers are difficult; hot


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