Alternative reactive support surfaces for preventing pressure ulcers
Current evidence is generally uncertain about the differences between non-foam and non-air-filled reactive surfaces and other surfaces in terms of pressure ulcer incidence, patient comfort, side effects, health-related quality of life, and cost-effectiveness. Reactive gel surfaces used for operating tables and subsequent foam surfaces applied to hospital floors may increase the risk of developing new pressure ulcers compared to alternating pressure (active) air surfaces applied to both operating tables and hospital floors.
Future research in this area should consider assessing the most important support surfaces from the decision-maker's perspective. Future research should consider time to event outcomes, careful assessment of adverse events, and trial-level cost-effectiveness assessments. Trials need to be designed to minimize the risk of detection bias. For example, by using digital photos and photo adjudicators who are not informed of group assignments. Further review using a network meta-analysis will add to the findings reported here.
Shi C, Dumville JC, Cullum N, Rhodes S, McInnes E. Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers. Cochrane Database of Systematic Reviews 2021, No. 4. Art. No.: CD013623. doi: 10.1002 /14651858.CD013623.pub2.
Commentary
This study involved interventions such as changing sleeping mats with the aim of preventing pressure ulcers.
The study reviewed 4653 subjects from 20 studies with an average intervention period of 4 weeks. The average age of the subjects was 73 years. The studies compared bed mats filled with water or gel or made of fiber to mats made of other materials. In these studies, it was not clear whether bed mats that were "airless" or "not made of foam" could prevent pressure ulcers when compared to each other.
In addition, an intervention conducted on people undergoing surgery suggested that they were more likely to develop pressure ulcers if they used an operating table with a gel-based bed mat and a bed mat made of a foam surface upon admission.
However, it is unclear from this study to find the benefits and risks of each material, and the study does not seem to report any costs or information that would fit with "quality of life" in daily life.Pressure ulcers, as they are commonly known, are a condition that occurs in people who have difficulty turning over or moving due to deep tissue damage caused by prolonged pressure. The study compared materials that are used for bedding, but the fact that they are good materials does not necessarily mean that they can prevent pressure ulcers.
