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The physiological response of soft tissue to periodic repositioning as a strategy for pressure ulcer prevention

The physiological response of soft tissue to periodic repositioning as a strategy for pressure ulcer prevention
The physiological response of soft tissue to periodic repositioning as a strategy for pressure ulcer prevention
Background: individuals who have reduced mobility are at risk of developing pressure ulcers if they are subjected to sustained static postures. To reduce this risk, clinical guidelines advocate healthcare professionals reposition patients regularly. Automated tilting mechanisms have recently been introduced to provide periodic repositioning. This study compared the performance of such a prototype mattress to conventional manual repositioning.

Methods: ten healthy participants (7 male and 3 female, aged 23-66 years) were recruited to compare the effects of an automated tilting mattress to standard manual repositioning, using the 30° tilt. Measures during the tilting protocols (supine, right and left tilt) included comfort and safety scores, interface pressures, inclinometer angles and transcutaneous gas tensions (sacrum and shoulder). Data from these outcomes were compared between each protocol.

Findings: results indicated no significant differences for either interface pressures or transcutaneous gas responses between the two protocols (p > 0.05 in both cases). Indeed a small proportion of participants (~ 30%) exhibited changes in transcutaneous oxygen and carbon dioxide values in the shoulder during a right tilt for both protocols. The tilt angles at the sternum and the pelvis were significantly less in the automated tilt compared to the manual tilt (mean difference = 9.4-11.5°, p < 0.001). Participants reported similar comfort scores for both protocols, although perceived safety was reduced on the prototype mattress.

Interpretation: although further studies are required to assess its performance in maintaining tissue viability, an automated tilting mattress offers the potential for periodic repositioning of vulnerable individuals, with potential economic savings to health services
pressure ulcers, pressure redistributing mattress, repositioning, lateral rotation, biomechanics, tissue viability
0268-0033
166-174
Woodhouse, Marjolein
9e0d64cc-325f-4dd5-a15e-f54fa5b37b7f
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Woodhouse, Marjolein
9e0d64cc-325f-4dd5-a15e-f54fa5b37b7f
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf

Woodhouse, Marjolein, Worsley, Peter, Voegeli, David, Schoonhoven, Lisette and Bader, Dan L. (2015) The physiological response of soft tissue to periodic repositioning as a strategy for pressure ulcer prevention. Clinical Biomechanics, 30 (2), 166-174. (doi:10.1016/j.clinbiomech.2014.12.004).

Record type: Article

Abstract

Background: individuals who have reduced mobility are at risk of developing pressure ulcers if they are subjected to sustained static postures. To reduce this risk, clinical guidelines advocate healthcare professionals reposition patients regularly. Automated tilting mechanisms have recently been introduced to provide periodic repositioning. This study compared the performance of such a prototype mattress to conventional manual repositioning.

Methods: ten healthy participants (7 male and 3 female, aged 23-66 years) were recruited to compare the effects of an automated tilting mattress to standard manual repositioning, using the 30° tilt. Measures during the tilting protocols (supine, right and left tilt) included comfort and safety scores, interface pressures, inclinometer angles and transcutaneous gas tensions (sacrum and shoulder). Data from these outcomes were compared between each protocol.

Findings: results indicated no significant differences for either interface pressures or transcutaneous gas responses between the two protocols (p > 0.05 in both cases). Indeed a small proportion of participants (~ 30%) exhibited changes in transcutaneous oxygen and carbon dioxide values in the shoulder during a right tilt for both protocols. The tilt angles at the sternum and the pelvis were significantly less in the automated tilt compared to the manual tilt (mean difference = 9.4-11.5°, p < 0.001). Participants reported similar comfort scores for both protocols, although perceived safety was reduced on the prototype mattress.

Interpretation: although further studies are required to assess its performance in maintaining tissue viability, an automated tilting mattress offers the potential for periodic repositioning of vulnerable individuals, with potential economic savings to health services

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More information

Accepted/In Press date: 8 December 2014
e-pub ahead of print date: 13 December 2014
Published date: February 2015
Keywords: pressure ulcers, pressure redistributing mattress, repositioning, lateral rotation, biomechanics, tissue viability
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 372772
URI: http://eprints.soton.ac.uk/id/eprint/372772
ISSN: 0268-0033
PURE UUID: ada72274-701f-45a4-ac75-1804d2ef1ce3
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for David Voegeli: ORCID iD orcid.org/0000-0003-3457-7177
ORCID for Lisette Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766
ORCID for Dan L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 22 Dec 2014 08:58
Last modified: 15 Mar 2024 03:41

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Contributors

Author: Marjolein Woodhouse
Author: Peter Worsley ORCID iD
Author: David Voegeli ORCID iD
Author: Dan L. Bader ORCID iD

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