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Pressure signatures can influence tissue response for individuals supported on an alternating pressure mattress

Pressure signatures can influence tissue response for individuals supported on an alternating pressure mattress
Pressure signatures can influence tissue response for individuals supported on an alternating pressure mattress
Prolonged mechanical loading can lead to the breakdown of skin and underlying tissues which can, in turn, develop into a pressure ulcer. The benefits of pressure relief and/or redistribution to minimise risk have been well documented. Manufacturers have developed alternating air pressure mattresses (APAMs) to provide periodic relief for individuals on prolonged bed-rest. The present study describes the development of a control system, termed Pneumatic Manager which can vary the signature of an APAM, namely its pressure amplitude, cell profile and cycle period. An experimental array was designed to investigate the effects of varying these parameters, particularly with respect to its ability to maintain skin viability in a group of five healthy volunteers lying in a supine position. Transcutaneous gas (TcPO2/TcPCO2) tensions at the sacrum were monitored. In addition, pressures and microclimate parameters at the loaded support interface were also measured.

In the majority of test conditions the alternating support produced sacral TcPO2 values, which either remained relatively high or fluctuated in concert with cycle period providing adequate viability. However, in 46% of cases at the extreme pressure amplitude of 100/0 mmHg, there was compromise to the skin viability at the sacrum, as reflected in depressed TcPO2 levels associated with an elevation of TcPCO2 levels above the normal range. In all cases, both the humidity and temperature levels increased during the test period. It is interesting to note that interface pressures at the sacrum rarely exceeded 60 mmHg. Although such studies need to be extended to involve bed-bound individuals, the results provide a design template for the optimum pressure signatures of APAM systems to ensure maintenance of skin viability during pronged loading.
0965-206X
180-188
Chai, C.Y.
9228e77d-f0f8-46b5-83df-6c497755069a
Sadou, O.
85caf6d7-db06-462a-bc06-1fa3f7a179b7
Worsley, P.R.
6d33aee3-ef43-468d-aef6-86d190de6756
Bader, D.L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Chai, C.Y.
9228e77d-f0f8-46b5-83df-6c497755069a
Sadou, O.
85caf6d7-db06-462a-bc06-1fa3f7a179b7
Worsley, P.R.
6d33aee3-ef43-468d-aef6-86d190de6756
Bader, D.L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf

Chai, C.Y., Sadou, O., Worsley, P.R. and Bader, D.L. (2017) Pressure signatures can influence tissue response for individuals supported on an alternating pressure mattress. Journal of Tissue Viability, 26 (3), 180-188. (doi:10.1016/j.jtv.2017.05.001).

Record type: Article

Abstract

Prolonged mechanical loading can lead to the breakdown of skin and underlying tissues which can, in turn, develop into a pressure ulcer. The benefits of pressure relief and/or redistribution to minimise risk have been well documented. Manufacturers have developed alternating air pressure mattresses (APAMs) to provide periodic relief for individuals on prolonged bed-rest. The present study describes the development of a control system, termed Pneumatic Manager which can vary the signature of an APAM, namely its pressure amplitude, cell profile and cycle period. An experimental array was designed to investigate the effects of varying these parameters, particularly with respect to its ability to maintain skin viability in a group of five healthy volunteers lying in a supine position. Transcutaneous gas (TcPO2/TcPCO2) tensions at the sacrum were monitored. In addition, pressures and microclimate parameters at the loaded support interface were also measured.

In the majority of test conditions the alternating support produced sacral TcPO2 values, which either remained relatively high or fluctuated in concert with cycle period providing adequate viability. However, in 46% of cases at the extreme pressure amplitude of 100/0 mmHg, there was compromise to the skin viability at the sacrum, as reflected in depressed TcPO2 levels associated with an elevation of TcPCO2 levels above the normal range. In all cases, both the humidity and temperature levels increased during the test period. It is interesting to note that interface pressures at the sacrum rarely exceeded 60 mmHg. Although such studies need to be extended to involve bed-bound individuals, the results provide a design template for the optimum pressure signatures of APAM systems to ensure maintenance of skin viability during pronged loading.

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Pressure signatures can influence tissue response for individuals supported on an alternating pressure mattress - Accepted Manuscript
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Accepted/In Press date: 9 May 2017
e-pub ahead of print date: 10 May 2017
Published date: August 2017
Organisations: Researcher Development

Identifiers

Local EPrints ID: 410231
URI: http://eprints.soton.ac.uk/id/eprint/410231
ISSN: 0965-206X
PURE UUID: 577db8b1-ff66-4aa9-ab6f-2428687a902e
ORCID for P.R. Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for D.L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 06 Jun 2017 04:02
Last modified: 17 Dec 2019 06:08

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