Pressure ulcers are a common occurrence in the medical field, affecting patients that are immobile due to illness or injury, or the elderly that typically have less mobility. A pressure ulcer can be defined as localized damage to the skin and soft tissue underneath as a result of intense or prolonged pressure, or pressure combined with shear. The prevalence of pressure ulcers has remained relatively consistent in the United States, affecting nearly 3 million adults. However, healthcare costs have been increasing and pressure ulcers, if left untreated, can cause severe health issues such as localized or general infection, or necrosis. Approximately 60,000 people die from pressure ulcer adverse outcomes each year (Mervis and Phillips, 2019).
Pressure ulcers can occur both during hospital stay or after discharge during homecare. Many housebound adults who may be immobile due to age, injury, post-surgery recovery, or other illnesses are at-risk to develop pressure ulcers. Unlike in hospitals, there is no regular nurse presence to aid in changing of positioning, dressings, or identifying ulcers early on. Therefore, literature indicates thatan effective solution for adults in community settings is the use of pressure reducing surfaces. At the most primitive level, there are recommendations to use pillow, cushions, or mattress pads to reduce the pressure and support the area (MedlinePlus, 2020).
More complex interventions would be the use of pressure reducing support surfaces. This is identified as durable medical equipment (DME) and used to care for pressure sores and ulcers. Pressure reducing support surfaces can be split into three groups dependent on complexity. Group 1 are surfaces meant to replace the mattress or serve as an overlay include specialized mattresses, pressure pads, and overlays from foam, water, or gel. Group 2 is similar but includes more complex devices such air flotation beds and powered pressure reducing mattresses. Finally, Group 3 are complete bed systems including air-fluidized beds which use circulation of filtered air (United Healthcare, 2021). Pressure reducing support surfaces are meant to prevent pressure ulcers or contribute to the healing of existing sores. This is achieved by limiting tissue interface pressure to the best possible extent, most often by improving circulation and conforming to the contours of the body and spreading pressure over wider areas of the body (Rae, Isbel and Upton, 2018). There is a general consensus among literature that active and reactive support surfaces are effective in prevention and treatment of pressure ulcers.