Did you know that in the UK, treating pressure ulcers costs the NHS more than £1.4 million every day?
Prevalent in care homes and hospices, hospitals and in the community, pressure ulcers are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. When people are confined to a bed or sitting position for extended periods of time, they are at a higher risk of developing pressure ulcers.
These types of injuries can be largely preventable, especially with the use of a pressure relief mattress. However, with so many different variations available, it can be difficult to know which one to choose.
To help you find the right mattress, this blog will guide you through each step, ensuring that you find the right match for an individual’s risk of developing a pressure injury.
A pressure relief mattress is designed to increase comfort for an individual suffering from (or at risk of developing) pressure ulcers. The mattress provides high levels of support for the head and body to relieve any mounting stress on pressure points.
Unlike a regular mattress, pressure relief mattresses have carefully designed air pockets, specifically designed to place less pressure on the main pressure points in the body.
There are three main types of pressure relief mattresses to consider.
Foam mattresses are mostly designed for the prevention of pressure ulcers rather than the treatment.
Responding to an individual’s body shape, heat, and movement, they are comprised of single or multiple pressure relieving foam. Their surface remains static and relieves pressure overtime by evenly distributing an individual’s weight over a large surface at a continuous low pressure.
Additional pressure relief is also provided by castellations and shaped surfaces as well as the air pockets within the foam layers.
For individuals who are confined to a bed, it is important they are repositioned by their carer regularly. If an individual is not moved regularly, pressure ulcers cab can develop. Therefore, foam mattresses are mainly recommended for those at low-medium risk of developing a pressure ulcer.
You can learn more about the different grades for pressure ulcers in the blog below:
Recommended for Grade 3 and Grade 4 pressure ulcers, alternating air pressure mattresses are mostly used to treat developed ulcers as well as preventing them for those unable to move themselves.
Providing constant relief to the individual, they also bring the benefit of reducing the need for manual repositioning by a carer.
Assembled with a row of lateral air cells that constantly alternate, they relieve and redistribute pressure through a dynamic lying surface. Air-flow is controlled via a pump unit connected to the mattress, with the pump inflating deflated cells and deflating the inflated cells.
Inflated air cells provide pressure to support the user whilst the deflated cells provide relief for the skin above them. The pump ensures that there is constant movement under the user’s skin as well as periods of no pressure.
Whilst foam mattresses don’t suit those with higher pressure relief needs, and air mattresses can give some patients nausea from vibration, the hybrid provides optimum pressure relief whilst maintaining high levels of comfort.
Hybrid mattresses are designed for those at high/ very high risk of developing pressure ulcers, but still have some level of mobility.
Combining the foam and alternating systems into one mattress, the hybrid has a unique cell stricture. Foam in the cells dull the vibration of the pump, yet still provides air flow to contour to the individual’s shape.
As a result, it helps create a surface that is softer and more supportive.
You can learn more about the benefits of a hybrid pressure mattress in the blog below:
We have looked at the different types of pressure mattresses, but how do we know which one is most suitable?
To solve this, an individual needs to have a risk assessment of developing a pressure ulcer. Once the assessment has been carried out, care providers can then match the right pressure relief mattress to the right grade of pressure ulcer.
Risk can be assessed in a variety of ways, varying on care setting and who is involved in the risk assessment.
According to NICE, pressure ulcer risk assessment should be based on clinical judgement and/or use of a validated tool.
Practitioners use their clinical judgement by looking, listening, and learning to assess when a patient is at risk of pressure ulcers.
They also need to know and be aware of known risk factors, relating to susceptibility or tolerance of the individual or the mechanical boundary conditions.
Here is a breakdown of the factors:
| Susceptibility and tolerance of the individual |
| · Individual mechanical properties of tissue (how well tissue can cope with pressure shear or friction) |
| · Individual morphology (size and shape) of the tissue and bones |
| · Individual physiology and repair |
| · Individual transport and thermal properties |
| · Nutrition/hydration |
| · Diabetes |
| · Body build |
| · Age |
| · Sensory impairment |
| · Mental/cognitive impairment |
| Mechanical boundary conditions |
| · Magnitude of mechanical load (how much pressure shear/friction is applied) |
| · Duration of mechanical load (for how long the pressure shear or friction is applied) |
| · Type of loading (shear, pressure, friction) |
| · Moisture |
| · Poor moving and handling |
| · Reduced mobility |
| · Incontinence |
A benefit of using clinical judgement is that is delivers a quick individualised assessment and early intervention for preventative care.
However, compared with formal score-based tools, it is an informal measurement. By relying on an individual health professional’s knowledge and experience, it makes it difficult to validate or replicate.
A risk assessment tool is a formal tool that uses a point scale or a traffic-light system to rate a selection of known risk factors.
There are more than 50 pressure ulcer risk tools/scales currently used around the world, with the Norton Scale one of the most popular.
Created in England in 1962, the Norton Scale was the first pressure ulcer risk evaluation scale to be created, with its simplicity making it still widely used today.
Giving a rating from 1 (low risk) to 4 (high risk), the scale looks at physical condition, mental condition, activity, mobility, and incontinence. Using these criteria, the scale allows care providers to predict the likelihood a patient will develop pressure ulcers.
Here is an example:
| Physical Condition | Mental State | Activity | Mobility | Incontinence | |||||
| Good | 4 | Alert | 4 | Ambulatory | 4 | Full | 4 | Not | 4 |
| Fair | 3 | Apathetic | 3 | Walks with help | 3 | Slightly Limited | 3 | Occasionally | 3 |
| Poor | 2 | Confused | 2 | Chairbound | 2 | Very Limited | 2 | Usually urinary | 2 |
| Very Bad | 1 | Stuporous | 1 | Bedfast | 1 | Immobile | 1 | Double | 1 |
Unlike relying on clinical judgement, risk assessment tools such as the Norton Scale have the advantage of being validated, repeatable, and reliable. They give clear prescriptive guidelines and are easy to audit.
However, they are not personalised to individual patients, and health professionals can become reliant on the score to prescribe care.
NICE recommend that the most effective way of carrying out a pressure ulcer risk assessment, is to include a validated risk assessment tool to support clinical judgement.
Under these set of guidelines, it also includes a third factor to consider.
To enhance the prevention and treatment of pressure ulcers, care providers must also reassess pressure ulcer risk if there is a change in clinical status.
For example, this could include the worsening of an underlying health condition or a change in mobility.
Risk assessments for pressure ulcers are common practice in hospitals, but for many care homes and hospices, they require additional support on pressure care and help with grading of mattresses to suit their residents.
To help with this request, we have invested in a tissue viability consultant!
From visiting care homes and hospices to holding online study days, our consultant provides training to staff to help them assess and treat individuals who are at risk or who have pressure ulcers.
For more information, get in touch with our friendly team.
Having gone though the different types of pressure mattresses and the different grades of pressure ulcers, it is now time to identify which mattress is best for your patient’s requirements.
From low to very high risk, there are a range of pressure relieving mattresses available to suit everyone.
Depending on an individual’s risk and also what they find most comfortable, we have put together a simple guide to help you decide!
| Risk | Our Recommendation |
| Low to Medium | Somlent Nebula |
| High | Somlent Eos |
| High to Very High | Somlent Serene |
| Very High | Somlent Percept, Autosense & Air Egg Plus |
For the lower end of the risk spectrum, the Somlent Nebula is a great everyday pressure relief mattress.
The castellated foam insert provides excellent pressure reduction without compromising on comfort and support. Meanwhile, the reinforced foam of outer core also helps to hold the mattress securely to ensure it is keeping every patient supported and comfortable.
The Nebula is also covered in a waterproof, vapour permeable, two-way stretch material, enabling the patient’s skin to breathe whilst protecting the interior of the mattress itself.
A particularly low maintenance mattress, it doesn’t need turning or rotating, minimising the need for manual handling.
Whilst a moving lying surface is good for relieving pressure for medium to high-risk patients, comfort on some alternating pressure mattresses can be compromised.
However, with the Somlent Eos, that isn’t an issue.
With 5″ air cells and a self-inflating 2″ sealed foam base, the Eos’ alternating pressure system is perfect blend of comfort and functionality.
This makes it ideal for high-risk individuals in care home environments.
Equipped with a wide range of features such as removable heel cells, the Eos is a highly versatile and cost-effective solution.
Manufactured to comply with the most stringent quality and in-use guidelines, the Eos is also easy to use for carers with simple to use settings and functions.
Care providers can quickly set up the mattress system and have it operating at optimal pressure for a specific user with ease.
We have a wide selection of pressure relieving mattresses for high-risk patients, tailored to suit individual requirements and budgets.
However, there is one mattress that stands out from the crowd – the Serene!
As the world’s first 4 in 1 hybrid mattress, the Serene offers both alternating and static pressure therapy. Equipped with foam-filled air cells, SensaGel adaptive foot cells and an in-use height of 6”, its innovative design ensures the best possible care for the patient.
When used without a pump, the Serene performs the same as a high specification foam mattress and when used with a pump, it performs the same as an alternating air system.
There is no requirement to remove the user from bed to change from a foam system to an alternating air system, reducing the strain on care providers.
Looking at the very top of the market, there aren’t many more advanced mattresses than the Percept.
An alternating pressure relieving system, it includes cell-on-cell air cells, a static base section and an in-use height of 8″ for effective prevention and treatment of those at very high risk.
Alternating pressure adapts the mattress to the patient and their position, delivering both comfort and safety.
One of the most innovative pressure relief mattresses on the market, the Autosense is a fully auto weight sensing system.
Thanks to auto weight sense technology, the mattress pump continuously adjusts interface pressures according to the user’s weight. Not only does this minimise manual handling, but it also helps reduce the chances of pressure ulcers developing.
Just like the Precept, the Autosense also includes cell-on-cell air cells, a static base section and an in-use height of 8″, to make it highly effective for prevention and treatment of pressure injuries.
Combining the latest pressure care technology with the ultimate patient comfort, the Air Egg Plus delivers on all fronts.
Using an anti-decubitus system with a choice of two or three air outputs, it gives carers total control over the mattress. It also enables you to determine the amount of airflow and pressure in each cell of the mattress so that the patient’s comfort and needs are always taken care of.
Slightly deeper than the standard Air Egg, the Plus is split into seven pressure zones to enhance patient comfort and support.
In choosing a pressure relief mattress for your healthcare environment, it is important to assess on an individual basis. By focusing on person-centred care, you can match the right mattress to your patient’s specific needs, whether it is their individual risk of developing a pressure ulcer or treating a particular pressure grade.
That is why we provide demos and trials for all our pressure relief mattresses, ensuring you have the knowledge of what to look for and have peace of mind with your decision.
When we supply your whole mattress fleet (for multi-user settings), we can cover the whole spectrum of risk to ensure all patients/residents are comfortable and protected.
To find out more about how we can help you, book a free consultation with our team today!
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