Support surface / overlay | Patient's risk group (Shape Risk Scale [SRS*] or Braden points 10) | Characteristics and mechanisms of action |
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* If SRS or SRS-D scales are used to assess the risk of pressure ulcer, only the SRS score should be considered when choosing the support surface.. ** The risk is very high whenever a patient has or has had a pressure ulcer. |
Hygiene mattresses, or standard polyurethane mattresses (reactive static support surface)
- For example, high specific weight or viscoelastic foam mattresses or combinations of these, including profiled mattresses
| Low risk patients (SRS score < 6, Braden score 19-23) | - Equalization of pressure on the tissue mainly by controlling immersion
- No redistribution of body pressure on the support surface
- Increased temperature increases oxygen consumption
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Active (dynamic), alternating pressure mattresses | Select, low to at most medium risk patients (SRS score 7-12, Braden score 15-18) | - Cyclic tissue deformation
- No tissue pressure equalization; on the contrary, there is significant variation in pressure
- Immersion control combined with constant alternation of tissue pressure and cyclic stimulation of circulation and oxygenation
- No redistribution of body pressure on the support surface
- Probably neutral temperature effect
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Other reactive mattresses
- For example, non-adjustable honeycomb-structured overlays, i.e. static support surfaces
| No more than medium risk patients (SRS score 7-12, Braden score 15-18) | - Equalization of tissue pressure by controlling both immersion and envelopment
- Redistribution of body pressure on the support surface may occur to some extent particularly when certain types of combination mattresses with foam and honeycomb structure are used
- The effect of temperature depends on the structure of the support surface
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Special reactive mattresses
- For example, high-quality, or medium-risk, foam mattresses (MRFM, static support surface) and active adjustable honeycomb-structured overlays
| Medium-risk (SRS score 7-12, Braden score 15-18) and certain high-risk (SRS score 13-18, Braden score 10-14) patients | - Equalization of tissue pressure by controlling both immersion and envelopment
- Redistribution of body pressure on the support surface may occur to some extent particularly when certain types of air mattresses are used
- Air-cell structured mattresses have a favourable temperature effect
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Special reactive/active mattresses
- For example, automatically adjusted air-cell structured overlays or support surfaces with no antideformation properties
| Medium-risk (SRS score 7-12, Braden score 15-18) and high-risk (SRS score 13-18, Braden score 10-14) patients | - Equalization of tissue pressure by controlling both immersion and envelopment
- There may be redistribution of body pressure on the support surface
- Air-cell structured mattresses have a favourable temperature effect
|
Minimum-pressure support surfaces
- Reactive support surfaces adjusting automatically to the patient's weight, position and body structure, function based on antideformation
| High-risk (SRS score 13-18, Braden score 10-14) and very high-risk (SRS score >19**, Braden score 6-9) patients
- The only choice in certain special patient groups, e.g. patients with extreme pain, multiple injuries, fractures of the spine/cervical spine, hypothermia therapy
- End-of-life palliative treatment
| - Equalization of tissue pressure and optimal control of the combined effect of immersion and envelopment
- Regardless of the patient and his/her position, the support surface provides a continuous maximum contact surface with good pressure equalization and redistribution, particularly if the effect is based on evidence of antideformation characteristics
- Air-cell structured mattresses have a favourable temperature effect
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