Pressure-relieving devices to prevent pressure injury in bedridden patients: a literature review

Fitri Anita; Nur Chayati; Wantonoro Wantonoro

doi:10.15562/bmj.v10i3.3037

Pressure-relieving devices to prevent pressure injury in bedridden patients: a literature review

Fitri Anita ,

Nur Chayati ,

Wantonoro Wantonoro ,

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DOI: https://doi.org/10.15562/bmj.v10i3.3037 |
Published: 2021-12-30

Abstract

Introduction: Immobility is a factor directly related to pressure injury, that could progress to osteomyelitis, sepsis, decreased the quality of life and increased care costs. Therefore, this study is intended to review primary studies related to using the most effective device to prevent pressure injury in immobile patients, the duration for applying the device and tools for assessing pressure injury risk.

Method: This literature review was sourced from PubMed, ProQuest, and Willey Online Library databases. Studies that met the following criteria were included; experimental research using assistive devices as an intervention to prevent and assess pressure injury, published between 2014 and 2020, and the full-text article was available in English.

Result: The total number of articles found was 6,029 articles. Seven articles met the criteria for inclusion in the review. Assistive devices proven to prevent pressure injury included air mattresses, dressings/pads, and wheelchairs equipped with pillows/cushions. The duration of assistive devices was varied from minutes to weeks and assessment for pressure injury mostly used the Braden scale. Air mattresses were the most effective device to prevent pressure injury, with a press time of fewer than 10 minutes. Air mattresses were recommended devices in order to prevent pressure injury for immobile patients in clinical and community practices. In addition, developing air mattresses with advanced technologies is recommended for future work.

Conclusion: The widely used assistive devices to prevent pressure injury were air mattresses or viscoelastic foam mattresses made of silicone. Mattress usage time ranged from 5-7 minutes, while dressings usage could be up to four weeks. The Braden Scale was the leading choice for measuring pressure injury in bedridden patients.

References

Coleman S, Gorecki C, Nelson EA, Closs SJ, Defloor T, Halfens R, et al. Patient risk factors for pressure injury development : Systematic review. Int J Nurs Stud. 2013;50:974–1003.
Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of comorbidities and the development of pressure injury among older adults. BMC Geriatr. 2018;18(305):1–11.
Bai DL, Liu T, Id HC, Hsu Y. Relationship between a pressure redistributing foam mattress and pressure injuries : An observational prospective cohort study. 2020;1–15.
Tavares C, Domingues MF, Paixão T, Silva H, Antunes P. Wheelchair Pressure injury Prevention Using FBG Based Sensing Devices. 2019;
Chamorro AM, Thomas MCV, Mieras AS, Leiva A, Martínez MP, Yeste MMSH. Multicenter randomized controlled trial comparing the effectiveness and safety of hydrocellular and hydrocolloid dressings for treatment of category II pressure injury in patients at primary and long-term care institutions. Int J Nurs Stud. 2019;94:179–85.
Bereded DT, Salih MH, Abebe AE. Prevalence and risk factors of pressure injury in hospitalized adult patients ; a single center study from Ethiopia. BMC Res Notes. 2018;11(847):1–6.
Maria J, Chacon F, Blanes L, Hochman B, Ferreira LM, Federal U, et al. Original article Prevalence of pressure injury among the elderly living in long-stay institutions in São Paulo. 2009;127(4):211–5.
Suttipong C, Sindhu S. Predicting factors of pressure injury in older Thai stroke patients living in urban communities. J Clin Nurs. 2011;21:372–9.
Gorecki C, Brown ÃJM, Nelson ÃEA, Briggs M, Schoonhoven L, Dealey C, et al. Impact of Pressure injury on Quality of Life in Older Patients : A Systematic Review. JAGS. 2009;57(7):1175–83.
Gorecki C, Lamping DL, Brown JM, Madill A, Firth J, Nixon J. Development of a conceptual framework of health-related quality of life in pressure injury : A patient-focused approach. Int J Nurs Stud. 2010;47(12):1525–34.
Institute for Quality and Efficiency in Health Care (IQWiG). Preventing pressure injury (InformedHealth.org [Internet]. 2006.
Masithoh RF. Pencegahan luka tekan dengan penggunaan matrass. In: The 4 th Univesity Research Coloquium. 2016. p. 114–22.
Santamaria N, Gerdtz M, Wilson L, Gefen A. A randomised controlled trial of the clinical effectiveness of multi-layer silicone foam dressings for the prevention of pressure injuries in high-risk aged care residents : The Border III Trial. Int Wound J. 2018;1–9.
Sauvage P, Touflet M, Pradere C, Portalier F, Charru P, Passadori Y, et al. Pressure injury prevention efficacy of an alternating pressure air mattress in elderly patients: E2MAO a randomised study. J Wound Care. 2017;26(6):304–12.
Beeckman D, Serraes B, Anrys C, Tiggelen H Van, Hecke A Van, Verhaeghe S. A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure injury in nursing home residents. Int J Nurs Stud. 2019;97:105–13.
Nixon J, Brown S, Smith IL, McGinnis E, Vargas-Palacios A, Nelson EA, et al. Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure injury in high-risk patients : the PRESSURE 2 RCT. In: Health technology assessment. 2019. p. 1–101.
Jiang Q, Liu Y, Yu H, Song S, Li G, Liu H, et al. A Multicenter , Comparative Study of Two Pressure-Redistribution Mattresses with Repositioning Intervals for Critical Care Patients. Adv Skin Wound Care. 2020;33:1–9.
Brienza DM, Karg PE, Bertolet M, Schmeler M, Poojary-mazzotta P, Vlachos H, et al. A Randomized Clinical Trial of Wheeled Mobility for Pressure Injury Prevention and Better Function. Clin Investig (Lond). 2018;1–8.
Kalowes BP, Messina V, Li M. Five-layered soft silicone foam dressing to prevent pressure injury in the intensive care unit. Am J Crit Care. 2016;25(6):e108-120.
Ogawa Y, Mori T, Noguchi H, Nakagami G, Sanada H. Development and evaluation of an air mattress structure and function for reducing discomfort when elevating the head-of-bed. Disabil Rehabil Assist Technol. 2015;10(1):81–8.
Ningrum KC, Puji A, Wahyu. Kasur angin anti decubitus dilengkapi monitoring tekanan berbasis mikrokontroller AT89S51. Vol. 51. 2010.
Choi JS, Hyun SY, Chang SJ. Comparing Pressure Injury Incidence Based on Repositioning Intervals and Support Surfaces in Acute Care Settings : A Quasi-Experimental Pragmatic Study. Adv Skin Wound Care. 2021;34:1–6.
Denzinger M, Krauss S, Held M, Joss L, Kolbenschlag J, Daigeler A, et al. A quantitative study of hydration level of the skin surface and erythema on conventional and microclimate management capable mattresses and hospital beds. J Tissue Viability. 2019;1–5.
Bai DL, Liu T, Id HC, Hsu Y. Relationship between a pressure redistributing foam mattress and pressure injuries : An observational prospective cohort study. PLoS One. 2020;15(11):1–14.

[1] Coleman S, Gorecki C, Nelson EA, Closs SJ, Defloor T, Halfens R, et al. Patient risk factors for pressure injury development : Systematic review. Int J Nurs Stud. 2013;50:974–1003.

[2] Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of comorbidities and the development of pressure injury among older adults. BMC Geriatr. 2018;18(305):1–11.

[3] Bai DL, Liu T, Id HC, Hsu Y. Relationship between a pressure redistributing foam mattress and pressure injuries : An observational prospective cohort study. 2020;1–15.

[4] Tavares C, Domingues MF, Paixão T, Silva H, Antunes P. Wheelchair Pressure injury Prevention Using FBG Based Sensing Devices. 2019;

[5] Chamorro AM, Thomas MCV, Mieras AS, Leiva A, Martínez MP, Yeste MMSH. Multicenter randomized controlled trial comparing the effectiveness and safety of hydrocellular and hydrocolloid dressings for treatment of category II pressure injury in patients at primary and long-term care institutions. Int J Nurs Stud. 2019;94:179–85.

[6] Bereded DT, Salih MH, Abebe AE. Prevalence and risk factors of pressure injury in hospitalized adult patients ; a single center study from Ethiopia. BMC Res Notes. 2018;11(847):1–6.

[7] Maria J, Chacon F, Blanes L, Hochman B, Ferreira LM, Federal U, et al. Original article Prevalence of pressure injury among the elderly living in long-stay institutions in São Paulo. 2009;127(4):211–5.

[8] Suttipong C, Sindhu S. Predicting factors of pressure injury in older Thai stroke patients living in urban communities. J Clin Nurs. 2011;21:372–9.

[9] Gorecki C, Brown ÃJM, Nelson ÃEA, Briggs M, Schoonhoven L, Dealey C, et al. Impact of Pressure injury on Quality of Life in Older Patients : A Systematic Review. JAGS. 2009;57(7):1175–83.

[10] Gorecki C, Lamping DL, Brown JM, Madill A, Firth J, Nixon J. Development of a conceptual framework of health-related quality of life in pressure injury : A patient-focused approach. Int J Nurs Stud. 2010;47(12):1525–34.

[11] Institute for Quality and Efficiency in Health Care (IQWiG). Preventing pressure injury (InformedHealth.org [Internet]. 2006.

[12] Masithoh RF. Pencegahan luka tekan dengan penggunaan matrass. In: The 4 th Univesity Research Coloquium. 2016. p. 114–22.

[13] Santamaria N, Gerdtz M, Wilson L, Gefen A. A randomised controlled trial of the clinical effectiveness of multi-layer silicone foam dressings for the prevention of pressure injuries in high-risk aged care residents : The Border III Trial. Int Wound J. 2018;1–9.

[14] Sauvage P, Touflet M, Pradere C, Portalier F, Charru P, Passadori Y, et al. Pressure injury prevention efficacy of an alternating pressure air mattress in elderly patients: E2MAO a randomised study. J Wound Care. 2017;26(6):304–12.

[15] Beeckman D, Serraes B, Anrys C, Tiggelen H Van, Hecke A Van, Verhaeghe S. A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure injury in nursing home residents. Int J Nurs Stud. 2019;97:105–13.

[16] Nixon J, Brown S, Smith IL, McGinnis E, Vargas-Palacios A, Nelson EA, et al. Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure injury in high-risk patients : the PRESSURE 2 RCT. In: Health technology assessment. 2019. p. 1–101.

[17] Jiang Q, Liu Y, Yu H, Song S, Li G, Liu H, et al. A Multicenter , Comparative Study of Two Pressure-Redistribution Mattresses with Repositioning Intervals for Critical Care Patients. Adv Skin Wound Care. 2020;33:1–9.

[18] Brienza DM, Karg PE, Bertolet M, Schmeler M, Poojary-mazzotta P, Vlachos H, et al. A Randomized Clinical Trial of Wheeled Mobility for Pressure Injury Prevention and Better Function. Clin Investig (Lond). 2018;1–8.

[19] Kalowes BP, Messina V, Li M. Five-layered soft silicone foam dressing to prevent pressure injury in the intensive care unit. Am J Crit Care. 2016;25(6):e108-120.

[20] Ogawa Y, Mori T, Noguchi H, Nakagami G, Sanada H. Development and evaluation of an air mattress structure and function for reducing discomfort when elevating the head-of-bed. Disabil Rehabil Assist Technol. 2015;10(1):81–8.

[21] Ningrum KC, Puji A, Wahyu. Kasur angin anti decubitus dilengkapi monitoring tekanan berbasis mikrokontroller AT89S51. Vol. 51. 2010.

[22] Choi JS, Hyun SY, Chang SJ. Comparing Pressure Injury Incidence Based on Repositioning Intervals and Support Surfaces in Acute Care Settings : A Quasi-Experimental Pragmatic Study. Adv Skin Wound Care. 2021;34:1–6.

[23] Denzinger M, Krauss S, Held M, Joss L, Kolbenschlag J, Daigeler A, et al. A quantitative study of hydration level of the skin surface and erythema on conventional and microclimate management capable mattresses and hospital beds. J Tissue Viability. 2019;1–5.

[24] Bai DL, Liu T, Id HC, Hsu Y. Relationship between a pressure redistributing foam mattress and pressure injuries : An observational prospective cohort study. PLoS One. 2020;15(11):1–14.

Pressure-relieving devices to prevent pressure injury in bedridden patients: a literature review

Abstract

References

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