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Support surfaces

BY: NANCY MORGAN, RN, BSN, MBA, WOCN, WCC, CWCMS, DWC
Support surfaces are geared for managing our patients’ tissue load and redistributing it to prevent skin breakdown. There are three types of pressure redistribution mattresses available, classified as group 1, group 2, and group 3.  Group 1 mattresses lack a power source and maintain a constant state of inflation.  They include foam mattresses, gel mattresses, and air mattresses.  Group 2 support surfaces, such as powered, low-air-loss, and alternating pressure mattresses use inflation and deflation to spread the tissue load over a large surface area. Group 3 mattresses include the air-fluidized mattress, a special type of powered mattress that provides the highest-pressure redistribution via a fluid-like medium created by forcing air through beads, as characterized by immersion and envelopment.

We need to consider many factors when choosing a support surface, such as the patient’s medical status, risk assessment score, wound stage, environment, and (one of the most important factors) who’s paying for the support surface. Depending on your work setting, you may face many challenges getting your resident on the appropriate support surface. Do you know that experts recommend any patient at risk for skin breakdown should put on a therapeutic redistribution surface, not a regular hospital-type mattress? Are your patients able to get therapeutic mattresses in your setting when their skin is intact and they are only at risk for breakdown? What types of mattresses are available in your healthcare setting?  Does cost play a part in the type of support surface your patients get?

DISCLAIMER: All clinical recommendations are intended to assist with determining the appropriate wound therapy for the patient. Responsibility for final decisions and actions related to care of specific patients shall remain the obligation of the institution, its staff, and the patients’ attending physicians. Nothing in this information shall be deemed to constitute the providing of medical care or the diagnosis of any medical condition. Individuals should contact their healthcare providers for medical-related information.

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