Comparing the effects of 3 different pressure ulcer prevention support surfaces on the structure and function of heel and sacral skin: An exploratory cross-over trial

Abstract

Special support surfaces are key in pressure ulcer prevention. The aim of this study was to measure the effects of 3 different types of mattresses (reactive gel, active alternating air, basic foam) on skin properties of the sacral and heel skin after 2 hours loading. Fifteen healthy females (median age 66 years) were included. Transepidermal water loss, skin surface temperature, erythema, stratum corneum hydration, epidermal hydration, skin extensibility, elastic function, and recovery as well as skin roughness parameters were measured under controlled room conditions before loading, immediately after loading, and 20 minutes post-loading in the supine position on the different mattresses. The highest increases in transepidermal water loss, skin temperature, and erythema were observed for the foam mattress after loading, indicating higher deformation and occlusion. Cutaneous stiffness decreased in all 3 groups, indicating structural changes during loading. There was a substantial decrease of mean roughness at the heel skin in the foam group, leading to a flattening of the skin surface. Study results indicate that the type of support surface influences skin structure and function during loading. The gel and air mattress appeared to be more protective compared with the foam mattress, but the differences between the gel and air were minor.

Keywords: microclimate; pressure ulcer; stratum corneum hydration; support surfaces; transepidermal water loss.

Conflict of interest statement

All authors declare that they have no conflicts of interest.

© 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Figures

Figure 1

Visioscan images at heel skin per intervention and time point for 1 subject. This figure shows skin surface images of the right lateral heel skin taken with a Visioscan VC 98 camera before loading (baseline), after 2 hours loading, and 20 minutes after off‐loading per 3 different support surfaces (air, gel and standard foam)

Figure 2

Visioscan images at sacral skin per intervention and time point for 1 subject. This figure shows skin surface images of the sacral skin taken with Visioscan VC 98 camera before loading (baseline), after 2 hours loading, and 20 minutes after off‐loading per 3 different support surfaces (air, gel, and standard foam)