Hospital mattress research helps find effective way to reduce bedsores

Glasgow Caledonian University's School of Health and Life Sciences Dean, Professor Andrea Nelson, has been involved in a major study which found that mattresses costing the NHS £1,000 were "only marginally better" at preventing pressure ulcers than cheaper foam beds.

She has been working with nurse researchers at the University of Leeds on a scientific trial to investigate the benefits of high-tech mattresses, commissioned by UK Government health regulator, the National Institute of Health and Care Excellence.

The research paper entitled ‘Pressure relieving support surfaces for pressure ulcer prevention: clinical and health economic results of a randomised controlled trials’ has just been published in the journal EClinicalMedicine, which is published by The Lancet.

Known as an alternating-pressure mattress, the high-tech devices contain air pockets that inflate and deflate to constantly change pressure points on the skin.

In comparison, a specialist foam mattress is around £200 and is made up of high-quality polyurethane and viscoelastic foam designed to cradle the patient to reduce pressure on the skin.

Professor Nelson said: “This study, the largest one worldwide, shows that we can make a fair test of the two of the main types of mattresses, a specialised foam mattress or an air bed with a pump that varies the pressure on the skin.

“Previous work has shown that the air pressure mattresses are uncomfortable for some patients.

“This new research means that nurses can make their decision about which mattress to use with the benefit of the most reliable evidence about what works.”

The specialist foam mattresses are widely used across the NHS while the air mattresses are used on approximately 10 per cent of NHS hospital beds and are given to patients considered to be at high risk of developing pressure ulcers.

Researchers found 6.9 per cent of patients on the high-tech air mattresses developed a pressure sore that was grade two – a blister or break in the skin – or worse compared with 8.9 per cent on the specialist foam mattress.

Jane Nixon, Professor of Tissue Viability and Clinical Trials at the University of Leeds, who led the study, said: “The outcome of this study provides the evidence that specialist foam mattresses are appropriate for most patients who are at high risk of developing pressure ulcers.

“But staff should be free to exercise clinical discretion in provision of either mattress, informed by patient preference, comfort or rehabilitation needs, as well as specific risk factors such as being completely immobile, being confused, having nutritional deficits or early signs of pressure damage.”

The research paper is available to view online here - https://doi.org/10.1016/j.eclinm.2019.07.018