Support surface
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Support surface is a medical term used to describe materials such as mattresses that support people who are bed-ridden through illness. Research and development of appropriate support surfaces can alleviate some of the complications of immobility, such as bedsores and respiratory problems.
The National Pressure Ulcer Advisory Panel's (NPUAP) Support Surface Standards Initiative (S3I) has released the first public draft of its Terms and Definitions Document. This set of definitions is provided in an attempt to redefine commonly used and confused terms. The terms describe support surface features, components, categories, and performance characteristics.
The Terms and Definitions Document and an evaluation form can be found at:
Contents |
[edit] Problems of immobility
As long as people have been bed-ridden through illness, they have fallen victim to the complications of immobility. These can include, but are not limited to:
- Disorders of the skin and underlying tissue.
- Pneumonia and other related respiratory illnesses.
- Disorders of the renal and gastrointestinal systems.
- Disruption in the cognitive systems resulting in neuro-psychological disorders.
Critically ill patients, unable to move spontaneously, are nursed in the supine position for extended periods of time. This is in striking contrast to normal human beings who, even during sleep, change their position approximately every 11.6 min–a phenomenon described by Keane as "minimum physiological mobility requirement." The deleterious effects of prolonged immobilization affect the heart, vascular system, musculoskeletal system, skin, and kidneys, despite the usual nursing practice of repositioning every two hours.
[edit] Traditional methods of dealing with immobility
The traditional method of dealing with immobility is to turn the patient at least every two hours, following a side-back-side protocol. Through the years, many mechanical systems have been improvised to prevent these complications of immobility:
- Sheepskin laid on top of the patient's mattress.
- Foam mattresses and overlays.
- Non-powered and powered air mattresses
[edit] Support surface therapy
Some of the first attempts to turn patients through mechanical means were crude and had a tendency to complicate the patient's condition if not used correctly.
Although there are now many different designs and constructions of support surfaces, no particular one can be said to effective in all cases.
The major goal of support surface therapy, is to reduce the interface skin pressure by spreading pressure across a greater skin surface area. This results in lower overall skin interface pressure at the bony prominences, where most ulcers occur. This should occur concurrently with the reduction in skin shear or tearing, and reduced friction. Moisture is addressed by the use of high-tech fabrics that wick moisture vapor away from the skin. This is generally termed, "low-air-loss therapy."
[edit] National authorities
In the United States, the recognized national authority on treatment guidelines, for pressure ulcers, including support surfaces, is the National Pressure Ulcer Advisory Panel (NPUAP), a multidisciplinary organization founded in 1987. The NPUAP supports "improved patient outcomes in pressure ulcer prevention and management through Education, Public Policy, & Research. "
[edit] References
- ↑ Suhail Raoof , MD, FCCP; Naseer Chowdhrey , MD; Sabiha Raoof , MD; Martin Feuerman , MS; Alan King; Rajesh Sriraman , MD and Faroque A. Khan , MBBS. Effect of Combined Kinetic Therapy and Percussion Therapy on the Resolution of Atelectasis in Critically Ill Patients, FCCP (Chest. 1999;115:1658-1666.)
- ↑ Brienza, David M. PhD; Geyer, Mary Jo PhD, PT, CWS, CLT-LANA. Using Support Surfaces to Manage Tissue Integrity. Advances in Skin & Wound Care. 18(3):151-157, April 2005
- ↑ Brienza, DM; Geyer, MJ. Understanding Support Surface Technology. Advances in Skin and Wound Care. 2000; 13(5):237-44.
