Authors
- Thompson, Patricia A. MS, RN
Article Content
Defloor T, De Schuijmer, JDS. Preventing pressure ulcers: an evaluation of four operating-table mattresses. Applied Nursing Research 2000;13:134-41
ABSTRACT
Pressure is a major factor in the development of pressure ulcers. This research focused on assessing the pressure-reducing effects of operating-table mattresses. Five mattresses were tested: a standard operating-table mattress, a foam mattress, a gel mattress, a visco-elastic polyether mattress, and a visco-elastic polyurethane mattress. Four intraoperative postures were evaluated: supine, lateral, fossa, and the Miles-Pauchet position. Interface pressure measurements were performed on 36 healthy volunteers. The foam mattress and the gel mattress seem to have little or no pressure-reducing effect; the polyurethane mattress and the polyether mattress reduce interface pressure significantly better (p <.001), but none of the mattresses reduce pressure sufficiently to prevent the occurrence of pressure ulcers.
COMMENTS
Many factors contribute to pressure ulcer (PU) formation during surgery, including the patient's age, weight, presence of vascular disease, type of surgery, and amount of time spent on the operating table. In this study, 5 types of mattress products were used on 36 healthy volunteers in 4 potential surgical positions to examine the pressure-reducing effects of these products. According to the results of this study, PUs may be reduced, but not eliminated, by using pressure-relieving mattresses in the operating room. The visco-elastic polyether and polyurethane mattresses were found to have lower interface pressures and may be the preferable mattresses for use in surgery that lasts longer than 2 hours. Gel and foam mattresses were not found to be effective in relieving pressure, yet they are often used in practice. Interface pressures remained highest throughout the testing of all mattresses in the lateral position. The supine, fossa, and the Miles-Pauchet positions did not show a significant decrease in pressure. It is important to know the patient's position during surgery, the areas of high interface pressures that occurred during surgery, and the type of mattress utilized to allow for careful inspection of PU development postoperatively. Future controlled clinical trials should be conducted to assess the role of pressure-relieving devices, positioning, and assessment of the surgical patient during surgery and postoperatively.
-Patricia A. Thompson, MS, RN
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