Guidelines for Selecting a Pressure Reduction Mattress


By Russell C. Hauptman, Tender Care Products
rchauptman@aol.com

Foam mattresses have become very popular because of the comfort, support, and the protection they provide. But when it is time to replace your facility's mattresses you will encounter a dizzying array of choices. The following is a short guide to assist you in selecting the features needed in a pressure reduction mattress for your facility.

The most important factor to consider in mattress selection will be the foam grade or density. This aspect, more than any other, will directly affect the therapeutic outcome and lifespan of your mattress selection.

Understanding Density
Density simply refers to the actual weight of 1 cubic foot of any particular foam. For example, foam with a density of 2.3lb has a 0.8lb difference per cubic foot when compared to a mattress made with a foam density of 1.5lb. When translated over the entire mattress, it becomes clear that you are purchasing 8 pounds more foam in a mattress made of 2.3 density foam than a mattress made of 1.5 density foam. There is another aspect of foam to consider: the higher the density, the thicker the cell walls will be. This means that higher density foam can be made softer, and still retain its pressure reduction characteristics much longer than less dense foams. When selecting a foam mattress, be sure to select one with the density required for optimal support and comfort.

Foam Matters
Foam is also graded on its firmness, referred to as ILD (indentation load deflection). There is no correlation between density and ILD. ILD refers to the chemicals that are added to the mixture during the foaming process that determines how firm the foam will be. Use of this additive helps foam with lower densities to hold up over time, but the process reduces the ability of the foam to conform to the body. This will also increase the interface pressures of the mattress. In order to enhance the performance of less dense higher ILD foam, modifications to the foam are made usually by adding grooves, channels, cuts, slopes and layers. When selecting a foam mattress, it helps to understand that a mattress with a lower density foam and higher ILD will cost less than a high-density foam mattress. With appropriate cuts and sculpting, the lower density type of mattress may serve you well, just not for as long. Be sure to monitor the performance of the mattress as the years pass to ensure it maintains its effectiveness.

Do Some Homework
To measure your results, you should keep accurate records of the specifications (e.g. density, ILD, design) of the mattresses you purchase. In addition, record information about the patients that were served, such as their body weight, overall nutritional status, skin condition, etc. Knowing these patient details and relating their physical conditions to the mattress characteristics will help you make better choices when it is time to replace your mattresses again.

Cover It
Once you have determined the type of foam you will need, you should decide how to cover it. Mattress covers are available in a wide array of fabrics. Moisture absorbing fabrics require more care and are not recommended for incontinent patients.

Urethane fabrics are available in either 2-way or 4-way stretch and are the most costly of the options. A urethane fabric will be more conforming to the body and often be referred to as "low friction". Remember that the conformity of the fabric will be reduced if you are using a sheet over the cover.

Nylon covers are exceptionally durable and the most frequently used type of cover for health care mattresses. Nylon comes primarily in two thread counts, 70-denier and 200-denier (threads going in each direction 100 + 100 =200). A 200-denier material will be slightly heavier thus lasting much longer, but only minimally diminishes the pressure reducing characteristics of the mattress. Nylon simply wipes clean with the cleanser of your choice.

Vinyl is the cheapest and least used due to the inability to conform. In addition, vinyl tends to breakdown or crack over time with the constant use of some cleaning agents. Vinyl is mainly used on bottom surfaces for protection against sharp objects.

Butyl backed products allow for zero moisture penetration, but also eliminate any vapor transmission which increases the incidence of moisture build up on the body.

Special Features
Many new mattress designs include special features and special protections. It helps to do some research, as well as ask questions prior to your selection. It is also important to review all of the available information about the special features prior to selection. Here are some sample questions:
1) If the special features are meant to reduce shear, how will that happen with a sheet covering the mattress?
2) If the features and cover are meant to conform, how well will they conform with a sheet?
3) When using a non-stretch cover, will the cover and sheet reduce the effectiveness?
4) How will the use of an underpad inhibit the effectiveness to reduce pressures?
5) Were the mattress and its features evaluated against a competitor‚s mattress under the same patient conditions?
6) Are there any studies available?
7) How much time/money was spent on research?

Ideally, the best pressure reduction mattress is the one that has the best features and benefits to assist your staff in protecting your patients. This could be best found with an actual trial at your own facility, under your own particular conditions.

Tender Care Products specializes in pressure reduction mattress manufacturing, positioning aids, wheelchair cushions, and fall prevention products. New designs have been added to address some special pressure reduction problems including products for bariatrics, back pain and for diabetic patients with special heel and foot protection.