Decubital prophylaxis

Different positioning methods in comparison


To beginn with, there is no ready-made anti-decubitus mattress or anti-decubitus pad which always fits. Patients and conditions are too different for that. The following shall describe some of the common care-aids with their advantages and disadvantages. Please do not misunderstand the assessment: this is not about maligning competitors´ products or ideas. Rather we try to ascertain advantages and disadvantages without bias. Based on physics, biology and common sense.
 


Solid pad
 

 
+ facilitates remaining mobility
+ generally orthopedically favourable in mobile people
 
- poor pressure distribution
- high punctual pressure, risk in immobile patients
 

 
The solid mattress is usually ideal for normally mobile people in the supine position, since the spine is stretched while lying, and thus the inside areas of the intervertebral discs are relieved. It is these areas that are under particular stress while standing and sitting during the day. When the relatively high punctual pressure becomes uncomfortable, the sleeping person usually changes position without waking up.
People who are not able to change the lying position sufficiently or who do not feel the pressure, are especially at risk to develope bed sores.


Soft pad
 

 
+ better pressure distribution
 
 
- remaining mobility is constricted
 
 

 
The resting pressure is distributed over a larger area and the punctual pressure is reduced.
By sinking deeper in, the remaining mobility is constricted and each position change is more difficult. Especially creases are more likely to form, which might exert pressure on the skin and increase the risk for developing decubital ulcers. In very soft systems, a correct perception of the position is often not possible.


Convoluted foam mattress
 

 
+ good punctual pressure distribution
 
 
- approx. 30% less resting area. Therefore approx. 50% higher resting pressure
- shearing forces
 

 
 


Small surface pad
 

 
 
- be it gel pad, foam or any other material: the resting pressure is always increased
 

 
 


Other systems
 

  • 5 - pillow positioning
    Well adjustable, also for patients with contractures. A really good pressure relief by distribution is possible, but depends on the skills of the health care worker.
    This system of positioning is certainly costly in care and time, becaus after every activity at the patient the individual adaption is necessary. Formation of creases and accumulation of heat is possible.
     
  • Alternating pressure mattress
    Body regions are stressed and relieved in intervals. Anyhow the regularly relocation of the patients is mandatory. Temporarily high pressure on small area. If the inner vessel pressure is very low, the compressed vessels might not fill even after pressure relief and become necrotic. Some systems may cause sleeping trouble in patients due to the pressure alternation intervals or the generated noise. In addition to this the costs for investment, maintenance and possibly them for adjusting to the current technological standard after some time, are very high.

     
  • Moisture barrier pads
    Since the anti-decubitus mattresses and systems are often expensive, they should last long and be kept clean. Therefore, more often than not protective pads are used, which do not allow the skin to breathe or sweat to evaporate.
 

 

The LIGASANO®-Positioning

 
Feel where the patient´s weight does not rest fully on the bed.
 
Fold the bed sheet back on the edge, so that you can apply plaster strips as marks directly on the mattress.

Mark the positions on the mattress that you would like to underpad.
Cut fitting pads
 
and place them on the marked positions.
Cover with the normal bed sheet
and the patient may return to bed.
1 cm LIGASANO® (white) directly in contact with the skin reduces formation of creases, improves blood flow and regulates skin moisture.  

You only need to do this positioning once; the pads always remain on the bed, directly on the mattress. Optimally you cover the mattress with the applied LIGASANO® pads with an elastic bed sheet. This elastic bed sheet and the pads are now an integral part of the mattress.


The objective is that the patient distributes his resting pressure evenly (pressure relief by pressure distribution). Your flat hand under the patient´s body is a very sensible measuring instrument.

 
 
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