G 0` D+ 0 @@@ @@@@$pP ! EN DB yC7,>U{;qz\\((`vv ;MRR|a;h!.. !"""~'p.218;<?CHHJNsRTLZ[]\cgiZ  #Ql !!$p*2x1177777==?CCEEGGGHMNPQSSSTTZ[[^````````oce Bours2001%r Cullum2001h Garfin19803\ Hoffman1996n Laurent1999I] Murray1993f Ryan19933q Suzuki19999are units of a tertiary care facility  36-42sxqA retrospective chart audit of 55 patients placed on specialty beds in the medical and surgical intensive care units of a tertiary care hospital during 1989 was performed to establish criteria for placement on specialty beds. A modified Knoll Assessment of Pressure Ulcer Potential tool was used to determine S Suzuki19999Svensson19849jSvensson1988 Swain1988 Swain1990 Swain1990k Swain1992  Swain1992 Swain1992 Swain1992 Swain1993 Swain1994 Swain1994 Swain1995= Swain1995 Swain1997 Swain1998l Swope1994m Sylvia1993n Symm1987 Tafari1994> Taggart1992o Takiguchi1992p Takiguchi1995 Talati19971q Tallon1996r Tallon1996s Tamura1990 Tappin1980t Tarpey20009 Tayback1998G Taylor19844u Taylor1989v Taylor1999o Taylor2000 Teasley20021 Tempur-MedM Teodorescu1999lw Tetlow1997x Thayer1991y Thier1979 Thomas19717z Thomas1989J Thomas1993K Thomas1993L Thomas1993 Thomas19969{ Thomas1998| Thomas Hess1992}Thomason1993{Thompson1979Thompson1987Thompson1995~Thompson-Bishop1992 Thomson1980 Thomson19809 Thorne1992 Thornhill1968i Timar Banu2001lj Timar-Banu2001l Timmes1975 Timsit1991 Timsit1991 Todd19888s Togawa19909 Tooke1988k Topliss2001Z Tordecilla1993P Torii1998Torrance1981Tourtual1997i Tousignant2001lj Tousignant2001l, Towers19677UTownsend1987 Tracey1970W Trainer1988 Trainor1979 Trainor1981 Trainor1984 Trandel1975' Transmission.1995 Trout1994s Tsuji19909 Tsuji1998b Tsuru1997 Tuggle19909) Tunell1989* Tunell1989+ Tunell1993 Turnock1983 Tweed2001 Tweed2001 Twomey19877 Tymec1997l Tymec1997 Ulcers1992 Utter1999i Vachon20010j Vachon20010 Valdez1990* Valenta1995Valentin1977 Van Marum1993 van Marum1997m van Marum2002 Van Meter1997$ van Rijswijk19941l van Rijswijk1995* Van Tatenhove1995) VanLeeuwen1996 Verhonick1972 Verhonick1975 Vesley1986i Viau20010j Viau20010W Vibulsresth1987= Vimeux1998lM Vistnes1973z Vistnes1975 Vistnes1980 Vistnes1984 Volker1999 Vollman1997l Vollman1997 Vowell19959Vyhlidal1997 Wagner1991e Wahid2000 Walker1987 Walker19933* Walker1995v Walker2001 Wallace1982 Walsh1988 Walsh1990 Walsh1990Walthall19888 Wang19944{ Wang2000an Wang2000o Warner1992 Warnock1995 Warren1999 Warren20000 Wasserman1988Waterlow1996 Waters19898 Watkins1977 Watret1999 Watson1982 Watt19944$ Watts1986  Waxman1980E Weaver1990 Weaver1994 Weaver1998@ Webb1969bk Webb20010- Weber1997 Webster1993Wedgwood19822 Weinstein1973 Weiss1992 Welch1987C Welch1987 Welch1989 Welch1990 Welch1992 Wells1984 Wells1998- Wenzel19979_ Wharton1976Wheatley1981 White1981 White1982 White1997 White1999 White2002 Whitney1984p Whittemore1993l Whittemore19982 Whittington1968qWiesemes19939 Wilber19991 Wild1991H Wilke1995* Wille1994 Willey1989Williams19688Williams1979fWilliams1985Williams1988Williams1993DWilliams1993kWilliams1994VWilliams19955Williams1995Williams1997Williams1998Williams1998Williams2000Williams-Marburger1988 Willis1995 Willis1996 Willis1996 Willy1999 Wilson1974 Wilson1976 Winet1996 Winkler1984 Winman1992 Winn1969 Winner1966 Winslow1994 Winters1990 Winwright1996+ Wirta1990 Wirtz1987. Wisnia19989\Witherow1999 Witko1998 Witkoswski1975 Witkowski1980E Wittman1989WOCN Wolf1995z Wolkenstein1991 Wolsley2000Woollons1998 Woolsey1991G Wright19733 Wroblewski1994} Wurzel19939r Wyss1989n Wyss1990n Wytch1989Xakellis1991Xakellis1992Xakellis1993Xakellis1993Xakellis1995n Xue2000bYamamoto1997P Yang1984 Yarbrough2000S Yasui1999L Yeston19949 Yoder1999 Yoshida1997 Young1971 Young1990 Young1997 Young1998 Young1998Young-McCaughan1999 Yu19944p Yu19959n Yuan20000 Zegers19949e Zelizkova1983 Zernike1997 Zetterqvist1984 Zhang1993= Zhao1998e Zink19911 Zoller20022 Zoller20022 Zoller20022 Zoller20022 Zoller20022 Zoller20022 Utter1999 Valdez1990* Valenta1995Valentin1977 Van Marum1993 Van Meter1997$ van Rijswijk19941l van Rijswijk1995* Van Tatenhove1995) VanLeeuwen1996 Verhonick1972 Vesley1986W Vibulsresth1987M Vistnes1973z Vistnes1975 Vistnes1980 Vistnes1984 Vollman1997 Vowell19959Vyhlidal1997 Wagner1991e Wahid2000 Walker1987 Walker19933* Walker1995v Walker2001 Wallace1982 Walsh1988 Walsh1990 Walsh1990Walthall19888{ Wang2000a Warner1992 Warnock1995 Warren1999 Warren20000 Wasserman1988Waterlow1996 Watkins1977 Watret1999 Watson1982 Watt19944$ Watts1986  Waxman1980E Weaver1990 Weaver1994 Weaver1998@ Webb1969b& Webb20010- Weber1997 Webster1993Wedgwood19822 Weinstein1973 Weiss1992 Welch1989 Welch1990 Welch1992 Wells1984 Wells1998- Wenzel19979_ Wharton1976Wheatley1981 White1981 White1982 White1997 White1999 Whitney1984 Whittemore1993 Whittemore1998 Wilber19991 Wild1991* Wille1994 Willey1989Williams19688Williams1979fWilliams1985Williams1988kWilliams1994VWilliams19955Williams1995Williams1997Williams1998Williams1998Williams2000 Willis1995 Willis1996 Willis1996 Wilson1974 Wilson1976 Winet1996 Winkler1984 Winman1992 Winn1969 Winner1966 Winslow1994 Winters1990 Winwright1996 Wirtz1987\Witherow1999 Witko1998 Witkoswski1975 Witkowski1980E Wittman1989 Wolf1995z Wolkenstein1991 Wolsley2000Woollons1998 Woolsey1991G Wright19733} Wurzel19939Xakellis1992Xakellis1993Xakellis1993Xakellis1995 Yang1984 Yarbrough2000S Yasui1999L Yeston19949 Yoder1999 Yoshida1997 Young1971 Young1990 Young1997 Young1998 Young1998Young-McCaughan1999 Yu19944p Yu19959 Zegers19949e Zelizkova1983 Zernike1997 Zhang1993 Zink19911 Zoller20022er20022 t z uv!" #$~&'(p)*+-./02x1456879:;w<=?@ABCEDFGHJKMNOsPQRS|TVWXLZYr[]\^_`abocdeghjiklqmn Authors1Journals-Keywords   tt zz uuuuuvvv!!""""" ###$$$$$$&''''''((((((ppp)))*******+++++4321x0. J.LFPressure ulcers. Physical, supportive, and local aspects of management 1991Clin P3319927m244i 1987$Ergonomic aspects of equipment 331-7 ^XMechanical patient-lifting devices have been available for hospital use for at least the past 100 yr. Mobile hoists have been available since the 1950s and the most common U.K. hospital mobile hoist, the Mecanaids' Ambulift, has been available since 1966. Recent investigations have confirmed that these devices are not being used to any significant extent to ease most of the patient-lifting problems in hospital wards. Attention to four variables, the patient, the attendant, the task and the environment, is essential in determining the right systematic approach to equipment design and selection.'JDDepartment of Physiotherapy, Queen Margaret College, Edinburgh, U.K.Bell, F.2,0020-7489 Historical Article Journal ArticleInt J Nurs StudnBaths Beds Biomechanics *Equipment and Supplies, Hospital Great Britain History of Medicine, 19th Cent. History of Medicine, 20th Cent. Human *Human Engineering Nursing Care Support, Non-U.S. Gov't Toilet Facilitiesojdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=33199271388625t386v 1992Jul-Aug/4-Cost-effective technology for pressure reliefr6eBell, G.0889-5899 Comment LetterOstomy Wound ManagehTNBeds/*standards Decubitus Ulcer/*prevention & control Human *Physics *Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=13886258110886D205m 1993Sep-Octv\UResults of a clinical investigation of four pressure-reduction replacement mattresses 204-10Pressure ulcer prevention and treatment are major issues in health care, with new products flooding the market constantly. This article presents the results of a clinical investigation of four pressure-reducing mattresses and a foam overlay used in five different nursing units (neurology, oncology, respiratory, medical/surgical intensive care, and cardiovascular surgery). A total of 246 patients were evaluated on the trial mattresses and 46 were evaluated on the foam overlay."Bell, J. C. Matthews, S. D.  1055-3045 Journal Articlep J ET Nurs1Beds/economics/*standards Clinical Nursing Research Cost-Benefit Analysis Decubitus Ulcer/epidemiology/nursing/*prevention & control Human Risk Factors jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=811088610655862456  1999 Junv@9Spinal cord injury, pressure ulcers, and support surfacesp 48-50, 52-3  Bell, G. B.e810889-5899 Journal Article Review Review, TutorialBOstomy Wound Manage*Beds/supply & distribution Decubitus Ulcer/*etiology/*prevention & control Human Spinal Cord Injuries/*complications Transportation of Patients/methodslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10655862t1408907 8839 1992 Sep 23-29*$Pressure relief--supporting evidence 64, 66 Benbow, M. 0954-7762 Journal Articley Nurs TimestnBedding and Linens/*standards Beds/*standards Decubitus Ulcer/*prevention & control Human Purchasing, Hospitaljdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1408907vut11111609902 2000 MarfhaEvaluating support surfaces for patients in transit through the accident and emergency departmento 189-98Little attention has been given to pressure area care for patients admitted via the accident and emergency department (A & E) in UK hospitals, despite evidence that they may wait for considerable periods on hard surfaces, placing them at risk of tissue damage. The literature was searched, and in the absence of existing guidelines to evaluate the suitability of the standard hospital trolley for use with emergency admission patients, criteria were developed by consensus among stakeholders with relevant expertise who were employed in an acute NHS hospital trust. Audit of the existing patient support surfaces using these criteria revealed deficiencies in all of them. Some of the problems identified were related to deterioration of the equipment; others were related to its design. The criteria were used to inform the purchase of new equipment, and a system of auditing to improve pressure area care for emergency admission patients has been established in the trust. The initiative has also drawn attention to significant omissions in the literature relating to pressure area care, including the need to evaluate patient comfort and inclusion of consumer views.'<5Faculty of Health, South Bank University, London, UK.:3Tarpey, A. Gould, D. Fox, C. Davies, P. Cocking, M.2,0962-1067 Evaluation Studies Journal Article J Clin NursRKAcute Disease Aged Beds/*standards/supply & distribution Decubitus Ulcer/nursing/*prevention & control Emergency Nursing/methods Emergency Treatment/*instrumentation/*nursing Female Great Britain Guideline Adherence Human Male Middle Age Nursing Audit Practice Guidelines Support, Non-U.S. Gov't Transportation of Patients/*methodsNlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11111609n2723237y1631 1989May-Junp>8Use of a pressure-reducing cushion in a neonatal setting 137-8nTaylor, K. J. Dalbec, S. 0270-1170 Journal Article9J Enterostomal Therpj*Beds Decubitus Ulcer/*prevention & control Human Infant, Newborn *Intensive Care Units, Neonatal Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2723237106702928.12 1999 Jun 24-Jul 7@9Evaluating the Pegasus Trinova: a data hierarchy approache 771-4, 776-8Understanding the efficacy of patient support surfaces is essential if pressure sore management is to be both efficient and effective. However, laboratory and clinical studies in this area are fraught with well recognized problems. This investigation reports a combination of laboratory, randomized controlled trial (efficacy data) and measures of effectiveness to illustrate the beneficial role of a new dynamic integrated mattress and seat cushion system: the Pegasus Trinova. Successful prevention of sores among a vulnerable patient population, along with positive comments regarding the system's comfort and 'user-friendliness' are supported by laboratory measures of interface pressure to provide a hierarchy of data. Such an approach may present one solution to the lack of timeliness of most mattress clinical trials, thus allowing decisions regarding new support surfaces to be made upon the basis of evidence, not on anecdote or solely upon marketing claims.'&Portsmouth Hospitals NHS Trust.a Taylor, L.JD0966-0461 Clinical Trial Journal Article Randomized Controlled Trial Br J Nurs Beds/*standards *Data Interpretation, Statistical Decubitus Ulcer/*prevention & control Equipment Design Evaluation Studies Female Human Male Pressure Research Design/*standardsslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10670292e+*)r9306782i104n 1997Jul-Augt60Fourth national pressure ulcer prevalence survey 18-26od^The fourth national pressure ulcer prevalence survey was conducted on November 9, 1995, with stuff at 265 acute-care hospitals surveying 39,874 patients for the presence of pressure ulcers. Data were collected on patient demographics, ulcer site, ulcer stage, and support surface. The goal was to determine the aggregate prevalence of pressure ulcers and to compare the results to those of the previous three surveys. The overall prevalence was 10.1% (range 1.4% to 36.4%), with the sacrum and heels the most common pressure ulcer sites. The predominant age group of patients with pressure ulcers was 71 to 80 years. Seventy-four percent of pressure ulcers were superficial (i.e., Stages I and II). The national pressure ulcer prevalence has remained relatively constant throughout the four surveys, despite the many changes in health care over the past 7 years.@9Barczak, C. A. Barnett, R. I. Childs, E. J. Bosley, L. M.n 1076-2191 Journal ArticleeAdv Wound Care Adolescence Adult Age Distribution Aged Aged, 80 and over Beds Child Child, Preschool Decubitus Ulcer/*epidemiology/prevention & control Health Surveys Human Infant Infant, Newborn Middle Age Population Surveillance Prevalence Risk Factors United States/epidemiologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=93067828704836.226i 1995 Nov7LESelection of a standard hospital mattress: data-based decision makinge 267-70By means of a scientific method, standard hospital mattresses were evaluated for pressure-relieving properties and patient comfort. Vendors' written materials and product demonstrations led to the initial selection of seven mattresses. On the basis of findings from a survey of staff nurses and environmental services and pressure readings obtained with three healthy volunteers, three mattresses were selected for intensive evaluation. Eighteen mattresses (six of each type) were placed in six clinical care units; at 2-week intervals, interface pressure readings (occipital, sacral, and heel) were performed on patients by means of a computerized measurement system. Caregiver and patient questionnaires (n = 100) were analyzed for clinical significance and patients' responses. We conclude that there are no significant differences among the three mattresses tested in pressure-reducing capabilities, nursing functions, or patient comfort.XQBarhyte, D. Y. McCance, L. Valenta, A. Van Tatenhove, J. Walker, M. S. Bethea, S.HB1071-5754 Clinical Trial Controlled Clinical Trial Journal Article$J Wound Ostomy Continence NursBeds/*standards/supply & distribution *Decision Making Decubitus Ulcer/*nursing Human Pressure Purchasing, Hospital Questionnaires *Signal Processing, Computer-Assistedjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=87048363633272131b 1986Jan-Febc^XAir-fluidized therapy as a cost-effective treatment for a "worst case" pressure necrosis 27-9 Barnes, S. Rutland, B. S.V 0270-1170 Journal ArticlesJ Enterostomal Ther |v*Beds Case Report Community Health Nursing Decubitus Ulcer/*nursing Human Male Middle Age Necrosis Paraplegia/*nursingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3633272ional to the loading pressure. The repeatability for a given system was approximately constant. The mean error (+/- SD) (%) and repeatability (kPa) for the systems were: 28 mm Talley 12 +/- 1%, +/- 0.07 kPa; 100 mm Talley 15 +/- 1%, +/- 0.07 kPa; DIPE 27 +/- 3%, +/- 0.12 kPa; 0.1 ml water bladder 17 +/- 1%, +/- 0.13 kPa; 0.3 ml water bladder 26 +/- 3%, +/- 0.07 kPa. Different interfaces affected accuracy markedly, and repeatability was affected when an inhomogeneous interface was used. The study shows that the errors associated with interface pressure measurement systems can be substantial, and can vary from one system to another.'VORegional Medical Physics Department, Freeman Hospital, Newcastle-upon-Tyne, UK.o0*Allen, V. Ryan, D. W. Lomax, N. Murray, A. 0141-5425 Journal Article  J Biomed Eng`Y*Beds Calibration Pressure Reproducibility of Results Support, Non-U.S. Gov't Transducersljdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8361161 L08361158c154r 1993 JulrB8Beds Decubitus Ulcer/*nursing/prevention & control Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3658716/www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=61926364100413r1p 7696 1971 Feb 27 Hospital beds  442-5b Andrews, J.d 0140-6736 Journal ArticleI Lancet *Beds jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4100413 67893324 6135 1978 Aug 12:4Selecting equipment for elderly patients in hospital 484-6uAndrews, J. Atkinson, L. 0007-1447 Journal Article1Br Med Jxq*Aged Beds Decision Making *Equipment and Supplies, Hospital Great Britain Human Patient Admission Rehabilitation-jchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=678933s3254240t1e4u 1988 Novl`YThe prevention and treatment of pressure sores by use of pressure distributing mattresseso 14-21eAndrews, J. Balai, R. 0898-1655 Journal ArticleT DecubitusPAged Beds/*standards Decubitus Ulcer/diagnosis/*prevention & control/therapy Evaluation Studies Female Human Male Pressure Prospective Studies Wound Healingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=32542409814339s174a 1998Jul-Aug JCPressure ulcers: causes, risk factors, assessment, and interventione65-81; quiz 82-3Pressure ulcers are an extensive and expensive patient care issue. Knowledge of the underlying causes of and risk factors for pressure ulcer development allows the nurse to implement actions to prevent and/or effectively treat pressure ulcers. Familiarity with assessment and interventions, including appropriate dressing selection, allows the nurse to promote positive outcomes for patients at risk for and/or experiencing pressure ulcers. This article reviews the anatomy of the skin and discusses underlying causes and risk factors for pressure ulcer development. This article also explains the importance of patient assessment, including wound measurement, and presents appropriate interventions for pressure ulcer prevention and treatment.'6/Community Hospitals Indianapolis, Indiana, USA.fAndrychuk, M. A.810744-6020 Journal Article Review Review, Tutorialh Orthop Nursr Bandages Beds Debridement Decubitus Ulcer/*etiology/*nursing/physiopathology/prevention & control Human Nursing Assessment/methods Nutritional Status Orthopedic Nursing/methods Patient Education Patient Selection Primary Prevention/methods Risk Factors Wound Healingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=98143393658716t8334 1987 Aug 26-Sep 1,%Pressure sores. Pointers to good care  27-302 Anthony, D.e 0954-7762 Journal Articlei Nurs Times>8Beds Decubitus Ulcer/*nursing/prevention & control Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3658716  $708i 3-4s 1991LEPressure ulcers: critical considerations in prevention and management0 209-22Pressure ulcer development is a serious problem occurring predomin9282045f437a 1997 Augh:4Effect of practice guidelines on therapeutic bed use34-8, 40Therapeutic beds, though clinically beneficial, can prove to be costly if their use is not directed. In this research utilization project, the use of therapeutic beds in five patient care units and one intensive care unit in a 300-bed acute care hospital were evaluated before and after the implementation of practice guidelines. Usage time and cost for each patient were measured and compared over the same four-month period in 1994 and 1995. Our findings indicated there were no significant differences between the two groups with regard to the time patients spent on therapeutic beds and the total cost of these beds. The mean time on the bed and the mean cost per patient were, however, lower for the practice guideline group. It was concluded that even without demonstrating significant differences, practice guidelines are a useful tool in providing a standard for nursing practice when caring for patients in the acute care setting.r'LEEducation Department, Cabell Huntington Hospital, West Virginia, USA.h& Altizer, G. Godbey, V. Davis, B. 0889-5899 Journal Article Ostomy Wound ManagesBeds/classification/economics/*standards/supply & distribution Female Human Male Nursing Evaluation Research Outcome and Process Assessment (Health Care) *Practice Guidelines Skin Ulcer/economics/*prevention & controlnjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9282045101491708i 3-4s 1991LEPressure ulcers: critical considerations in prevention and management0 209-22Pressure ulcer development is a serious problem occurring predominately among elderly persons, who are confined to bed or chair. Factors associated with pressure ulcer development include: cerebrovascular accident, impaired nutritional intake, fecal incontinence, lymphocytopenia and a high comorbidity score. Implementation of preventative measures, such as: in-depth assessment for mobility, a pressure relieving device combined with adequate repositioning, thorough evaluation for nutritional status and urinary incontinence, significantly reduce pressure ulcer incidence. If the pressure ulcer is a partial thickness (Stage II) wound, the causative factors are probably friction and/or moisture. If the ulcer is full thickness (Stage III, IV) it is secondary to pressure and/or shearing forces. The development of wound infection is the most common complication. Osteomyelitis is not an uncommon occurrence and must be initially ruled out in all full thickness pressure ulcers. Surgical debridement of necrotic tissue is necessary prior to further treatment and /or assessments. Cultures and antibiotic therapy are indicated only upon evidence of infection (erythema, edema, cellulitis, osteomyelitis, leukocytosis, bandemia or fever). Topical pharmacologic agents may be used to prevent or treat infection but must be carefully controlled to avoid such adverse effects as toxicity to the wound, allergic reaction and development of resistant pathogens. Proper use of occlusive dressings increase patient comfort, enhance healing, decrease the possibility of infection, save time and reduce costs. A patient presenting an ulcer which fails to improve, or due to its size will take a great deal of time to heal, should be evaluated for surgical closure.'B;University Wound Healing Clinic, New Brunswick, New Jersey.Alvarez, O. M.810267-6605 Journal Article Review Review, Tutorial Clin MaterAged Animal Beds *Decubitus Ulcer/diagnosis/etiology/pathology/prevention & control/therapy Human Occlusive Dressings Osteomyelitis/etiology Risk Factorsilehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10149170-er prevention. Skin oxygen tension measurement allows immediate assessment of the efficacy of measures to prevent decubitus ulcers.a.'Seiler, W. O. Allen, S. Stahelin, H. B.e 0002-8614 Journal ArticleeJ Am Geriatr SocAdolescence Adult Beds Decubitus Ulcer/*prevention & control Female Human Male Middle Age Oxygen/*analysis Partial Pressure Posture Sacrococcygeal Region Skin/*analysisjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6655181BhLF6989559174i 1980 Aprp"Management of pressure sores 229-44Antypas, P. G. 0011-3840 Journal Article-Curr Probl Surg0*Bedding and Linens Beds Debridement Decubitus Ulcer/etiology/prevention & control/*surgery Human Muscle Spasticity/etiology Nutrition Postoperative Care Postoperative Complications Preoperative Care Skin Transplantation Spinal Cord Injuries/*complications Surgical Flaps Transplantation, Homologousjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6989559105241111342 1999Jul 7-134.An evaluative approach to selecting mattresses 56, 58-634.Gillian Arblaster discusses the process undertaken by the Walsgrave Hospitals NHS Trust to evaluate dynamic pressure-relieving/reducing mattresses before deciding which type to rent or purchase. The study was undertaken over three years ago and, therefore, the products discussed in this article may have been superceded by newer ones. Structural and educational changes might also have taken place within the companies. John Timmons, a tissue viability nurse specialist at Monklands Hospital, Airdrie, evaluates the process and outcomes of this small study.'$Walsgrave Hospitals NHS Trust.Arblaster, G. M. 0029-6570 Journal Articlee Nurs StandBeds/*standards/supply & distribution Clinical Nursing Research Decubitus Ulcer/etiology/*nursing/*prevention & control Evaluation Studies Human Nursing Assessment/*methods *Patient Selectionalehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10524111r199854032 1991Jan-Febnd^Nursing QA and ET working together. A clinical evaluation of the Iris 10,000 Dry Flotation Pad 27-30oArnell, I. Holloman, F. 0889-5899 Journal ArticleOstomy Wound Manage Aged Aged, 80 and over Beds/*standards Case Report *Coronary Artery Bypass Decubitus Ulcer/*nursing/prevention & control Evaluation Studies Human Male Nurse Clinicians Postoperative Complications/*nursing/prevention & control Quality Assurance, Health Carejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19985401731820)5r1i 1992 JanA retrospective study of the use of specialty beds in the medical and surgical intensive care units of a tertiary care facility  36-42sxqA retrospective chart audit of 55 patients placed on specialty beds in the medical and surgical intensive care units of a tertiary care hospital during 1989 was performed to establish criteria for placement on specialty beds. A modified Knoll Assessment of Pressure Ulcer Potential tool was used to determine which risk factors were common among the patients. Mean total risk scores was 21.15 with a standard deviation of 4.74. Significant correlations were found between seven of the eight risk factors and the total risk score. A high total score on the modified Knoll tool indicates a need for placement on specialty beds.sAronovitch, S. A.U 0898-1655 Journal Articleg DecubituseAdolescence Adult Aged Aged, 80 and over *Beds Decubitus Ulcer/*diagnosis/prevention & control Female Human Intensive Care Units Male Middle Age *Nursing Assessment Retrospective Studies Risk Factors?jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17318208363715S3941 1993 May5VOThe use of an assessment tool in managing placement on pressure relief surfaces 18, 20-3, 26-8 passimpAronovitch, S. A. 0889-5899 Journal ArticleOstomy Wound ManagepAdolescence Adult Aged Aged, 80 and over *Beds Decubitus Ulcer/epidemiology/*nursing/*prevention & control Female Human Intensive Care Units Male Middle Age *Nursing Assessment Nursing Evaluation Research Risk Factorsrjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=83637159729956F113 Suppl 1998May-JunA comparative, randomized, controlled study to determine safety and efficacy of preventive pressure ulcer systems: preliminary analysisE 15-6'&Regents College, New York, USA.:Aronovitch, S. A. JD1076-2191 Clinical Trial Journal Article Randomized Controlled TrialAdv Wound CareAged Aged, 80 and over Beds/*standards Comparative Study Decubitus Ulcer/*prevention & control Female Human Intraoperative Complications/*prevention & control Male Middle Age Postoperative Complications/*prevention & controljdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=97299569729950u113 Suppl2 1998May-Jun5LEIntraoperatively acquired pressure ulcer prevalence: a national studya 8-9s'&Regents College, New York, USA. Aronovitch, S. A.8 1076-2191 Journal ArticletAdv Wound CareAdolescence Adult Aged Beds/adverse effects Decubitus Ulcer/epidemiology/*etiology Human Intraoperative Complications/epidemiology/*etiology Middle Age Operating Rooms Population Surveillance Prevalence Surgical Equipment/adverse effects Time Factors United States/epidemiologyrjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9729950103475184531 1999 MarptmA comparative study of an alternating air mattress for the prevention of pressure ulcers in surgical patientss 34-40, 42-4eResearch indicates that 8.5% of all patients undergoing surgical procedures for more than 3 hours develop pressure ulcers. In some types of surgery, incidence rates in excess of 25% have been reported. An 11-month study was conducted on the safety and efficacy of an experimental alternating air device in comparison with a tertiary care facility's conventional practice. A series of 217 patients undergoing surgical procedures scheduled for a minimum of 3 hours were enrolled. No ulcers developed in the experimental group and 11 ulcers developed in seven patients in the control group (8.75% incidence rate). Of the 11 ulcers, one was Stage I, four were Stage II, and six were unstageable secondary to eschar. The difference between the groups is significant at the P = 0.005 level. Individuals who developed ulcers had a length of stay approximately 7 days longer than the hospital average for comparable patients who did not develop ulcers.'&Albany Medical Center, NY, USA.nB{zt-,:$Barnett, R. I. Ablarde, J. A.e 1994TMSkin vascular reaction to standard patient positioning on a hospital mattressAdv Wound Care71 58-65 Jan8149049oAdult *Beds Clinical Nursing Research Decubitus Ulcer/physiopathology/prevention & control Female Flushing/physiopathology Human Male Middle Age *Posture Pressure Skin/*blood supply Skin Temperature Support, Non-U.S. Gov't Thermography Time FactorsThe effects of duration and posture on reactive hyperemia in the skin overlying the greater trochanter of the femur was determined in normal subjects using thermography. Multivariate analysis revealed that in the six subjects studied, post-lying blood flow within the skin superficial to bony prominences was significantly increased over that of the preexperimental and passively-warmed controls. These analyses also showed that both maximal interface pressures and vascular reactions were experienced in the side-lying position when the legs were extended, and significantly reduced when the legs were flexed. While there was good correlation between magnitudes of interface pressures measured and vascular responses within each individual, there was no such direct correlation between individuals. The individual with the highest interface pressures did not have the most intense reactive hyperemic reactions, and the individual with the least interface pressures did not have the least intense reactive hyperemic reactions. Intrinsic features of each individual's vascular response to the normal mechanical forces experienced during lying appear to be a sensitive measure of the individual's susceptibility to develop pressure ulcers..*#1076-2191 Journal Article TIG annexpjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=81490499450403E107 1997Nov-Decu81Measurement of support surface efficacy: pressures 21-9~Two methods can be used to assess the relative pressure-relieving/pressure-reducing effects of clinical support surfaces. The interaction occurring at the interface between the human body and the support surface--known as the interface pressure--can be measured with an interface pressure system. Reactive hyperemia, the physiologic response to pressure, can be measured with thermography and laser Doppler flowmetry. Using mannequins and human subjects that represent typical body types in the older population, a protocol was developed for collecting data on the effects of support surfaces on interface pressure and reactive hyperemia.'& Hill-Rom, Charleston, S.C., USA.& Barnett, R. I. Shelton, F. E. th 1076-2191 Journal ArticlepAdv Wound CareAged Beds/*standards Decubitus Ulcer/*nursing/*prevention & control/ultrasonography Human Laser-Doppler Flowmetry Models, Anatomic Pressure Thermographyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9450403  Barnett, R.I. 1998& The science of support surfaces. Charleston, S.C. Hill-Rom 1-7oHBPressure sores viewed by electron microscope and thermographically Barton, A. A.o 1973Geriatrics [Geriatrics]2810 143-7H:4Using Smart Source Parsing Oct; ( pp Journal ArticleDecubitus Ulcer/*pathology Aged Decubitus Ulcer/classification Female Human Ischemia/complications Male Microcirculation Microscopy, Electron Necrosis/etiology Posture Pressure Skin/blood supply Skin Temperature Thermography73248146>8Selected soft-tissue research: an overview from carville"Beach, R. B. Thompson, D. E. 1979"Physical therapy [Phys Ther]591p 30-3:4Using Smart Source Parsing Jan; ( pp Journal ArticleFoot Injuries* Foot/*innervation Animal Foot/blood supply Gait Human Patient Education Pressure/adverse effects Rats Stress, Mechanical Support, U.S. Gov't, P.H.S. Vasoconstriction Wounds and Injuries/physiopathology79137346114363943125 2001 Jun 18jdAn industry barometer. Dominant player Hillenbrand Industries rises and falls with hospitals' health 80, 82, 84 Becker, C. 0160-7480 Journal Articlel Mod Healthc Beds/economics/*supply & distribution Equipment and Supplies, Hospital/economics/*supply & distribution Financial Management Health Care Sector/*trends Income Indiana Mortuary Practice/economics Product Line Managementlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11436394e38442661101l 1985Jan-FebLFHelping yourself and your patients when working with Clinitron therapy 29-30dB;Belanus, A. R. Paradiso, C. Konzelmann, N. M. Roosma, M. C.  0278-4807 Journal Article  Rehabil NursF@*Beds Human *Immobilization Microspheres Rehabilitation/*nursingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3844266 F4.3341322 142 2t 1988 Feb8VOWaterbed care of narcotic-exposed neonates. A useful adjunct to supportive care3 186-86ztWe describe the neonatal course of 30 antenatal narcotic-exposed newborns, half of whom were randomly assigned to nonoscillating waterbeds and half to conventional bassinets. The infants were comparable at birth regarding drug exposure, ethnicity, maternal medical factors, gestational age, growth, and severity of withdrawal at the time of onset. Evaluation of total and subscores of the abstinence syndrome showed a lower total score and a significantly lower central nervous system subscore on day 5 for infants on waterbeds. The infants on waterbeds required less medication to control symptoms. The waterbed group demonstrated a significantly earlier onset of consistent weight gain as compared with the control group. This study demonstrates that nonoscillating waterbeds are an inexpensive and effective component of supportive therapy in the care of narcotic-exposed neonates.'JDDepartment of Pediatrics, University of California, San Diego 92103.Oro, A. S. Dixon, S. D..JD0002-922x Clinical Trial Journal Article Randomized Controlled TrialAm J Dis Child*Beds Cocaine/adverse effects Heroin/adverse effects Human *Infant Care Infant, Newborn Methadone/adverse effects Methamphetamine/adverse effects Neonatal Abstinence Syndrome/*nursing Random Allocation Support, U.S. Gov't, P.H.S.jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=33413227912337d 344  8914 1994 Jul 281Therapeutic beds: the Trojan horses of the 1990s?u 65-6ZSOrr, K. E. Gould, F. K. Perry, J. D. Ford, M. Morgan, S. Sisson, P. R. Morrison, D.0140-6736 Letter Lancet*Beds Case Report Cross Infection/*microbiology *Enterococcus faecium/drug effects Equipment Contamination Female Gram-Positive Bacterial Infections/*transmission Human Middle Age Vancomycin/pharmacologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7912337107962142w 2000NHKinesthetic stimulation versus theophylline for apnea in preterm infantsCD000502 BACKGROUND: Apnea of prematurity may lead to hypoxemia and bradycardia requiring resuscitative measures being instituted. Many treatments have been used in infants with apnea of prematurity, such as theophylline. Kinesthetic stimulation, which uses various forms of oscillating mattress, might also prevent apnea without using a standard drug such as theophylline. OBJECTIVES: Main question: in preterm infants, how does kinesthetic stimulation compare with methylxanthine therapy in the treatment of apnea of prematurity. SEARCH STRATEGY: The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, Cochrane Controlled Trials Register, MEDLINE, previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants and journal handsearching mainly in the English language. SELECTION CRITERIA: All trials using random or quasi-random patient allocation, in which kinesthetic stimulation was compared to methylxanthine therapy for apnea of prematurity, were eligible. No trials were excluded from the review that met these criteria. DATA COLLECTION AND ANALYSIS: Standard methods of the Cochrane Collaboration and its Neonatal Review Group were used with separate evaluation of trial quality, data extraction by both authors and synthesis of data using relative risk and weighted mean difference. MAIN RESULTS: A single small study of 20 infants (Saigal 1986) demonstrated a significant benefit to the infants receiving theophylline compared to those on an oscillating water bed in terms of mean rates of clinically important apnea (apnea > 14 seconds and bradycardia < 100, and cyanosis or receiving stimulation). There were no significant differences in adverse effects (death, sleep states, the Albert Einstein Neurobehavioural Index, adverse neurological outcomes, and the Bayley Mental Development Index at six and 12 months), although the infants on the OWB had a higher psychomotor index at six but not 12 months. There were some differences between the groups in incidence and severity of respiratory distress syndrome, and baseline apnea rates. REVIEWER'S CONCLUSIONS: The results of this review should be treated with caution. Theophylline has been shown in one small study to be superior to kinesthetic stimulation at treating clinically important apnea of prematurity. There are currently no clear research questions regarding the comparison of methylxanthines and kinesthetic stimulation to treat apnea of prematurity.'Department of Neonatal Medicine, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, NSW, Australia, 2050. davido@peri.rpa.cs.nsw.gov.au.*$Osborn, D. A. Henderson-Smart, D. J.811469-493x Journal Article Review Review, Academic Cochrane Database Syst RevApnea/*therapy *Beds Central Nervous System Stimulants/*therapeutic use Human Infant, Newborn Infant, Premature Infant, Premature, Diseases/*therapy Kinesiology, Applied Physical Stimulation/*instrumentation Theophylline/*therapeutic use Xanthines/*therapeutic usehttp://www.update-software.com/abstracts/ab000502.htm http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1079621484D=Bennett, L. Kavner, D. Lee, B. Y. Trainor, F. S. Lewis, J. M.a2,Skin blood flow in seated geriatric patients 1981Arch Phys Med Rehabil628 392-8:4Using Smart Source Parsing Aug; ( pp Journal ArticleAging:* Posture:* Skin:*BS Adult Aged Blood Flow Velocity:IS Decubitus Ulcer:PP Pressure Regional Blood Flow Stress:PP Human Male2,A hard seat was equipped with devices sensing arteriolar pulsatile blood flow volume rate, externally developed pressure, and shear, all taken in lateral proximity to the ischial tuberosities of sitting subjects. Tests of 14 geriatric hospitalized patients and 9 healthy young men indicated the following: (1) No young healthy man demonstrated blood flow occlusion at pressure values less than 120mmHg. Of the geriatric hospitalized subjects, 2 occluded at less than 20mmHg. (2) Average shear values developed by the geriatric hospitalized group were 3 times that of the young healthy group. (3) Average pressure values demonstrated by the geriatric hospitalized subjects were roughly equal to those of the younger subjects (roughly 70mmHg). (4) Tipping the seat backwards through 20 degrees produced major benefits to the hospitalized geriatric group in terms of increased blood flow, lessened pressure, and lower shear. The young, healthy group experienced some increase in blood flow with no significant change in sitting reactions when tested in a tipped attitude.81255235D=Bennett, L. Kavner, D. Lee, B. Y. Trainor, F. S. Lewis, J. M.a@9Skin stress and blood flow in sitting paraplegic patients 1984Arch Phys Med Rehabil654 186-90:4Using Smart Source Parsing Apr; ( pp Journal Article{Paraplegia:*PP Posture:* Skin:BS/*PP Adult Aged Buttocks Hospitalization Middle Age Pressure Regional Blood Flow Human Male82Sitting paraplegic subjects, tested on a hard seat at a location 2 to 3cm lateral to the ischial tuberosities, develop roughly the same median pressure values (range 52 to 60mmHg) as groups of normal subjects and hospitalized geriatric patients. However, median paraplegic and hospitalized geriatric shear values are roughly three times median normal values. Median rates of pulsatile skin blood flow volumes for sitting paraplegic subjects, while roughly equal to those of hospitalized geriatric subjects, are only one third those of comparable normal subjects.84177904Bennett, L Lee, B.Y. 198560Pressure versus shear in pressure sore causation  Lee, B.Y. Chronic Ulcers of the Skin New York McGraw-Hill Book CompanyBennett, L. Lee, B. Y.HAVertical shear existence in animal pressure threshold experimentsi 1988 Decubitus11 18-24:4Using Smart Source Parsing Feb; ( pp Journal ArticlePIDecubitus Ulcer:*ET Disease Models, Animal:* Manometry Pressure:AE Animalt893351642918193r373e 1989 MaroNHAir-fluidized bed treatment of nursing home patients with pressure sores 235-42 There are no large studies on long-term treatment of nursing home patients with pressure sores. A 4-year experience of treating 95 nursing home patients on air-fluidized beds was reviewed. Treated patients were elderly (median age 73 years) and neurologically impaired (79% with dementia, cerebral vascular accident, or anoxic encephalopathy). The index pressure sores (deepest truncal sore for each patient) were large (median surface area 35.3 cm2) and commonly located on the sacrum (41%) and trochanters (38%). Only 13 of 95 (14%) index sores healed completely, and only two small sores healed in less than 30 days. No others treated less than 30 days had greater than or equal to 50% reduction in sore surface area. Patients were grouped according to whether or not treatment was less than 30 days, and for those treated greater than or equal to 30 days, according to whether or not greater than or equal to 50% reduction in sore surface area occurred. None of the easily measured patient characteristics examined were associated with longer or more successful treatment. These results indicate that although air-fluidized beds can be used to treat pressure sores successfully, even in severely debilitated nursing home patients, no simple criteria can be used to predict which patients will benefit from this treatment. Because long periods of time are necessary for treatment [median trial length 79 days and 17 of 95 (18%) trials greater than 180 days], substantial patient-care expenditures result.(ABSTRACT TRUNCATED AT 250 WORDS)'Division of Geriatric Medicine, Johns Hopkins University School of Medicine, Mason F. Lord Chronic Hospital and Nursing Home, Baltimore, MD 21224.81Bennett, R. G. Bellantoni, M. F. Ouslander, J. G.r 0002-8614 Journal ArticleJ Am Geriatr SocAdult Aged Aged, 80 and over *Beds Cognition Disorders Decubitus Ulcer/*therapy Evaluation Studies Female Human Male Middle Age *Nursing Homes Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2918193-=<(6;:1038627h101a 1975 Mari$Treatment of decubitus ulcers171-210tBerecek, K. H. 0029-6465 Journal ArticlenNurs Clin North AmAir Animal Astringents/therapeutic use Bedding and Linens Beds Carbohydrates/therapeutic use Casts, Surgical Decubitus Ulcer/drug therapy/*prevention & control/surgery Dermatologic Agents/therapeutic use Gelatin Sponge, Absorbable/therapeutic use Gold/therapeutic use Human Massage Oxygen/therapeutic use Phototherapy Polyvinyls Pressure Rotation Sheep Silicone Elastomers Skin Soaps Vibration Waterojdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=103862758416333923 1965 Dec 1c~xHow hospitals and industry work together. 1. Rehabilitation experts confer with manufacturers on design of hospital beds 101-6\:4Bergstrom, D. A. Ellwood, P. M., Jr. Grendahl, B. C. 0018-5973 Journal Article  HospitalsmNH*Beds *Equipment and Supplies, Hospital Human *Rehabilitation Technologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=5841633 0)Bergstrom, N. Bennett, M.A. Carlson, C.E.n 1994"Treatment of Pressure Ulcers  Rockville, MD ~xU.S. Department of Health and Human Services. Public Health Service Agency, Agency for Health Care Policy and Reasearch.F@Clinical Practice Guideline, No.15 AHCPR Publication No. 95-06529227938d133d 1997 Aug-0)Strategies for preventing pressure ulcersn 437-54The Agency for Health Care Policy and Research supported the development of guidelines for the prediction and prevention of pressure ulcers. Based on the best available scientific evidence, the guidelines recommend that individuals who are bed- or chair-bound should be assessed further for risk and receive care according to the risk factors. Appropriate actions include managing tissue loads, reducing exposure to moisture, managing incontinence, and assuring adequate nutrition. The guidelines are presented, research supporting the guidelines is summarized, and relevant articles published since the release of the guidelines are reviewed.e'haGraduate Nursing Program, University of Nebraska Medical Center, Omaha, Nebraska 68198-5330, USA.RBergstrom, N. I.810749-0690 Journal Article Review Review, TutorialClin Geriatr MedActivities of Daily Living *Algorithms Beds Biomechanics Decubitus Ulcer/etiology/*prevention & control Human Orthotic Devices *Practice Guidelines Risk Factors Skin Care United States United States Agency for Healthcare Research and Qualitytjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=92279386624882625o 1983 OctiPJSkin pressure measurements on various mattress surfaces in cancer patients 217-26Twenty-eight patients with histologically proven carcinoma were studied on two dynamic and six static mattress surfaces to determine which mattress surface would provide the least skin surface pressure at the sacrum, dorsal spine, trochanter and heels. Measurements were taken with an especially designed inflatable bladder, and the mean of the maximum skin surface pressures was determined for the static and dynamic surfaces in the inflated and deflated state. Using less than or equal to 32 mm Hg as the skin surface pressure at which the arteriolarcapillary blood flow is interrupted, we concluded that the mud gel bed generally tended to record the lowest skin surface pressure for all of the sites. Although some of the static surfaces recorded pressures less than or equal to 32 mm Hg at the sacrum and dorsal spine, the deflated dynamic surfaces were superior to the remaining static surfaces in reducing the skin surface pressures.VOBerjian, R. A. Douglass, H. O., Jr. Holyoke, E. D. Goodwin, P. M. Priore, R. L.  0002-9491 Journal Articlec Am J Phys Medu*Bedding and Linens *Beds Decubitus Ulcer/*prevention & control Human Neoplasms/*nursing Pressure/adverse effects Regional Blood Flow Skin/*blood supplyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6624882TMBernardi, L. Hayoz, D. Wenzel, R. Passino, C. Calciati, A. Weber, R. Noll, G. 1997xrSynchronous and baroceptor-sensitive oscillations in skin microcirculation: evidence for central autonomic control Am J Physiol 273d 4 Pt 2H1867-78To determine whether skin blood flow is local or takes part in general regulatory mechanisms, we recorded laser-Doppler flowmetry (LDF; left and right index fingers), blood pressure, muscle sympathetic nerve activity (MSNA), R-R interval, and respiration in 10 healthy volunteers and 3 subjects after sympathectomy. We evaluated 1) the synchronism of LDF fluctuations in two index fingers, 2) the relationship with autonomically mediated fluctuations in other signals, and 3) the LDF ability to respond to arterial baroreflex stimulation (by neck suction at frequencies from 0.02 to 0.20 Hz), using spectral analysis (autoregressive uni- and bivariate, time-variant algorithms). Synchronous LDF fluctuations were observed in the index fingers of healthy subjects but not in sympathectomized patients. LDF fluctuations were coherent with those obtained for blood pressure, MSNA, and R-R interval. LDF fluctuations were leading blood pressure in the low-frequency (LF; 0.1 Hz) band and lagging in the respiratory, high-frequency (HF; approximately 0.25 Hz) band, suggesting passive "downstream" transmission only for HF and "upstream" transmission for LF from the microvessels. LDF fluctuations were responsive to sinusoidal neck suction up to 0.1 Hz, indicating response to sympathetic modulation. Skin blood flow thus reflects modifications determined by autonomic activity, detectable by frequency analysis of spontaneous fluctuations.on file TIG annexSRQ8PfON7484486r244u 1995 Jul \VPreventing pressure sores in elderly patients: a comparison of seven mattress overlays297-3029Long-term elderly patients at risk of pressure sores as shown by superficial skin breaks in the pressure areas were randomly allocated to seven low-priced mattress overlays, alternating pressure (AP): Large Cell Ripplebed; constant low pressure (CLP): Preventix, a 'Groove' prototype, Modular Propad (contoured foam); Ardo Watersoft; Spenco, Surgicgoods Hollowcore Mattress Pad (fibrefills). Assessments of the patients' medical condition, nursing management and pressure areas were carried out twice weekly for a mean of 17.7 days. If the pressure areas deteriorated significantly the trials were stopped and the patients were transferred to other supports. Thirteen per cent of trials on Ripplebeds had to be stopped compared with 32%, 35% and 37% respectively on contoured foam mattresses (p = 0.0005), 47% on the water mattress (p < 0.001) and 51% and 54% on fibrefills (p < 0.0001). Respective healing rates were: 45%, 37%, 24% and 20% (p = 0.001). Although the contoured foam mattresses provided better protection than the fibrefills (p < 0.01), only the AP mattress effectively prevented and healed sores in these patients who could not be regularly repositioned.'HBDepartment of Medicine for the Elderly, Homerton Hospital, London. Bliss, M. R.JD0002-0729 Clinical Trial Journal Article Randomized Controlled Trial Age AgeingAged Aged, 80 and over *Bedding and Linens *Beds Comparative Study Decubitus Ulcer/etiology/nursing/*prevention & control Female Geriatric Assessment Human Male Nursing Assessmentejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=74844867833708l 310a 6972 1995 Jan 14PIPressure sores. Clinical trials best way of assessing different matresses 126u Bliss, M. R.0959-8138 Comment Letter BmjPJ*Beds Clinical Trials Decubitus Ulcer/*prevention & control Human Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7833708969746467s6t 1998 Jun 0*Alternating-pressure mattress replacements 302/ Bliss, M. R.0969-0700 Comment Letter J Wound CareLE*Bedding and Linens *Beds Decubitus Ulcer/*prevention & control Human jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9697464 Bliss, M. R. Hyperaemia 1998J Tissue Viability84 4-13TNUsing Smart Source Parsing Oct; ( pp Journal Article; Review; Review, TutorialHyperemia:ET/ME/*PP Skin:*BS Decubitus Ulcer:ET Microcirculation:PH Regional Blood Flow Vasoconstriction:PH Vasodilation:PH HumanHyperaemia is the process by which the body adjusts blood flow to meet the metabolic needs of its different tissues in health and disease. Meticulous control of the microcirculation--the arterioles, capillaries and venules--is essential to life. Reactive hyperaemia, the local vasodilatation which occurs in response to oxygen debt and accumulation of metabolic waste products due to interruption of blood flow; active hyperaemia, the increased blood flow in an organ during a period of activity; and the hyperaemic response to infection and trauma are vitally important. The microcirculation is controlled partly by sympathetic vasoconstrictor impulses from the brain and partly by vasoactive substances secreted locally by the endothelial cells. The most important of the latter is nitric oxide which facilitates flow by causing relaxation of vascular smooth muscle. Neural and endothelial control of blood flow are impaired by illness. Neurological disease and vascular disease which affect the microcirculation, predispose patients to develop ischaemic organ damage, including pressure sores, during periods of intercurrent illness. Severe sepsis or trauma may cause irreversible microcirculatory dysfunction resulting in multi-organ failure and death.99403665112995691030 2000 Jul2.(Pressure sores--demographic perspectives 106, 109-15t Bliss, M.,2,0965-206x Historical Article Journal ArticleJ Tissue ViabilityAged Beds/history Decubitus Ulcer/*history/therapy Geriatric Nursing/*history Great Britain History of Medicine, 20th Cent. HumanHlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11299569d10839096101u 2000 Jans.(An update on horizontal support surfaces 35-6 Bliss, M.1 0965-206x Journal ArticlenJ Tissue Viability`YBeds/*standards/supply & distribution Decubitus Ulcer/nursing/*prevention & control Human lehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10839096 341772499531 1988May-Juns\UPrevention of pressure necrosis over the medial epicondyle: the use of eggcrate cuffst 291-25 Blumer, K. A.T 0273-8481 Journal Article J Burn Care Rehabil VO*Beds Burns/*therapy Decubitus Ulcer/*prevention & control *Elbow Human Posture jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3417724FEn.TC1420530d195t 1992Sep-Octp2+Air support therapy: ethical considerationsi 171-3 Pressure ulcers are a major health problem for the elderly population in the United States. Billion of health care dollars are spent for hospitalization, air support therapy, wound care products, and nursing care. In addition, the cost in human suffering is priceless. Many patients with pressure ulcers have several chronic diseases that make wound healing difficult. Nurses must begin to examine the ethical principles that guide their care of these patients. This article focuses on some ethical issues related to the care of patients with pressure ulcers and the difficulties encountered with pressure ulcer care. Careful analysis of the goals of pressure ulcer treatment may help nurses develop ethical guidelines to direct them in the care of these patients. Blaylock, B. 1055-3045 Journal Article  J ET NurslAged *Air Beds/*standards Beneficence Case Report Decubitus Ulcer/complications/*nursing Dementia/*complications Ethical Theory *Ethics, Nursing Female Human Moral Obligations Patient Selection *Withholding Treatmentjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1420530Blaylock, B. Gardner, C. 1994^WMeasuring tissue interface pressures of two support surfaces used in the operating roomOstomy Wound Manage402 42-4, 46, 48*Beds ; *Decubitus Ulcer prevention and control; *Intraoperative Complications prevention and control; *Operating Rooms Evaluation Studies; Pressure Comparative Study; HumanoB;Patients undergoing surgery are often overlooked for the prevention of pressure ulcers. Anesthetized patients are at very high risk for pressure injury due to forced immobility which occurs during surgery. This risk has been reported to be higher for patients undergoing vascular surgery. Few studies have been conducted which examine the tissue interface pressure of the conventional operating table pad and products available to reduce pressure for patients undergoing surgery. Several cases of pressure injury in patients undergoing vascular surgery led to this study.research, interface pressure, support surface, OR, prevention Challenge 2000 Operating Room Acute Care Support surface interface pressure TIG annex 8704835m226. 1995 NovpBMattresses for preventing pressure sores in geriatric patients 238-682+Bliss, M. R. McLaren, R. Exton-Smith, A. N.f 0368-881x Journal Article4-Mon Bull Minist Health Public Health Lab Serv Aged Bedding and Linens *Beds Decubitus Ulcer/*prevention & control *Equipment and Supplies, Hospital Female *Geriatric Nursing Human Malejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6013600Y /HXdWtV<7236975342 1981 AprpVPA clinical evaluation of the air-fluidised bed in a general plastic surgery unit 165-8t6/Over a period of seven months nine patients were nursed on an air-fluidised bed. Measurements showed that skin-bed interface pressures were significantly lower on this bed than on a conventional hospital bed, particularly over the areas of the highest pressure. Whilst the bed did not shorten the patients' hospital stay, it did simplify nursing and improve patient comfort, especially in burns cases. Perhaps even more important was the observation that with correct use of the bed, no new pressure sores developed and established sores did not become worse.o,%Boorman, J. G. Carr, S. Kemble, J. V.e 0007-1226 Journal ArticleGBr J Plast SurgyAdult Aged *Beds Burns/nursing/surgery Decubitus Ulcer/prevention & control Evaluation Studies Female Human Male Middle Age Pressure Surgery, Plastic/*nursingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=72369751408906d8839 1992 Sep 23-292*#Pressure relief--stand by your beds61 Booth, B.  0954-7762 Journal Article4 Nurs Times^XBedding and Linens/*standards Beds/standards Decubitus Ulcer/*prevention & control Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=140890681399478934 1993 Aug 25-31=D=Guide to pressure-relieving beds and mattresses. Soft optionsn 60-2 Booth, B.w0954-7762 Directory Nurs Times81*Beds Decubitus Ulcer/*prevention & control Human jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8139947Bos, W. de Koenig, J., 1992b[Description, pathogenesis and prevention of ulcers caused by tangential forces on the skin.a 2,Harding, K. Cherry, G. Dealey, C. Turner, T.RKProceedings of the 2nd European Conference on Advances in Wound Management.  Harrogate Macmillan Magazines Ltd. 167-9(!Bosboom, E. Bouton, C. Oomens, C. 1998`ZThe aetiology of pressure sores - influence of mechanical load on muscle tissue (abstract)J of Biomechanicse 31(Suppl)5 144>ha[Experiences in the treatment of decubital ulcers with synthetic skin grafting (author's transl)]tnErfahrungen bei der Behandlung von Dekubital-Geschwuren unter Berucksichtigung des synthetischen hautersatzes. Botel, U.aAktuelle Traumatol 1982123s 155-8dPressure sores have always been, and still are, a serious threat to health and life of patients paralysed by a transverse lesion of the cord; hence, intensive-care treatment is essential. The most important basic measure is a consequential relief of the damage caused by pressure; success is achieved with synthetic skin grafting using polyurethane foam for the conditioning of wound areas prior to final surgery. Extended pressure sores are particularly suitable for treatment with synthetic skin graft, whereas this principle is unsuitable in skin defects with many " pockets" and cavities. On account of its microporous surface which is impervious to bacteria while offering the possibility of gas exchange, polyurethane foam is also used to protect wounds against superinfection.o|v*Artificial Organs; *Decubitus Ulcer surgery; *Skin surgery Decubitus Ulcer pathology; English Abstract; Methods Human116853002710 2001 Octo}Prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units. Results of a cross-sectional surveyn1599-605 OBJECTIVE: Evaluating the prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units (ICUs). DESIGN: Cross-sectional design. SETTING: ICUs of acute care hospitals that participated in the 1998 and 1999 national prevalence surveys. Data were collected on 1 day in each year. PATIENTS: Eight hundred fifty patients admitted to Dutch ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Six categories of data were collected: (1) characteristics of the institution, (2) characteristics of the ward, (3) characteristics of the patients (age, sex, date of admission, reason for admission), (4) risk assessment using the Braden scale and two additional risk factors (malnutrition and incontinence), (5) severity of the pressure ulcers and (6) supportive surface used. The prevalence of pressure ulcers was 28.7%. In a forward logistic regression analysis, four risk factors were significantly associated with the presence of pressure ulcers: infection, age, length of stay and total Braden score. Of the patients at high risk of developing pressure ulcers but without actual pressure ulcers, 60.5% were positioned on a support system. Only 36.8% of the patients who were determined to need repositioning were actually being turned. CONCLUSIONS: The prevalence of pressure ulcers in Dutch ICUs is high and their prevention is flawed, especially as regards the use of support systems. Patients for whom turning is indicated are not being turned. Predicting pressure ulcers in ICU patients is difficult and needs further investigation.'Maastricht University, Department of Health Care Studies, Section of Nursing Science, PO Box 616, 6200 MD Maastricht, The Netherlands. G.Bours@zw.unimaas.nl:3Bours, G. J. De Laat, E. Halfens, R. J. Lubbers, M. 0342-4642 Journal ArticleIntensive Care Medd]Age Distribution Age Factors Aged Bed Rest/adverse effects/nursing Beds/statistics & numerical data Cross-Sectional Studies Decubitus Ulcer/*epidemiology/etiology/nursing/*prevention & control Human Intensive Care/methods/standards Intensive Care Units/*standards Length of Stay/statistics & numerical data Logistic Models Middle Age Netherlands/epidemiology Nursing Assessment Nursing Evaluation Research Nutrition Disorders/complications Population Surveillance Prevalence Risk Assessment Risk Factors Sensitivity and Specificity Severity of Illness Index Time Factors Urinary Incontinence/complicationslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11685300hg(tf0y[Comparison of 3 decubitus prevention measures stemming from the same principle--with reference to cost-benefit analysis]n~wVergleich von drei Decubitus-prophylaxemassnahmen gleichen Prinzips--unter Berucksichtigung des Kosten-/Nutzeneffektes.c Buchner, T.s Krankenpfl J 1995336a 248-52xq*Decubitus Ulcer prevention and control Bedding and Linens; Beds ; Cost Benefit Analysis Comparative Study; Humann9769087,291c 1998 FebtRKMattress evaluation--assessment of contact pressure, comfort and discomfort9 35-9The ergonomic evaluation of mattresses is largely ignored in the current literature. This is somewhat surprising given their importance and the length of time spent using them. This study considers some ergonomic aspects of their design, including body contact pressure and subjective ratings of comfort. Subjects (12 females) found all of the mattresses tested to be significantly more comfortable than an incompressible wooden reference surface. However, no significant differences were found between mattress types, which included orthopaedic and normal designs. Analysis of body contact pressures (measured at the shoulder, elbow, hip, knee and ankle) found few significant differences between experimental conditions. It is argued that limitations in the methodology may not take account of the change in surface area and anatomical sites of contact under different conditions of mattress compressibility. No significant associations were found between comfort ratings and peak body contact pressures. It seems likely that subjective ratings of mattress comfort are dependent on a wider set of factors than contact pressure alone, a finding reported elsewhere in studies of seating.'*$University of Surrey, Guildford, UK.Buckle, P. Fernandes, A. 0003-6870 Journal Article Appl ErgonAdult Beds/*adverse effects/classification/*standards Consumer Product Safety Equipment Design/standards Evaluation Studies Female Human Human Engineering/*methods Middle Age Monitoring, Physiologic Pain/*etiology Pressure *Prone Positionjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9769087Budinski, K.G. 199260Engineering materials: Properties and selection.  Prentice Hallt 4the101293632343 1993 Oct 254-Hill-Rom faces second antitrust investigationu 3, 14Burda, D. Scott, L.e0160-7480 News Mod Healthct~*Antitrust Laws Beds/*economics Equipment and Supplies, Hospital/economics Industry/*legislation & jurisprudence United Stateslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10129363 834728216p3i 1993 May7D>Using pressure measurements to evaluate different technologies 38-42rDespite ongoing efforts to improve the prediction, prevention, and treatment of pressure ulcers, clinicians continue to face an overwhelming array of confusing, and sometimes conflicting, information about the technologies used to lower pressure. The purpose of this article is to explain the fundamental differences among units of pressure measurement and those pressures (capillary closing, tissue interface, internal cushion, and hydrostatic) that are commonly described in research as well as sales literature. A clearer understanding of these parameters will help clinicians make informed evaluations of distinct technologies, set realistic expectations for different products, and achieve desired outcomes cost-effectively.h Burman, P. M.  0898-1655 Journal Articlee DecubituseyBeds/*standards Decubitus Ulcer/*prevention & control Human Manometry/*instrumentation *Technology Assessment, Biomedicalrjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8347282[f&Sprigle, S. Press, L. Davis, K.Uf`Development of uniform terminology and procedures to describe wheelchair cushion characteristics 2001J Rehabil Res Dev384 449-61XRUsing Smart Source Parsing Jul-Aug; ( pp Journal Article; Review; Review, TutorialEquipment Design:*ST Guidelines:* Terminology:* Wheelchairs:*ST Sensitivity and Specificity Human Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S.521447206>8Sprigle, S. Linden, M. McKenna, D. Davis, K. Riordan, B. 2001PJClinical skin temperature measurement to predict incipient pressure ulcersAdv Skin Wound Care143n 133-7s21902749|vOBJECTIVE: To evaluate temperature differences between areas of erythema and surrounding healthy tissue to determine whether clinical temperature measurement of sites at risk for pressure ulcer development could be used to indicate tissue damage. To validate the temperature portion of the National Pressure Ulcer Advisory Panel's new Stage I pressure ulcer definition. DESIGN: Repeated measures design. SETTING: Acute rehabilitation hospital. SUBJECTS: 65 outpatients and inpatients presenting with pressure-induced erythema at areas at risk for pressure ulcer development. The subjects were primarily non-ambulatory and exhibited a range of skin pigmentation and disabilities, including spinal injury, multiple sclerosis, and lower-limb amputations. MAIN RESULTS: The temperature and appearance of 80 pairs of erythematic and control sites were documented. Sites were considered to have equal temperatures if the difference was within plus or minus 1.0 degree F. Fifteen percent (n 12) of the erythematic sites were the same temperature as the surrounding tissue, 23% (n 18) of the erythematic sites were cooler than the control sites, and 63% (n 50) were warmer. CONCLUSION: Both increased and decreased temperature differences can be used to indicate reactive hyperemia or a Stage I pressure ulcer, but a tissue integrity problem may still exist despite the absence of a temperature difference.HBUsing Smart Source Parsing May-Jun; ( pp Journal Article TIG annex10136372129o 1994 Sep81Mattress evaluation for long-term care facilities4 28, 30, 32Patients spend more than a third of their hospital time in bed and considerably more than that if they are residents in a long-term care facility. When our facility, Fair Acres Geriatric Center, a 911-bed long-term care facility in Lima, PA, noticed increasing losses of our standard mattresses, we decided to evaluate new products. We listed very important criteria (bacteria resistance, flame retardation, self-deodorization and comfort and resiliency) and important criteria (stain resistance, cost and warranty) and then brought in three standard mattresses for our staff to evaluate. We were able to procure a mattress that met our criteria and halved our costs in the process.',&Fair Acres Geriatric Center, Lima, PA.*#Stank, C. McFarland, H. Micucci, B. 0889-2482 Journal ArticleJ Healthc Mater ManageBeds/*standards Commerce/trends Decision Making, Organizational Evaluation Studies Human Nursing Homes/*organization & administration Pennsylvanialehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10136372ed cba3646981n8h3i 1987May-Jun1*#CLINITRON Therapy: is it effective?e 120-4o.(Bristow, J. V. Goldfarb, E. H. Green, M. 0197-4572 Journal Articleo Geriatr NursAged Aged, 80 and over Air *Beds Decubitus Ulcer/nursing/*therapy Economics, Nursing Evaluation Studies Female Human Male Microspheres Middle Age jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3646981 928559606. 1977 Dece`YA simplified water mattress in the prevention and treatment of pressure sores. Commentarya 915-6r Brody, G. S. 0032-1052 Journal ArticleYPlast Reconstr Surg>7*Beds Decubitus Ulcer/*prevention & control Human Water jchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=928559a103050942321 1977 Febd60Air beds: cost-effective prevention of bed sores20 Brostoff, D. 0018-5620 Journal ArticleHosp Equip SupplieslhbAir Pressure *Beds Cost-Benefit Analysis Decubitus Ulcer/*prevention & control Great Britain Humanlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10305094l111225031924 2000 Dec 30ySome practical issues in the design, monitoring and analysis of a sequential randomized trial in pressure sore prevention3389-400HBA sequential double blind (assessor and patient) triangular design was used to compare the incidence of pressure sores following elective major surgery among patients lying on a standard foam mattress with those on a dry visco-elastic polymer pad during their operation. A total of 446 patients were recruited into the trial between 1994 and 1996. Interim analyses were carried out after 181 patients were entered into the trial and then subsequently after approximately every 100 patients recruited. The trial unexpectedly reached a stopping boundary at the first interim analysis, however the Independent Data Monitoring Committee recommended continuation of the trial. They were concerned that there was a need for a larger definitive trial and about an apparent treatment by centre interaction. They required a substudy to be undertaken to further validate the subjective endpoint, and that further sensitivity analyses of the main trail endpoint should be carried out in the second interim analysis. The trial was stopped at the third interim analysis when again a stopping boundary was crossed indicating that the gel pad was associated with significantly fewer pressure sores than the standard mattress (log odds ratio -0.7, (95 per cent confidence interval (CI), -1.28, -0.11), p=0.02) (estimate CI, p-value adjusted for group sequential conduct). The design, monitoring and analysis of this trial will be presented as an example of the practical problems or non-problems encountered for the local hospitals, for the trials unit, for the data monitoring committee and for the funding committee.'leNorthern and Yorkshire Clinical Trials and Research Unit, University of Leeds, UK. medjmb@leeds.ac.uk@:Brown, J. McElvenny, D. Nixon, J. Bainbridge, J. Mason, S.HB0277-6715 Clinical Trial Controlled Clinical Trial Journal ArticleStat Med Beds/*standards Comparative Study Data Collection Data Interpretation, Statistical Decubitus Ulcer/epidemiology/*prevention & control Double-Blind Method Female Human Incidence Male Polymers *Postoperative Care *Randomized Controlled Trials *Research Design Support, Non-U.S. Gov'tlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=111225036199928t2545 198381"SSI Clinitron" air-fluidized bed in severe burns 224-89*#Broz, L. Konigova, R. Zelizkova, V.9 0001-5423 Journal ArticleActa Chir PlastHAAir Beds/*standards Burns/*therapy Female Human Male Microspheresvjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6199928vfut2198520i9731 1990May-Jun0$Understanding therapeutic beds 57-70a The use of "high-tech" therapeutic beds has increased during the past 5 years as a result of advances in medical technology, the early stabilization of trauma patients, and changes in the reimbursement system. Orthopaedic nurses need to understand how specialty beds can help them more effectively care for the immobilized patient. This article provides an overview of five categories of therapeutic beds along with criteria for patient selection, reviews of pertinent scientific studies, and relevant nursing considerations.i Ceccio, C. M.mF@0744-6020 Clinical Trial Journal Article Review Review, Tutorial Orthop Nurs\VBed Rest/*adverse effects Beds/*standards Clinical Trials Human *Patient Care Planningjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=219852011190854231P 2001 JannhaBackside first in head and neck surgery?: preventing pressure ulcers in extended length surgeries 25-8BACKGROUND: The operating room (OR) presents a high-risk environment for pressure injury. We designed a project to improve performance in the prevention of intraoperative pressure ulcers in extended length head and neck surgeries for malignancies (ELS) using a fluid mattress (RIK) intraoperatively. METHODS: A descriptive design was used to monitor performance improvement in this underrecognized aspect of patient care. A fluid, pressure-reducing OR mattress (RIK) was compared with the use of a standard foam OR mattress (Skytron). A convenience group of 36 consecutive patients, undergoing ELS, was included in the project. Patients were evaluated for presence or absence of a pressure ulcer immediately and 72 hours postoperatively. RESULTS: Patient groups were demographically and surgically comparable at a clinical level. Pressure ulcer incidence before intervention was 21% (4 of 19). This declined to 0% after intervention. CONCLUSIONS: Intraoperative pressure ulcers are a costly complication. Presence of a pressure ulcer extends time in the sick role and disrupts desired aesthetic outcomes. Use of a pressure-reducing device achieved the performance improvement objective. Implications for future research and current care are discussed.'Department of Otorhinolaryngology/Head and Neck Surgery, School of Medicine, University of Pennsylvania, Philadelphia 19104-4283, USA. chaliana@mail.med.upenn.edu"Chalian, A. A. Kagan, S. H.o.(1043-3074 Clinical Trial Journal Article Head NecklAged *Beds Decubitus Ulcer/*prevention & control Female Head and Neck Neoplasms/*surgery Human Intraoperative Complications/*prevention & control Male Middle Age Operating RoomsSlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1119085451129957610 3 su 2000 JulpVOShould weaker study designs ever be preferred over randomised controlled trials3 7-9eRandomised controlled trials are typically cited as the 'best' form of study design to be used when comparing the efficacy or effectiveness of different devices such as pressure-redistributing beds and mattresses. This article presents a RCT that compared two forms of alternating pressure air mattress. No statistically significant differences were found between the incidence of sores upon the two mattresses. However the study was under-powered, and so was unlikely to identify differences in efficacy should they have existed. In discussion it is suggested that randomised controlled trials may be less useful to those purchasing mattresses than 'weaker' study designs that capture the experience of the users of such devices.'&Walsall Community Health Trust.Chaloner, D. Cave, J.JD0965-206x Clinical Trial Journal Article Randomized Controlled TrialJ Tissue ViabilityAdult Aged Aged, 80 and over *Beds Clinical Nursing Research/*methods/*standards Comparative Study Decubitus Ulcer/*nursing/*prevention & control Female Human Male Middle Age Prospective Studies Support, Non-U.S. Gov'tlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11299576 @ .'Salisbury Rehabilitation Research Group 1988&Assessment of bedding surfaces.\Care Science and Pract.63a 84-85i6121180 1r 8270 1982 Feb 276/Pseudomonas septicaemia from plastic mattresses 5188 Grubb, D. J. Watson, K. C.0140-6736 Letter Lancet*Bedding and Linens/standards Cardiac Surgical Procedures/adverse effects Case Report Child, Preschool Human Male *Plastics/standards Postoperative Complications/etiology Pseudomonas Infections/*etiology Septicemia/*etiologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6121180$Guin, P. Hudson, A. Gallo, J. 199182The efficacy of six heel pressure reducing devices Decubitus4r315-6, 18, 20 passim*Decubitus Ulcer prevention and control; *Heel ; *Orthotic Devices standards Adult ; Aged ; Aged, 80 and over; Decubitus Ulcer nursing; Evaluation Studies; Orthotic Devices economics; Pressure ; Supination Female; Human; MalerTwenty to 90 percent of pressure ulcers are located on the heel. The purpose of this study was to evaluate the pressure exerted on the heel when the foot in both the supine and the 30 degree elevated position was placed in various heel pressure reducing devices. Interface pressures of six heel devices were measured to determine their performance. Other factors, such as body weight, height shoe size, shoe width, as well as whether the device provided leg support were examined.on file TIG annext3441766p213 1987HADifferent sorts of beds in the treatment of burns. Practical note 327-30The clinical experience of a burn team in using different types of beds for treating major burns is explained. This experience has led to development of a protocol for using these beds. Advantages and disadvantages of different sorts of beds are outlined.u'hbBurn Centre, Department of Plastic Surgery, Bergmannsheil Bochum, University Clinic, West Germany.,&Gunnewig, M. Neumeyer, R. Grabosch, A. 0284-4311 Journal Articleu,%Scand J Plast Reconstr Surg Hand Surg 82*Beds Burns/*nursing Environment, Controlled Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3441766115642341531 2001b\Risk, prevention and treatment of pressure ulcers--nursing staff knowledge and documentation 257-63}The aims were to investigate (i) registered nurses' and nursing assistants' knowledge of risk, prevention and treatment of pressure ulcer before implementing a system for risk assessment and pressure ulcer classification for patients with hip fracture (ii) interventions documented in the patient's records by registered nurses, and (iii) to what extent reported and documented interventions accord with the Swedish quality guidelines. Nursing staff (n=85) completed a questionnaire, and patient's records (n=55) were audited retrospectively. The majority of the nursing staff reported that they performed risk assessment when caring for a patient with hip fracture. These risk assessments were, however, not comprehensive. The most frequently reported preventive interventions were repositioning, use of lotion, mattresses/overlays and cushions for the heels. These interventions were to some extent documented in the patient's records. Nutritional support, reduction of shear and friction, hygiene and skin moisture, and patient's education were reported to a small extent and not documented at all. The Swedish quality guidelines regarding prevention and treatment of pressure ulcers were not fully implemented in clinical practice. It was concluded that nursing staff's knowledge and documentation of risk, prevention and treatment of pressure ulcers for patients with hip fractures could be improved. 'Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden. lena.gunningbberg@adm.uas.lul.se>7Gunningberg, L. Lindholm, C. Carlsson, M. Sjoden, P. O.e 0283-9318 Journal ArticleaScand J Caring SciAged Aged, 80 and over *Clinical Competence Decubitus Ulcer/etiology/*nursing/*prevention & control *Documentation Female Guideline Adherence Hip Fractures/complications/*nursing Human Male *Nursing Audit *Nursing Staff, Hospital Practice Guidelines Risk Assessment Swedenlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11564234]$Rycroft-Malone, J McInness, E 20014-Pressure ulcer risk assessment and prevention  London, UK Royal College of Nursing36 April 2001 guidelinec,&Sachse, R. E. Fink, S. A. Klitzman, B. 1998:4Multimodality evaluation of pressure relief surfacesPlast Reconstr Surg 1027 2381-7*Decubitus Ulcer etiology; *Skin blood supply; *Skin Physiology Blood Gas Monitoring, Transcutaneous; Laser Doppler Flowmetry; Pressure Human; Male; Support, Non U.S. Gov'tLEMultimodality evaluation of six different support surfaces was performed measuring interface pressure, transcutaneous oxygen tension, and blood flow in pressure ulcer-prone areas on healthy subjects. Interface pressure was measured with a flexible force-sensing resistor array. The interface pressure distribution patterns of 10 healthy male volunteers were measured in the supine and lateral positions using a pressure sensor (force sensing resistor) array. Transcutaneous oxygen (TcPO2) and laser Doppler flowmeter probes were placed over the sacrum, the right trochanter, and the right ischium. Data were recorded for 15 minutes each with the subject in the supine and lateral decubitus positions. Statistically significant differences (p < 0.05) between the various surfaces could be observed for blood flow and pressure measurements, especially in the lateral position over the trochanter and for the TcPO2 measurements in the supine position over the sacrum. We conclude that measuring interface pressure, transcutaneous oxygen tension, and blood flow allows a more thorough evaluation of the physiologic effects of special support surfaces than any single technique. Future studies on patients will assess algorithms for using these measurement techniques to predict the efficacy of various support surfaces in minimizing pressure ulceration.LElaser Doppler flow transcutaneous oxygen interface pressure TIG annex of such devices.'&Walsall Community Health Trust.Chaloner, D. Cave, J.JD0965-206x Clinical Trial Journal Article Randomized Controlled TrialJ Tissue ViabilityAdult Aged Aged, 80 and over *Beds Clinical Nursing Research/*methods/*standards Comparative Study Decubitus Ulcer/*nursing/*prevention & control Female Human Male Middle Age Prospective Studies Support, Non-U.S. Gov'tlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11299576 |*2{z)yx10729779 121 3n 2000 Mar:4Identification of Hev b1 in natural latex mattresses 211-4 BACKGROUND: Type 1 hypersensitivity to natural rubber latex proteins is a well-recognized health problem. Recent data have shown that allergens can be extracted from natural latex mattresses. As Hev b 1 (rubber elongation factor) and Hev b 6.02 (hevein) were described as major allergens, the present work was carried out to evaluate their presence in latex mattresses as well as in latex gloves. METHODS: Extracted proteins from latex mattresses and gloves were separated by SDS-PAGE or two-dimensional gel electrophoresis, transferred onto nitrocellulose and detected with monoclonal antibodies specific for Hev b 1 and Hev b 6.02. RESULTS: The results showed that various forms of Hev b 1, as well as degradation products of Hev b 1 were detected in latex mattresses and gloves, whereas Hev b 6.02 was not detected either in mattresses or in gloves. In a standardized latex extract, Hev b 1 and Hev b 6.01 (prohevein) were identified by the monoclonal antibodies. CONCLUSION: The fact that only Hev b 1 was detected by immunoblot in latex articles indicates that Hev b 1 may be the last protein to be washed out of latex products and that the Hev b 1 content may be used as a criterion for the estimation of the allergenicity of the latex products.'@9Institut Pasteur, Unite d'Immuno-Allergie, Paris, France.^XChardin, H. Chen, Z. Raulf-Heimsoth, M. Mayer, C. Senechal, H. Desvaux, F. X. Peltre, G. 1018-2438 Journal ArticleeInt Arch Allergy ImmunolAllergens/*isolation & purification Beds/*adverse effects Comparative Study Gloves, Protective/adverse effects Human Latex/*immunology/*isolation & purification Plant Proteins/*isolation & purification-http://www.online.karger.com/library/karger/renderer/dataset.exe?jcode=IAA&action=render&rendertype=fulltext&uid=IAA.iaa21211 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10729779 7612140n415t 1995 Junld^Evaluation of a low-air-loss mattress system in the treatment of patients with pressure ulcers 46-8, 50, 52Many individuals who are on prolonged bed rest suffer from pressure-induced ulcers. Pressure ulcers result from soft tissue being compressed between the skeleton or other supporting body structures and the relatively immovable surfaces commonly found with conventional mattresses in homes, hospitals, and prolonged care nursing facilities. In this study, we have evaluated the utility of a low-air-loss mattress system* in the treatment of patients with pressure ulcers by measuring stabilized ulcers before and after use of this system to determine if such ulcers worsened, improved or healed. Our observations indicate that use of this low-air-loss mattress system reduces the size and facilitates the healing of previously stable, chronic pressure ulcers..(Charles, M. A. Oldenbrook, J. Catton, C. 0889-5899 Journal ArticleOstomy Wound ManageAged Aged, 80 and over Beds/*standards Decubitus Ulcer/*nursing Female Human Male Middle Age Pilot Projects Retrospective Studies Wound Healingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7612140Charrier, J-M. 1991NHPolymeric Materials and Processing, Plastics, Elastomers and Composites. New York Oxford University Press& Chen, W-S. Higashi, L. Chang, M. 1999d]Characteristics of the internal tissue stress: a study using a heel contact model (abstract).\4.Archives of Physical Medicine & Rehabilitation80802071769e173- 1991.(Hypothermia related to air-fluidized bed 186-7 LFChosidow, O. Wolkenstein, P. Brun-Buisson, C. Roujeau, J. C. Revuz, J.0342-4642 LetterIntensive Care MedtnAdult *Air Beds/*standards Case Report Epidermal Necrolysis, Toxic/*therapy Female Human Hypothermia/*etiologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2071769 Chow, W.W. 1974yMechanical Properties of gels and other materials with respect to their use in pads transmitting forces to the human bodye University of MichiganPh.D Dissertation10984203213g 2000 Aug:3Respiratory monitoring using an air-mattress system3 345-54This paper describes a non-invasive respiratory monitoring system using an air mattress. The air-mattress system features multiple air compartments to monitor movements of the thorax and the abdomen separately. To evaluate the performance of the air-mattress system, four subjects were selected for the study and their separate ribcage and abdominal movements were monitored simultaneously by respiratory inductive phlethysmography belts and the air-mattress system. The sensitivity and accuracy indices of the air-mattress system for the detection of hypopnoeas scored remarkably well (above 90%). In addition, it was noted that the mean error in the measurement of the respiratory rate between the two systems was very small. This paper shows that the air-mattress system can be a reliable non-invasive respiratory monitoring system to detect simple abnormalities in breathing, such as respiration rate and hypopnoeas.'jcElectronics and Communication Engineering Department, Singapore Polytechnic, Republic of Singapore.:3Chow, P. Nagendra, G. Abisheganaden, J. Wang, Y. T..(0967-3334 Clinical Trial Journal Article Physiol MeasD>Abdomen/physiology Adult Air Anthropometry *Beds Human Male Middle Age Monitoring, Physiologic/instrumentation/*methods Movement/physiology Plethysmography/instrumentation/*methods Respiratory Mechanics/*physiology Sensitivity and Specificity Sleep/physiology Sleep Apnea, Obstructive/physiopathology Thorax/physiologylehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10984203 "Christensen, K.S. Klarke, M. 1986HATranscutaneous oxygen measurement In peripheral occlusive disease,%The Journal of Bone and Joint Surgery 68-B3423-426oon file TIG-IF.(A biomechanical evaluation of sorbothane*$Cinats, J. Reid, D. C. Haddow, J. B. 1987>8Clinical orthopaedics and related research [Clin Orthop] 222 281-8:4Using Smart Source Parsing Sep; ( pp Journal ArticleOrthotic Devices* Polymers* Shoes* Athletic Injuries/prevention & control Biomechanics Evaluation Studies Foot/physiology Humane8730256581031641 3426 8872 1993 Sep 110)Nosocomial infection and microsphere bedsp 680-1 Clancy, M. J.40140-6736 Comment Letter Lancet*Beds Cross Infection/*transmission *Enterococcus *Equipment Contamination Gram-Positive Bacterial Infections/*transmission Human5jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8103164vx2188312e153 1990May-JunoZTCosts and acceptability of two special overlays for the prevention of pressure sores 133-7- In a randomized clinical trial, 187 adult patients with chronic neurologic conditions who were at a high risk of developing pressure sores were assigned for 3 months to either an alternating air (AA) mattress overlay or a silicore (S) mattress overlay. Costs associated with each overlay were calculated and compared by adding depreciation and yearly expenses related to maintenance, operation, and repair for 148 patients who completed the trial. Acceptability was measured by questionnaires and interviews involving 45 of the patients' primary nurses and a sample of 40 patients (20 from each overlay group). The annual cost of the AA overlay was 54% more than that of the S overlay. Although most nurses (more than 74%) believed that both overlays helped prevent pressure sores and deter their progression, many (more than 56%) would not recommend either type to other facilities or to patients at home due to specific negative features. Implications for manufacturers, investigators, clinicians, and administrators are identified.81Conine, T. A. Daechsel, D. Choi, A. K. Lau, M. S.gJD0278-4807 Clinical Trial Journal Article Randomized Controlled Trial Rehabil NursAdolescence Adult Beds/*standards *Consumer Satisfaction Decubitus Ulcer/economics/nursing/*prevention & control Human Middle Age Questionnaires Randomized Controlled Trials Support, Non-U.S. Gov'tTjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21883122394540131  1990VPThe role of alternating air and Silicore overlays in preventing decubitus ulcers 57-65o"Patients with chronic neurological diseases who were at high risk of decubitus ulcers were randomly assigned to alternating air on silicore mattress overlays for a period of 3 months. Of 148 subjects who completed the trial, more than 50% in each group developed one or more ulcers. No statistically significant differences between groups were found in the incidence, severity, healing duration or the location of the ulcers; with the exception of a significant difference (p less than 0.001) in the categorical location of the trochanters.'PJSchool of Rehabilitation Medicine, University of British Columbia, Canada.,%Conine, T. A. Daechsel, D. Lau, M. S.cJD0342-5282 Clinical Trial Journal Article Randomized Controlled TrialInt J Rehabil Res Adolescence Adult Air *Beds Decubitus Ulcer/complications/epidemiology/*prevention & control Equipment Design Human Incidence Materials Testing Middle Age Nervous System Diseases/complications Silicon Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23945408318155s6c2a 1993 MarrhaIn vivo (CT scan) comparison of vertical shear in human tissue caused by various support surfacesg 20-3, 26-8Shear stress and shear strain of human tissue were calculated in vivo using measurements derived from pelvic CT scans of three subjects lying upon three depths of foam mattress overlays and an air mattress overlay commonly used in the prevention of pressure ulcers. The air mattress overlay plus three-inch foam had the lowest degree of tissue shear when compared with the foam overlays both quantitatively and qualitatively. In addition, it was found that the contouring air mattress overlay plus three-inch foam provided the greatest area of contact between surface support and subject when compared to the foam overlays, resulting in a greater distribution of applied load and ultimately decreasing tissue shear.y Conner, L. M. Clack, J. W..(0898-1655 Clinical Trial Journal Article DecubitusaAdult Beds/*standards Biomechanics Comparative Study Decubitus Ulcer/etiology/*physiopathology/prevention & control Human Ischium/*radiography Male Pressure *Tomography, X-Ray Computedjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=83181552315109r8611 1990 Mar 14-20wMattress conditions152 Conway, R. 0954-7762 Journal Articler Nurs TimesBeds/*standards Cross Infection/etiology England *Environmental Microbiology *Environmental Monitoring Evaluation Studies Hospitals, General Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23151091622538c385  1992 JunGEvaluation and cost analysis of a pressure reduction mattress. One hospital's study of a pressure reduction mattress and its effectiveness 43-51t Conwill, J.  0889-5899 Journal ArticleeOstomy Wound Manage *Beds Clinical Nursing Research/methods Costs and Cost Analysis Decubitus Ulcer/*prevention & control Human Intensive Care Units Risk Factorsnjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16225381044096l 142i40 1976 Jan 29>7Supporting patients on air: an answer to pressure soresl 45-6 Coombs, R. M. 0143-2524 Journal ArticleNurs Mirror Midwives J<6*Air *Beds Decubitus Ulcer/*prevention & control Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10440969832744 7 8 1998 Sep9F?A randomised controlled trial of two pressure-reducing surfaces) 374-6sThis randomised controlled trial of two dry-flotation pressure-reducing surfaces evaluates pressure sore incidence, patient comfort and the appropriate use of equipment in 100 orthopaedic patients. The trial involved five full Roho mattresses, five Sofflex mattresses and 10 Roho Quatro cushions to be used to complement the beds. Given the low rate of pressure sore incidence in this high-risk group it is not possible to determine whether there is any difference in effectiveness between the two mattresses. Both appear to provide similar levels of comfort, with the majority of patients finding them either comfortable or very comfortable. The initial setting of the equipment was, however, unsatisfactory.g'4-Medical School, Aberdeen Royal Infirmary, UK.f,&Cooper, P. J. Gray, D. G. Mollison, J.JD0969-0700 Clinical Trial Journal Article Randomized Controlled Trial J Wound Care Activities of Daily Living Aged Aged, 80 and over Beds/*standards Comparative Study Decubitus Ulcer/etiology/*prevention & control Female Geriatric Assessment Human Incidence Male Nursing Assessment Patient Satisfaction Pressure Risk Factors Support, Non-U.S. Gov'tsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9832744)( '&336270018413 1988 Mar 30-Apr 56/Tissue viability. Action against pressure soresn 68-73 Hibbs, P. 0954-7762 Journal Article, Nurs TimesXRBeds Decubitus Ulcer/*prevention & control Human *Nursing Assessment *Nursing Carejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3362700("Hickerson, W. Parks, J. Bishop, J. 1997VPA new measuring device and mattress to augment the prevention of pressure sores. ("Leaper, D. Cherry, G. Cockbill, S.:3New Approaches to the Management of Chronic Wounds. Milan Macmillan Magazines Ltd.652120715i103p 1990 Fall2+Choosing the correct pressure relief devicer 118-20, 125pHinojosa, R. J.2 0741-5206 Journal ArticlenPlast Surg NursSzt*Beds Decubitus Ulcer/*nursing/prevention & control Diagnosis-Related Groups *Equipment and Supplies, Hospital Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2120715 Hobson, D. A.hVOComparative effects of posture on pressure and shear at the body-seat interface 1992J Rehabil Res Dev+294 21-31<5Using Smart Source Parsing Fall; ( pp Journal ArticleDecubitus Ulcer:*PP/PC Posture:*PH Spinal Cord Injuries:*PP Wheelchairs:* Adult Aged Buttocks Middle Age Pressure Transducers, Pressure Female Human Male Support, Non-U.S. Gov'tThis study considers the effects of seated posture and body orientation on the pressure-distribution and surface shear (tangential) forces acting at the body-seat interface. Nine postures typically assumed by wheel-chair users were studied. Comparisons were made within and between two study groups, made up of 12 subjects with spinal cord injuries (SCI) and 10 nondisabled subjects. Both interface pressure and the surface shear were measured simultaneously in each of nine reproducible, seated postures. The same seat cushion was used for all trials. The Oxford Pressure Monitor, a pneumatic cell device, was used to measure and record the interface pressures. Instrumentation for measuring and recording the surface shear force was constructed specifically for the study. Analysis consisted of statistically comparing changes in pressure values and shear forces derived from eight sitting postures with reference to values recorded in a defined neutral sitting posture. The pressure-distribution findings suggest that in the postures studied SCI subjects have maximum pressures that are higher than nondisabled subjects in all postures, ranging from 6% to 46% depending on the posture. Maximum pressures can be reduced by postural changes: forward flexion to 50 degrees, -9%; backrest recline to 120 degrees, -12%; and, full body tilt, -11%. On average, the SCI group members have peak pressure gradients (PPG) that are 1.5 to 2.5 greater than the nondisabled group. The maximum reduction in PPG occurred at backrest recline of 120 degrees, -18%. Tangential shear force acts at the body-seat interface in all nine postures studied. Extrapolation of results suggests that full-body tilt to approximately 25 degrees reduces the surface shear force to near zero. In contrast, a backrest-only recline of 20 degrees causes a 25% increase in the surface shear force. These results suggest that caution must be taken when using nondisabled subjects as surrogates for people with SCI because of the inherent differences between the groups. Also, researchers and clinicians should recognize that posture and body orientation in space are additional variables that can have a profound effect on the interaction between a seated person and his or her supporting surface.93058677107866059541 1999 Oct 13-19mAnd so to beds 50-2 Hocking, J.o 0954-7762 Journal Article0 Nurs TimesBeds/*supply & distribution Cost Savings *Decision Making Decubitus Ulcer/economics/*prevention & control Human Information Services *Patient Selection*lehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=107866059069742i9842 1996Jul-Aug3^XUse and perceived effectiveness of pressure ulcer treatments in extended care facilities 43-781This study investigated the use and perceived effectiveness of available treatment products and procedures for pressure ulcers in extended care facilities (ECFs) in the southern border regions of Arizona, New Mexico, and west Texas. Respondents completed a questionnaire evaluating the effectiveness of products and procedures used by their facilities within the last 5 years. Using descriptive statistics, data from a sample of 96 ECFs in the southwestern United States were analyzed. Respondents reported a variety of products and procedures as effective, but the effectiveness of many of these products has not been supported by research, and some products have been found to be potentially harmful. ECFs are urged to select and use research-based, effective treatment protocols and guidelines for pressure ulcers.'JDDepartment of Nursing, New Mexico State University, Las Cruces, USA.2,Hoffman, R. G. Pase, M. N. VanLeeuwen, D. M. 1076-2191 Journal ArticleAdv Wound CareAttitude of Health Personnel Bandages/*standards Beds/*standards Decubitus Ulcer/*nursing Human Ointments/*standards Physician's Practice Patterns/*standards Questionnaires *Skilled Nursing Facilities Southwestern United States Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9069742ness of an alternating-pressure mattress overlay (AlphaXcell) used in combination with a pressure-reducing cushion (Multitec) in providing 24-hour pressure area care in a wide range of patients within a district general hospital.f,%Clifford, I. Candler, S. Starling, M.s.(0966-0461 Clinical Trial Journal Article Br J Nurs Aged Aged, 80 and over Beds/*standards Decubitus Ulcer/etiology/*prevention & control Female Human Male Middle Age Nursing Assessment Pilot Projects Risk Factorscjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8696098105319208.1r 1998 Jane>7Water vapour permeable materials for mattress coveringse 12-4 Clubb, M.m 0965-206x Journal ArticleeJ Tissue ViabilityBedding and Linens/*standards/supply & distribution *Beds Decubitus Ulcer/*prevention & control Gases Human Materials Testing Permeability Porosity *Waterlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10531920l 255558111t 1979 MarAPJThe intermittent air-fluidized bed and the neurologically impaired patient 31-3 Coker, K. E. 0047-2603 Journal ArticlerJ Neurosurg NursAdolescence Adult Air *Beds/standards Case Report Decubitus Ulcer/*prevention & control Female Human Male Nervous System Diseases/nursing1jchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=255558af9121889r9310 1997Mar 5-11 Know how. Kinetic therapy  48-9 It is normal practice for patients in intensive care units to be turned regularly--every two hours, or more, depending on their medical condition and at-risk status. Manual turning makes high demands on nursing time and can result in a high incidence of back injuries. The introduction of kinetic therapy as a means of keeping patients moving is proving beneficial in both intensive care and high-dependency care settings to patients and their carers. It is a therapy that can be initiated by both nursing and medical staff.'*#Addenbrooke's NHS Trust, Cambridge.i Collier, M.8810954-7762 Journal Article Review Review, Tutorialn Nurs Timesjd*Beds Human *Lifting *Movement Nursing Assessment Patient Selection *Posture Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=912188911868189919 2000 Oct 26-Nov 8F@Use of Pressurease and Airform mattresses in pressure ulcer care 2104-8TMLarge cell dynamic air mattresses are effective in the prevention of pressure ulcers but they still have inherent problems, e.g. the ability of the mattresses to move patients along the mattress through the inflation and deflation of the cells. Also, there have been reports that the inflation and deflation of cells can cause motion sickness. This article reviews two mattresses from Sareo Healthcare Ltd: a static system, Pressurease; and a unique dynamic system, Airform. These two systems offer a cost-effective and clinically effective method of pressure ulcer prevention and therapy.aCollins, F. Hampton, S.0 0966-0461 Journal Articlei Br J NursNlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1186818981025479392 4783 1982 Feb 11,&King's Fund beds: designing a standard 187-8, 190 Comer, S.7 0300-8347 Journal Article Health Soc Serv J0>8Beds/*standards Equipment Design Great Britain Hospitalslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10254793 10284003344 1985Jul-Augd82Selection of equipment based on a controlled trial 31-2.'Conine, T. A. Daechsel, D. Gueho, W. E. 0029-649x Journal Article- Nurs HomesXQBeds/*standards British Columbia Decision Making *Equipment Design *Nursing Homes lehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10284003 2781130m145  1989Sep-Oct0\UThe user--friendliness of protective support surfaces in prevention of pressure sores- 261-3o82Special mattress overlays and seat cushions for the prevention of pressure sores constitute a large portion of the rehabilitation products market. Consumers frequently face economic concerns in choosing among these products. This article summarizes the favorable and unfavorable features of major support surface types: foam, air-filled, flotation, and alternating air. A careful consideration of characteristics, such as fire safety, patient comfort, and ease of transfer and handling, may facilitate selection and result in more satisfied users and caregivers.(!Conine, T. A. Choi, A. K. Lim, R.f 0278-4807 Journal Articlee Rehabil Nursd^Beds/*standards *Consumer Satisfaction Decubitus Ulcer/*prevention & control Human Maintenancejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2781130  108959214 3e 2000Jul-Sep/haMaximizing comfort and minimizing ischemia: a comparison of four methods of spinal immobilization  250-2yOBJECTIVE: To determine which of four methods of spinal immobilization causes the least ischemic pain. METHODS: A prospective, nonblinded comparative trial was conducted at a statewide emergency medical services training facility using a convenience sample of emergency medical technician students. After lying motionless for 10 minutes, students evaluated each device using a 10-centimeter visual analog scale. Subjective comfort was used as a measure of ischemia. RESULTS: Comfort scores were significantly different for all methods (F = 101, p < 0.001). A backboard padded with a gurney mattress and eggcrate foam (the equivalent of a spinal rehabilitation bed) caused the least ischemic pain (9.6 cm, 95% CI, 8.9 to 9.8 cm). A backboard padded with a gurney mattress was the second most comfortable device (7.0 cm, 95%/CI, 6.4 to 7.4 cm). A backboard padded with a folded blanket was the third most comfortable (3.3 cm, 95% CI, 2.6 to 4.9 cm). The backboard alone caused the most pain (0.8 cm, 95% CI, 0.7 to 2.1 cm). CONCLUSION: Increasing the amount of padding on a backboard decreased the amount of ischemic pain caused by immobilization.'Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5246, USA. mhauswald@salud.unm.edu(!Hauswald, M. Hsu, M. Stockoff, C.JD1090-3127 Clinical Trial Journal Article Randomized Controlled TrialPrehosp Emerg CareAnalysis of Variance Bedding and Linens Beds Comparative Study Emergency Medical Services/*methods Human Immobilization/*adverse effects Ischemia/etiology/*prevention & control Pain/etiology/*prevention & control Prospective Studies Spinal Injuries/*therapyAlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10895921sRL(NHS Centre for Reviews and Dissemination and Nuffield Institute for Health) 19954.The prevention and treatment of pressure soresEffective Health Care21 1-161472426 104 1992 Decv4-A review of pressure reduction device studies 3-5iWhen considering patient morbidity, mortality and costs, pressure sore formation is a major health care concern. An adjunct to the nursing care plan for prevention and treatment is the selection of a pressure reduction/relief device. This review of four pressure reduction device studies is intended to increase the vascular nurse's knowledge base concerning pressure reduction device efficacy. Each study is reviewed and graphed to identify like patterns within each study. Foam is judged to be least effective. Air cell and air mattress overlays are found to be intermediate devices and the low air loss beds appear to be the most effective. Few of the tested devices reduced pressure below 32mmHg at the heel site, leaving the heel at risk for breakdown.cHedrick-Thompson, J. K.o811062-0303 Journal Article Review Review, Tutorials J Vasc NursmtnBedding and Linens Beds Decubitus Ulcer/*prevention & control *Equipment and Supplies Human Manometry Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1472426 't:: 1977 Editorial Nursing Times 1712 1980 Editorial Nursing Times 1527  1993@:Medical Devices Agency. Evaluation - Foam Mattresses. PS-1 London Medical Devices Agency 1999$Wheelchair cushion terminology West Haverstraw, NYR @9Helen Hayes Hospital Center for Rehabilitation Technology 9hVPThis work was supported by the Paralyzed Veterans of America Spinal Cord Research Foundation and the New York State Department of Health. Copyrighted to Helen Hayes Hospital Center for Rehabilitation Technology. This document may be reproduced and distributed only if free at cost, not for profit. Appropriate referencing is requested.  2000JCPressure ulcer prevention guidelines--An expert consensus statement 6/Wound Care Association of New South Wales, Inc. August 2000 2000xrJoint industry foam standards and guidelines: Section 9. Flex fatigue on in-use softening standards and guidelines ("Polyurethane Foam Association, Inc May 20, 2002Website RLPublished July 1994. Copyright to Polyurethane Foam Association, Inc in 2000 2000rlJoint industry foam standards and guidelines: Section 12. Seating foam performance standards and guidelines *#Polyurethane Foam Association, Inc.y May 20, 2002WebsiteF*#Published July 1994. Copyright 2000F?Abu Own, A. Sommerville, K. Scurr, J. H. Coleridge Smith, P. D.  1995XREffects of compression and type of bed surface on the microcirculation of the heelEur J Vasc Endovasc Surg9e3t 327-34pj*Beds ; *Decubitus Ulcer prevention and control; *Foot Ulcer prevention and control; *Heel blood supply; *Skin blood supply Adult ; Aged ; Case Control Studies; Decubitus Ulcer epidemiology ; Foot Ulcer epidemiology; Laser Doppler Flowmetry; Microcirculation physiology; Middle Age; Pressure ; Risk Factors; Supine Position Comparative Study; Female; Human; MaletnOBJECTIVE: To assess the effects of compression on the skin microcirculation of the heel using laser Doppler fluxmetry. DESIGN: Parallel groups comparing patients with control groups. SETTING: Department of Surgery, University College London Medical School, London. SUBJECTS AND MATERIALS: Ten patients at risk of developing pressure ulceration, 10 age- and sex-matched healthy subjects and 10 young, healthy volunteers. An acrylic indenter with a slot to accommodate a laser Doppler probe was used to apply compression to the heel region. A pressure sensor was used to measure the applied compression. OUTCOME MEASURES: The resting laser Doppler flux was measured with the subject lying supine. Compression forces were then applied in increments from 50 g to 1500 g and the corresponding interface pressure (IP) and laser Doppler flux (LDF) recorded. The IP and LDF were also measured from the heel while the subject was lying on a low air-loss system and then on an NHS conventional hospital bed. RESULTS: The resting LDF is lower in the patient group compared to the control groups (p < 0.05). Compression of the heel caused a progressive decrease in LDF in all groups. Compression greater than 50 mmHg as well as lying on an NHS bed reduced the LDF signal to a minimal value (biological zero). On the low air-loss system, the median LDF was 17% of the resting value in the age-matched control group and 32% in the patient group. CONCLUSIONS: The results indicate that the heel microcirculation is vulnerable to compression. The low air-loss system maintained the IP sufficiently low to prevent complete cessation of the heel microcirculation.on file TIG annexc1988243i111s 1991 JancD>Kinetic therapy: adjunct to conventional treatment of anasarca 12-3Adams, C. Ruple, S.1 0279-5442 Journal Article6Crit Care NurseAged Aged, 80 and over *Beds Case Report *Critical Care Edema/physiopathology/*therapy Female Human *Motion Therapy, Continuous Passiveejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1988243s to study the effects of nonoscillating waterbeds on three indices of energy expenditure: activity level, heart rate, and behavioral state. Subjects were 22 healthy preterm infants in a neonatal intensive care unit who had reached 31-35 weeks postconceptional age, and whose average weight was 1,482 grams at the onset of the study. Infants were placed on a waterbed for 3 consecutive days and on a standard incubator mattress for 3 consecutive days. Infants served as their own controls on and off the waterbed. Treatment order was randomly counterbalanced. One-hour observations of activity and state occurring in conjunction with heartbeat counts were the repeated measures on each day over both treatment and control conditions. Infants experienced longer durations of quiet sleep, less active awake and fuss states, and fewer state changes and awakenings while on the waterbed. Heart rates were higher after infants were taken off the waterbed. The findings suggest that nonoscillating waterbed flotation is a simple, cost-effective intervention that reduces energy expenditure.'>8School of Nursing, West Virginia University, Morgantown.Deiriggi, P. M.JD0029-6562 Clinical Trial Journal Article Randomized Controlled TrialNurs Res*Beds Energy Metabolism Evaluation Studies Female Heart Rate Human Infant, Newborn *Infant, Premature Intensive Care Units, Neonatal Male Sleep Support, Non-U.S. Gov'tajdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2342898tx 7793717a261/ 1995 JulLEPain and tissue-interface pressures during spine-board immobilizationm 31-6 STUDY OBJECTIVES: Although spine boards are one of the main EMS means of immobilization and transportation, few studies have addressed the discomfort and potential harmful consequences of using this common EMS tool. We compared the levels of pain and tissue-interface (contact) pressures in volunteers immobilized on spine boards with and without interposed air mattresses. DESIGN: Prospective crossover study. SETTING: Emergency department of Methodist Hospital of Indiana, Indianapolis, Indiana. PARTICIPANTS: Twenty healthy volunteers who had not taken any analgesic drugs in the preceding 24 hours, were not experiencing any pain at the time of the study, and did not have history of chronic back pain. INTERVENTIONS: To simulate prehospital transport conditions, we immobilized volunteers with hard cervical collars and single-buckle chest straps on wooden spine boards with or without commercially available medical air mattresses. The crossover order was randomized. After 80 minutes, immobilization measures were discontinued and the subjects were allowed to get off the boards for a recovery period of 60 minutes. Subjects were then studied for a second 80-minute period with the opposite intervention. At baseline and at 20-minute intervals, the level of pain was rated with a 100-mm visual analog scale. Tissue-interface pressures were measured at the occiput, sacrum, and left heel. RESULTS: Mean pain on the visual analog scale was 9.7 mm at the end of the mattress period and 37.5 mm at the end of the no-mattress period (P = .0001). Although there were no significant differences in pain between the two groups at time 0, volunteers reported significantly more pain during the no-mattress period at 20 (P = .003), 40 (P = .0001), and 60 minutes (P = .0001). All 20 subjects reported that immobilization on the spine board with the mattress was "much better" (five-point scale) than that without the mattress. Interface pressure levels were significantly less in the mattress period than in the no-mattress period measured at occiput (P = .0001), sacrum (P = .0001), and heel (P = .0001). CONCLUSION: In a simulated immobilization experiment, healthy volunteers reported significantly less pain during immobilization on a spine board with an interposed air mattress than during that on a spine board without a mattress. Tissue-interface pressures were significantly higher on spine boards without air mattresses. This and previous studies suggest that immobilization on rigid spine boards is painful and may produce tissue-interface pressure high enough to result in the development of pressure necrosis ("bedsores"). Emergency care providers should consider the use of interposed air mattresses to reduce the pain and potential tissue injury associated with immobilization on rigid spine boards.'^WEmergency Medicine and Trauma Center, Methodist Hospital of Indiana, Indianapolis, USA.sVOCordell, W. H. Hollingsworth, J. C. Olinger, M. L. Stroman, S. J. Nelson, D. R. JD0196-0644 Clinical Trial Journal Article Randomized Controlled Trial Ann Emerg MedoAdolescence Adult Air *Beds Cross-Over Studies Equipment Design Female Human Immobilization/*adverse effects Male Middle Age Pain/etiology/*prevention & control Pressure Prospective Studies Support, Non-U.S. Gov't jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7793717 8999676s31 1977 Auge,&A cheap electro-pneumatic high-low bed 175-8eA cheap, simple high-low bed is described for use in wards without a compressed air supply. A main design feature is ease of operation to ensure that the bed is at the correct height for the patient and nurse and to waste as little as possible of the nurse's time. Corless, D.. 0002-0729 Journal Articler Age AgeingTN*Beds Economics, Hospital *Equipment and Supplies, Hospital Evaluation Studiesjchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=899967A7827743y7k3t 1994 MayrSmall-celled mattresses8, 10-1l Cotner, R. L.1076-2191 LetterAdv Wound CarelfBeds/*standards Decubitus Ulcer/physiopathology/*prevention & control Equipment Design Human *Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=782774323804231174 1990Jul-AugeB;Interface skin pressures on four pressure-relieving devices  150-3tD>Nurses employed in acute care hospitals frequently encounter patients who require a pressure-relieving device. It is often difficult for nurses to decide which support surface should be used to best meet a patient's need for a pressure-reducing device because of the multiplicity of products available. One of the variables studied was found not to statistically influence the effectiveness of the various pressure-relieving devices. Body build is not a consideration when determining which support surface is effective in a healthy population of subjects. The two air-flotation low air-loss beds would be defined as effective pressure-relieving devices. The interface pressure readings vary from individual to individual on various bony prominences. The population studied was that of healthy volunteers. Healthy subjects have an increased fat pad in their sacral area compared with the critically ill patient. The heel had the highest interface pressure of the five that were studied. This is a bony prominence that requires additional attention if skin integrity is to be maintained.2,Counsell, C. Seymour, S. Guin, P. Hudson, A. 0270-1170 Journal Article4J Enterostomal ThervoBeds/*standards Decubitus Ulcer/nursing/physiopathology/*prevention & control Evaluation Studies Human Pressure jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23804239128660m122r 1996 Novd.(Pressure-reducing aids for community use131-4, 8, 136, 138*#The need for effective pressure support systems is often overlooked in the community. Through patient assessment is required for the selection of pressure-reducing aids. Patients should be involved in the selection process, and any equipment chosen must be suitable for the home environment.8 Cowan, T.8810266-8130 Journal Article Review Review, Tutorialu Prof Nursey*Beds *Community Health Services Decubitus Ulcer/nursing/*prevention & control Equipment and Supplies Great Britain Humanijdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=912866091554631127n 1997 Apr30)Pressure support systems for hospital use 511-6, 520The range of pressure support systems is constantly increasing. Accurate assessment will assist the selection process. Practical considerations and cost implications must also be taken into account when selecting a product.. Cowan, T.a810266-8130 Journal Article Review Review, Tutoriale Prof Nurse{*Beds/economics/standards/supply & distribution Decubitus Ulcer/*prevention & control Great Britain Human Patient Selectionsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9155463 107966622h 2000NHBeds, mattresses and cushions for pressure sore prevention and treatmentCD001735XQOBJECTIVES: To assess the effectiveness of pressure relieving beds, mattresses and cushions (support surfaces) in the prevention and treatment of pressure sores. SEARCH STRATEGY: Searches of 19 databases, hand searching of journals, conference proceedings, and bibliographies. SELECTION CRITERIA: Randomised controlled trials evaluating support surfaces for the prevention or treatment of pressure sores. There was no restriction on articles based on language or publication status. DATA COLLECTION AND ANALYSIS: Data extraction and assessment of study quality was undertaken by two reviewers independently. Trials with similar patients, comparisons, and outcomes were pooled. Where pooling was inappropriate, trials are discussed in a narrative review. MAIN RESULTS: Prevention: 29 RCTs of support surfaces for pressure sore prevention were identified. Some high specification foam mattresses were more effective than 'standard' hospital foam mattresses in moderate-high risk patients. Pressure relieving mattresses in the operating theatre reduced the incidence of pressure sores post-operatively. The relative merits of alternating and constant low pressure, and of the different alternating pressure devices are unclear. Seat cushions and simple, constant low-pressure devices have not been adequately evaluated. Limited evidence suggests that low air loss beds reduce the incidence of pressure sores in intensive care. Treatment: 6 RCTs of support surfaces for pressure sore treatment were identified. There is good evidence that air-fluidised and low air loss beds improve healing rates. Seat cushions have not been adequately evaluated. 2 RCTs evaluated surfaces for both prevention and treatment in the same trial. REVIEWER'S CONCLUSIONS: Prevention - There is good evidence of the effectiveness of high specification foam over standard hospital foam, and pressure relief in the operating theatre. Treatment - There is good evidence of the effectiveness of air-fluidised and low air loss devices as treatments. Overall, however, it is impossible to determine the most effective surface for either prevention or treatment.'Centre for Evidence Based Nursing, Department of Health Studies, University of York, Genesis 6, York, UK, YO10 5DQ. nac2@york.ac.ukB Cales1997k Callaghan1994 Calrow1996$Campbell1986Campbell1998 Campell1995 Campi1997) Can1989 Candler1995 Caplan1968l Carbona1995m Cardea1995 Cardi1992 Cardi1993A Cardi1994nCarleton1998oCarlisle1999 Carlson1994 Carlsson20010 Carmichael1995a Carney19955p Carpendale1974V Carr19819 Carr20002q Carroll1993r Carroll1995 Carsin1991 Carter19959! Casey2001 Castellino1998 Castro1993^ Catania1998y Catton19951~ Catz1999s Cave1998v Cave20002t Ceccio1990;Chagares1988u Chalian2001vChaloner2000 Chamberlain1994 Chan1993 Chandra1988 Chang1992 Chang1999w Chardin1999x Chardin2000y Charles1995)Charrier1991 Chen1984 Chen1999x Chen20000K Chestnutt1975^ Cheung19989 Chevalier1993 Childs19911) Childs19977 Choi19898 Choi19901 Choi19929zChosidow1991 Chou19922 Chow1974{ Chow20002 Christensen1986? Christensen1987 Christenson1993 Chung1988* Cinats1987 Clack1993M Clague1985| Clancy1993} Clancy1994~ Clark1980 Clark1981 Clark1987 Clark1988 Clark1989 Clark1989 Clark19893 Clark1990 Clark1991 Clark1991 Clark19925 Clark1993 Clark1994 Clark1996 Clark1996 Clark1996 Clark1998^ Clark1998 Clark1999 Clark1999 Clark1999 Clark2000 Clark2002 Clarke1990B Clarke19969 Clemens1994Clifford1995 Clubb1998 Cochran1980 Cochran1980t Cocking20009 Cohen1985 Coker1979` Coleman1974'Coleridge Smith1995?Coleridge-Smith1990 Colin1995 Colin1995 Colin19954 Colin19965 Colin1996 Colin1996 Colin1997 Colin1997 Colley1979 Collier1996 Collier1997 Collins2000 Comaish1974 Comer1982 Conine1985 Conine19858 Conine1989 Conine1990 Conine1990 Conner1993OConnolly19938PConnolly19938 Conway1990 Conwill1992 Cooke1993 Coombs1976 Cooper1998 Cooper1998 Cooper2001A Cooperstein1998$Corcoran1999 Cordell1995 Corless1977 Corsin1991d Cosper19755 Cotner1994 Cotter1990Counsell1990V Coverdale1995 Cowan1996 Cowan1997 Cowan1998 Cox-Martin1996Cracchiolo-Caraway1988 Cranmer1993 Crisp1970C Cronin2000e! Crook1999Croudace1995 Croxton1989 Crunden1995sCuddigan1999; Cuellar1986j Cullen19929 Cullum1992 Cullum1995 Cullum1999 Cullum2000 Cullum2001870 Buchner1995f Buckle1998g Burda1993# Burg2000d$ Burg2000 Burgess-Allen1999Burleson20000h Burman1993J Burniston1971K Burns19921 Burri1974Y Burry1972 Burry1973s Buschmann1991% Bussey19833 Butcher2000 Butcher2002i Butler1973< Butler1995j Butrej1998 Buzard19879 Byrne1989 Byrne1994 Cahill2000C Cahill2000e-Calciati19979k Calderale1976> Cales1997k Callaghan1994J Callaghan1994 Calrow1996$Campbell1986Campbell1998 Campell1995) Can1989 Candler1995 Caplan1968l Carbona1995m Cardea1995 Cardi1992 Cardi1993A Cardi1994nCarleton1998oCarlisle1999 Carlson1994 Carlsson20010 Carmichael1995p Carpendale1974V Carr19819  Carr20002q Carroll1993r Carroll1995 Carsin1991 Carter19959! Casey2001 Castellino1998 Castro1993y Catton19951s Cave1998v Cave20002t Ceccio1990;Chagares1988u Chalian2001vChaloner2000 Chamberlain1994 Chandra1988w Chardin1999x Chardin2000y Charles1995 Chen1984x Chen20000K Chestnutt1975 Chevalier1993 Childs19911) Childs19977 Choi19898 Choi19901 Choi19929zChosidow1991{ Chow20002 Christensen1986? Christensen1987 Christenson1993 Chung1988 Clack1993M Clague1985| Clancy1993} Clancy1994~ Clark1980 Clark1981 Clark1988 Clark1989 Clark19893 Clark1990 Clark1991 Clark19925 Clark1993 Clark1998 Clark1999 Clark1999  Clark2000 Clark2002 Clarke1990B Clarke19969 Clemens1994Clifford1995 Clubb1998 Cochran1980t Cocking2000 Cohen19859 Cohen1985 Coker1979` Coleman1974Coleridge Smith1995'Coleridge Smith1995?Coleridge-Smith1990 Colin1995 Colin19964 Colin19965 Colin1996 Colley1979 Collier1996 Collier1997 Collins2000 Comaish1974 Comer1982 Conine1985 Conine19858 Conine1989 Conine1990 Conine1990 Conner1993Connolly1993Connolly1993OConnolly19938PConnolly19938 Conway1990 Conwill1992 Cooke1993 Coombs1976 Cooper1998 Cooper1998 Cooper2001A Cooperstein1998$Corcoran1999 Cordell1995 Corless1977 Corsin1991d Cosper19755 Cotner1994 Cotter1990Counsell1990V Coverdale1995 Cowan1996 Cowan1997 Cowan1998 Cox-Martin1996Cracchiolo-Caraway1988 Cronin2000C Cronin2000e! Crook1999Croudace1995 Croxton1989 Crunden1995; Cuellar1986j Cullen19929 Cullum1992 Cullum1999 Cullum2000 Cullum2001 z98710150279141i 1995Jan-Feb.$High-tech home care solutionsd 37, 42 Diehm, S. L. 1057-428x Journal Articlec Contin Carevvo*Beds/economics/utilization Equipment Design *Home Care Services Nursing Care/methods Patient Transfer/*methods lehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10150279e10119197176h 1992 Jun7>7Hospitals, GPOs look to cut costs with refurbished beds  1, 10tDiekman, J. M. 0888-3068 Journal Article Hosp Mater Manage Beds/*economics Cost Savings/methods/statistics & numerical data Hospital Shared Services/*economics Industry/economics Purchasing, Hospital/*methods United Statesslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10119197iDinsdale, S. M. 1973TNDecubitus ulcers in swine: light and electron microscopy study of pathogenesisArch Phys Med Rehabil542 51-6 passim*Decubitus Ulcer etiology; *Skin pathology Decubitus Ulcer pathology; Ischemia complications; Microscopy, Electron; Paraplegia complications; Pressure ; Swine Animal; Female-on file TIG annexDinsdale, S. M.+ 1974B7Using Smart Source Parsing Summer; ( pp Journal ArticleaD=Ischemia/*metabolism Skin/*blood supply Sweat/*metabolism Adult Decubitus Ulcer/metabolism Female Heat Human Hyperemia/etiology Hyperemia/metabolism Ischemia/etiology Lactates/metabolism Male Pilocarpine/diagnostic use Pressure/adverse effects Sodium/metabolism Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S.88316769 "Ferguson-Pell, M. Cardi, M.R 19922,Pressure mapping systems (Team Rehab Report) 28-32October$Ferguson-Pell, M. Cardi, M. D.\VPrototype development and comparative evaluation of wheelchair pressure mapping system 1993Assist Technol5+2 78-916/Using Smart Source Parsing ( pp Journal ArticleiPressure:* Wheelchairs:* Consumer Satisfaction Equipment Design:IS/MT Evaluation Studies Questionnaires Weight-Bearing Comparative Study HumanWheelchair pressure mapping devices used in the prescription of seat cushions and postural supports have been limited in durability, data presentation, and/or clinical efficiency. This project sought to establish the ideal specifications for clinically useful pressure mapping systems, and to use these specifications to influence the design of an innovative wheelchair pressure mapping system (Tekscan "Seat"). Technology, previously developed for measurement of forces of dental occlusion and of the foot during gait, was applied to wheelchair seat mapping. Tests were designed to compare the performance of three pressure mapping systems: the Tekscan system, the FSA system, and the Talley TPM3. Bench tests were done to measure reproducibility, hysteresis, and creep of each of the pressure mapping systems. A contoured loader gauge was developed to test for the influence of hammocking. Tests were also performed using spinal cord-injured subjects to demonstrate the relative performance of the pressure mapping systems in a clinical setting. A focus group session was conducted with seating specialists to review the strengths and weakness of the systems for routine clinical use. The TPM3 was found to be the most accurate, stable, and reproducible but limited in ease of use, speed, and data presentation. FSA was rated well in clinical application and data management but demonstrated a pronounced hysteresis (+/-19%) and creep (4%). The Tekscan system also showed substantial hysteresis (+/-20%) and creep (19%) but was preferred by clinicians for its real-time display capabilities, resolution, and display options. Some trends in system performance on varied support surfaces were identified and can be a valuable guide to interpretation of measurements and prescription decision making in the clinic. Problems identified with the accuracy and stability of the Tekscan and FSA systems may be amenable to resolution with software correction and changes in fabrication. With these improvements all three systems show the potential to be useful clinical tools.94905716nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=407297g5118071146 249 1971 Oct:3Rippling mattress worked from compressed air supplyr 733-5s0*Etchells, A. H. Thomas, D. L. Young, D. G. 1468-2044 Journal ArticleArch Dis Child<6Atmospheric Pressure Beds/*instrumentation Electronicsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=51180716123027i1h 8284 1982 Jun 5aHBUse of the 'air wave system' to prevent pressure sores in hospital1288-90eBEvaluation of a sensor for low interface pressure applications 2000 Med Eng Phys229s 657-63:4Using Smart Source Parsing Nov; ( pp Journal ArticleyPressure:* Skin Physiology:* Bandages Burns:TH Clothing Edema:TH Reproducibility of Results Human Support, Non-U.S. Gov'tsPIAn ultra-thin, small sensor has recently been developed, "FlexiForce" (Tekscan, Boston, MA, USA), which may be effective for the measurement of low interface pressure between the skin, support surfaces and pressure garments.To evaluate the suitability of the sensor for these applications, drift, repeatability, linearity, hysteresis and curvature effects were tested under laboratory conditions.The drift was 1.7-2.5%/logarithmic time, the repeatability was 2.3-6.6% and the linearity was 1.9-9.9% in the range of forces of 10-50 g applied. The hysteresis was 5.4% on average. The output offset of the sensor increased with decreasing radius of curvature for radii less than 32 mm compared with a flat surface when no pressure was applied. The sensitivity to pressure decreased with curvature for radii less than 32 mm.It was found that the sensor had acceptable drift, repeatability, linearity and hysteresis. However, a significant curvature effect was observed indicating that the sensor is suitable for direct measurement on surfaces with the radii greater than 32 mm under static conditions.211605548338511u 269s4n 1993 Jan 27NHA randomized trial of low-air-loss beds for treatment of pressure ulcers 494-7 haOBJECTIVE--To assess the effectiveness of low-air-loss beds for the treatment of pressure ulcers in nursing homes. DESIGN--Prospective, randomized, clinical trial. SETTING--Three teaching nursing homes in Los Angeles, Calif. SUBJECTS--Eighty-four nursing home residents with trunk or trochanter pressure ulcers (Shea stage > or = 2). INTERVENTIONS--Subjects were randomly assigned to use either a low-air-loss bed (n = 43) or a 10-cm corrugated foam mattress (n = 41) throughout the healing of their ulcers. OUTCOME MEASURES--Ulcers were assessed twice weekly using surface area and two observational scales (median follow-up, 37.5 days; range, 4 to 571 days). RESULTS--Groups were similar with respect to demographics, medical variables, wound care, and early dropouts. Results indicate more than a threefold improvement in median rate of healing for low-air-loss beds compared with foam mattresses (9.0 vs 2.5 mm2/d; P = .0002). This finding was true for deep as well as superficial ulcers (deep ulcers, 9.9 vs 0.7 mm2/d; P = .02; superficial ulcers, 9.0 vs 3.2 mm2/d; P = .004). Cox regression models revealed that the bed, ulcer depth, and fecal continence had independent effects on healing. After controlling for fecal continence, the deep and superficial subgroups using low-air-loss beds remained 2.5 times more likely to heal in a given length of time compared with those using foam mattresses (combined cure probability ratio, 2.66; 95% confidence interval, 1.34 to 5.17; P < .004). CONCLUSION--Low-air-loss beds provide substantial improvement compared with foam mattresses despite other factors in pressure ulcer healing.'60Department of Medicine, UCLA School of Medicine.2,Ferrell, B. A. Osterweil, D. Christenson, P.JD0098-7484 Clinical Trial Journal Article Randomized Controlled Trial JamaAged Aged, 80 and over *Beds Comparative Study Decubitus Ulcer/*therapy Female Human Male Nursing Homes Prospective Studies Regression Analysis Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S. Treatment Outcomejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=83385117743399i503r 1995 MayeNHCost-effectiveness of low-air-loss beds for treatment of pressure ulcers M141-6 BACKGROUND. Cost-effectiveness of low-air-loss beds for the healing of pressure ulcers was analyzed in the nursing home setting. A statistical model of pressure ulcer healing was used to estimate cost-effectiveness based on patient and ulcer characteristics. METHODS. Results of a previous randomized trial (84 patients from three nursing homes in Los Angeles) were reanalyzed and combined with estimates of costs to calculate the cost-effectiveness in dollars per added day free of pressure ulcers achieved by the use of low-air-loss beds compared to conventional foam mattresses. RESULTS. The cost-effectiveness of the low-air-loss bed was $26 per added day free of ulcers for our standard patient. Results were sensitive to low-air-loss bed lease costs and patient and wound healing characteristics. Results were less sensitive to expected mortality, daily wound care costs, and time-frame of consideration. Low-air-loss beds were more cost-effective for patients with good healing characteristics and mild ulcers. CONCLUSIONS. Findings support the expanded use of this technology for patients with mild pressure ulcers and good healing characteristics. For these patients, the cost-effectiveness of low-air-loss beds is comparable to other accepted health treatments. For patients with severe ulcers and poor healing characteristics, low-air-loss bed cost-effectiveness compares poorly with other accepted health treatments unless the lease cost can be substantially reduced, or unless life with a pressure ulcer is valued close to death.'$UCLA School of Medicine, USA.dD=Ferrell, B. A. Keeler, E. Siu, A. L. Ahn, S. H. Osterweil, D.sJD1079-5006 Clinical Trial Journal Article Randomized Controlled Trial$J Gerontol A Biol Sci Med Sci Aged Aged, 80 and over Beds/*economics Cost-Benefit Analysis Decubitus Ulcer/*economics/*therapy Female Human Male Nursing Homes Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S.jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7743399110518719e6 SupplU 2000 Mar 23-Apr 12p>7Interface pressure measurements in leg ulcer management1S8-10, S12, S14 passim$Interface pressure measurements are undertaken in health care as a useful tool to assist in understanding the pressures that exist between the skin surface and another surface. Pressure monitors are utilized to measure pressures under compression bandages and pressure garments and in determining pressures between patients and support surfaces such as pressure-reducing mattresses and cushions. This literature review identified that many studies using these measurements are inadequately described, and that there are many variables such as the effect of time, posture and temperature associated with such measurements that may lead to misinterpretation of results. Studies utilizing interface pressure measurements should be interpreted with caution and measurement techniques could be improved.'82Vascular Studies Unit, Royal Infirmary, Edinburgh. Finnie, A.820966-0461 Journal Article Review Review Literature Br J NursBandages/*adverse effects Beds/*adverse effects Human Leg Ulcer/*etiology/*nursing Monitoring, Physiologic/*methods/nursing Nursing Assessment/*methods Pressurelehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11051871+------....////00000000022222xxxx111114444555555666666888887777799999999:::::;;;www<<<======?????????@@@@@@@AAABBBBCCCCCEEEDDDDDDFFFFFGGGGHHJJJKKKMMMMMNNNNOOOOOOOsPPPPPPPQQQQQQQRRRRRRD55462l 2000 Feb8Randomized controlled trial to determine the safety and efficacy of a multi-cell pulsating dynamic mattress system in the prevention of pressure ulcers in patients undergoing cardiovascular surgery  46-51, 54-5057852:382m 1972 Febdf_Thermal regulation of pediatric patients in the operating room by means of an air fluidized bed1 111-4>7Russell, H. E., Jr. Othersen, H. B., Jr. Hargest, T. S.G 0003-1348 Journal Article-Am Surg *Air Air Movements *Beds Biomedical Engineering *Body Temperature Burns/therapy Decubitus Ulcer/therapy *Equipment and Supplies Human Humidity Infant Infant, Newborn Operating Rooms Temperatureajdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=505785210745855462l 2000 Feb8Randomized controlled trial to determine the safety and efficacy of a multi-cell pulsating dynamic mattress system in the prevention of pressure ulcers in patients undergoing cardiovascular surgery  46-51, 54-5eThe purpose of this study was to determine the efficacy and safety of a multi-cell pulsating dynamic mattress system in comparison with conventional management for the prevention of pressure ulcers in the operative and postoperative period in patients having cardiovascular surgery. The study was a single center, prospective, randomized, controlled trial. Patients who were having cardiovascular surgery for a duration of at least 4 hours were randomly assigned, prior to surgery, to dynamic mattress system or conventional management--both of which were initiated in the operating room and continued for up to 7 days postoperatively. Patients were assessed daily using a standardized scoring system. The results of the study showed that 198 patients in the dynamic pressure system (n = 98) or conventional management group (n = 100) were similar at baseline. A strong trend of decreased pressure ulcers existed in the dynamic pressure system group (n = 2) compared to the conventional management group (n = 7). The study concluded that a multi-cell pulsating dynamic mattress system is safe and mitigates risks for and decreases incidence of pressure ulcers in patients who undergo cardiovascular surgery.'VPDepartment of Medicine, St. Paul's Hospital,Vancouver, British Columbia, Canada.("Russell, J. A. Lichtenstein, S. L.JD0889-5899 Clinical Trial Journal Article Randomized Controlled TrialOstomy Wound ManageActivities of Daily Living Aged Beds/*standards Cardiovascular Surgical Procedures/*adverse effects Decubitus Ulcer/classification/*etiology/*prevention & control Female Human Incidence Male Middle Age Nursing Assessment Postoperative Complications/classification/*etiology/*prevention & control Prospective Studies Risk Factors Severity of Illness Index Support, Non-U.S. Gov't Time Factorslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10745855<;\Flam, E. 19900*Skin maintenance in the bed-ridden patientOstomy Wound Manage28 48-54*Bed Rest nursing Bedding and Linens; Decubitus Ulcer etiology; Decubitus Ulcer nursing; Decubitus Ulcer prevention and control; Evaluation Studies Comparative Study; Human"The skin of a patient at risk of developing pressure ulcers can resist deterioration if the conditions that weaken it are controlled. The purpose of this study is to determine the relationships between hydration level, skin temperature, and friction in patients at risk of development or reoccurrence of pressure ulcers and in patients with newly created surgical flaps. Two systems were considered: the standard hospital mattress covered with a thick occlusive plastic film and a 50/50 cotton/polyester bed sheet and the KinAir and the TheraPulse support systems with nylon/High Air Loss GORE-TEX (n/HAL) laminate cushions and coverlets. The moisture vapor management and aeration capabilities of the support system materials were determined, and the frictional force generated against the skin was measured. The results revealed that excessive hydration increases the level of friction against the skin while at the same time reducing the mechanical properties of the protective skin layers. The n/HAL laminate coverlet also had a significantly lower skin friction coefficient than the 50/50 cotton/polyester bed sheet. The significance of these findings is that over-hydration accelerates the abrading action on the skin by increasing the frictional force and decreasing the shear resistance of the skin. TIG annex1954297s1865 1991Nov-DecoNGDynamics of pressure ulcer management: interaction of load and duration 184-9oFlam, E. Raab, L.r 1055-3045 Journal Articlen J ET NursBeds/*standards Decubitus Ulcer/etiology/physiopathology/*prevention & control Evaluation Studies Human *Pressure Support, Non-U.S. Gov't Time Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19542972018615133 1991Mar-Apre A new risk factor analysis 28-31, 34Flam, E. 0889-5899 Journal ArticleOstomy Wound Manage9Beds/*standards Decubitus Ulcer/epidemiology/*prevention & control Evaluation Studies Factor Analysis, Statistical Human Risk Factors Support, Non-U.S. Gov'trjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2018615B;Flam, E. Isayeva, E. Kipervas, Y. Shklyarevsky, V. Raab, L. 1995JDSkin temperature and moisture management with a low air loss surfaceOstomy Wound Manage419H 50-6*Bedding and Linens; *Decubitus Ulcer prevention and control; * Skin Temperature Aged ; Decubitus Ulcer physiopathology; Electric Conductivity; Humidity ; Middle Age Comparative Study; Female; Human; MaleImportant factors in the prevention and treatment of pressure ulcers are the maintenance of the physiological conditions of skin temperature and skin moisture level. Low air loss (LAL) therapy is a method of maintaining these conditions. The changes in the skin temperature and skin moisture level with an LAL support system were compared to those with a standard hospital mattress (SHM). The study was conducted on ten volunteers in the supine position for three hours in warm ambient room conditions. Skin temperature was measured continuously. The moisture level of the skin was determined using direct and indirect indicators. The results showed that, on the average, the skin temperature on the LAL system was 1.2 degrees F lower than that on the SHM (p = 0.0001). With the Moisture Vapor Transmission Rate skin moisture indicator, the moisture gain above normal with the LAL system was 87 percent lower than that with the SHM (p = 0.01). Similarly, with the conductance skin moisture indicator the conductance increase above normal with the LAL system was 96 percent lower than that with the SHM (p = 0.01). These results demonstrated the ability of the LAL system to maintain normal skin temperature and moisture content and aid in the protection against skin damage.on file TIG annex9128641t126 Suppl 1997 Mar2,Choosing pressure sore risk assessment tools S3-7ztThe validity and reliability of many commonly used risk assessment scores is inconclusive. Some risk assessment scores appear to be more suitable for specific clinical settings, therefore selection requires careful consideration. Further research is required on the relationship between predictions of risk status and the selection of appropriate patient support surfaces.'HBFaculty of Health and Human Sciences, University of Hertfordshire. Flanagan, M.810266-8130 Journal Article Review Review, Tutoriala Prof NurseBeds Decision Making Decubitus Ulcer/etiology/*nursing Human Nursing Assessment/*standards Predictive Value of Tests Reproducibility of Results Risk Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9128641P>hL 587386 145d9l 1977 Sep 1$The inhospitable hospital bed 25 French, D. J.T 0029-6511 Journal Articlei Nurs Mirrord *Beds jchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=587386J110968909546 1999 Nov 17-23= Bed covera56-8, 60 Friend, B. 0954-7762 Journal Article/ Nurs TimesBack Injuries/*prevention & control Beds/*standards/supply & distribution Equipment Design Human Human Engineering *Nursing Staff, Hospital Occupational Diseases/*prevention & controlalehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11096890e3830091E1911 1987 Jan-A new ERCP mattressX50Frimberger, E.0013-726x Letter EndoscopyERL*Beds Cholangiopancreatography, Endoscopic Retrograde/*instrumentation Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3830091TMFromy, B. Legrand, M. S. Abraham, P. Leftheriotis, G. Cales, P. Saumet, J. L.l 1997Effects of positive pressure on both femoral venous and arterial blood velocities and the cutaneous microcirculation of the forefootCardiovasc Res363a 372-6n>8OBJECTIVE: The balance between the apparent beneficial effect and the risk of arterial ischaemia resulting from an external uniform compression is unclear. The purpose of this study was to determine the effects of a positive uniform compression on the lower limb circulation until a critical threshold was reached. METHODS: We used Doppler ultrasound to measure femoral venous and arterial blood velocities. The effects of positive pressure on cutaneous microcirculation were evaluated by laser Doppler flux (LDF), transcutaneous oxygen pressure (tcpO2) and transcutaneous carbon dioxide pressure (tcpCO2) on the forefoot of 17 healthy subjects. RESULTS: The results are expressed as median [lowest observed value-highest observed value]. Whereas the arterial femoral velocity (A.F.V.) decreased from 0.21 [0.08-0.36] to 0.17 [0.08-0.28] m s-1 for an external pressure as low as 10 mmHg (p < 0.001), the venous femoral velocity (V.F.V.) decreased from 0.13 [0.06-0.40] to 0.09 [0.05-0.34] m s-1 at 20 mmHg (p < 0.001). An increase of tcpCO2 from 39.8 [29.9-53.7] to 40.2 [30.0-55.5] mmHg (p < 0.05) and a decrease of LDF from 8.7 [3.1-25.9] to 5.5 [2.3-21.1] A.U. (p < 0.001) occurred at 10 mmHg. However, tcpO2 decreased only from 76.7 [40.2-91.2] to 64.6 [18.9-85.2] mmHg when the splint pressure reached 60 mmHg (p < 0.05). The observed parameters (LDF, tcpO2, V.F.V. and A.F.V.) decreased further (except for tcpCO2 which increased) up to the end of the study as the applied pressure was increased. CONCLUSION: Positive pressure on the full leg provided no significant beneficial effect on femoral venous blood velocity. Whereas we showed that for an external uniform pressure as low as 10 mmHg, significant impairments in both arterial inflow of the lower limb and microcirculation of the forefoot appeared in recumbent healthy young subjects. TIG annexn6789973 283s 6285 1981 Jul 18\UGentamicin-resistant Pseudomonas aeruginosa infection from mattresses in a burns unitm 219-2081Fujita, K. Lilly, H. A. Kidson, A. Ayliffe, G. A. 0267-0623 Journal Article2Br Med J (Clin Res Ed)*Beds Burns/*microbiology Cross Infection/*transmission Drug Resistance, Microbial Gentamicins/pharmacology Hospital Units Human Pseudomonas Infections/*transmission Pseudomonas aeruginosa/drug effectsdjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=67899734100462 1e 7698 1971 Mar 13 Hospital beds1 5501Gainsborough, H. 0140-6736 Journal Article  Lancet *Beds jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=41004627416930-619 1980 Sep PISurface pressure distribution of the human body in the recumbent position: 409-13Surface pressure measurements of human body weight as distributed on 4 different commercial beds were examined. Sixty-five water-filled bladders connected to pressure transducers were employed to measure the pressure distribution patterns of the human body. These pressure measuring bladders were distributed on a sheet shaped to conform to the human figure and then placed on 5 different surfaces, including an orthopedic 720 coil mattress and box spring, a standard 500 coil bed, a standard 10-inch deep waterbed, a hybrid bed composed of a central water core surrounded by polyurethane, and the floor. Subjects were tested in both a supine and prone position on the various surfaces after the pressure measuring sheet was interposed. The results demonstrated a more uniform pressure distribution over the entire body on both the waterbed and the orthopedic bed than on any of the other surfaces. The softer (500 coil) bed, the hybrid bed, and the floor supported the body essentially on only 5 points (occiput, shoulders, buttocks, calves and heels) in the supine position. The water and orthopedic beds differed markedly, having more uniform and equally distributed surface pressures. The skin pressures measured over the bony prominences were significantly greater than the critical value for ischemia (30mmHg), thereby enhancing the development of decubiti--particularly in the beds which poorly distribute body weight.c<5Garfin, S. R. Pye, S. A. Hargens, A. R. Akeson, W. H.  0003-9993 Journal Article3Arch Phys Med RehabilhBeds/*standards Body Weight Human Ischemia/etiology *Pressure Skin/blood supply Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S. Transducers, Pressure-jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7416930HH$?T Gebhardt, K. 19984-The evidence for support surfaces (abstract).aB;Second European Pressure Ulcer Advisory Panel Open Meeting.o Oxfordzt[Prevention and therapy of pressure sores in quadriplegics (with special reference to a special positioning method)]Prophylaxe und Therapie von Druckschaden Querschnittgelahmter ( unter besonderer Berucksichtigung einer speziellen Lagerungstechnik. Gerner, H. J. Hefte Unfallheilkd 1978 132e 346-9i*Bedding and Linens; *Decubitus Ulcer prevention and control; * Quadriplegia complications Decubitus Ulcer etiology; Decubitus Ulcer surgery; Posture ; Quadriplegia nursing; Skin transplantation; Skin Transplantation; Transplantation, Autologous Human Glicksman, A. 1998F?Sterilizing a Clinitron air-fluidized bed with colistine powderJ Burn Care Rehabil193 245-6May-Jun9622470Antibiotics/*administration & dosage/pharmacology Beds/*standards Burns/*therapy Cross Infection/*prevention & control Drug Resistance, Microbial Human Powders Sterilization/methodsAfter cross-patient infection occurred with the Clinitron bed, we looked for a way to deliver an antibiotic agent into the inner environment of the Clinitron bed through the filtering system in a manner that would sterilize the contaminated microspheres. Multiple cultures of the contaminated microspheres from the Clinitron air-fluidized bed were done, and the infecting microorganisms were identified. The appropriate antibiotic powder was delivered through the filter system of the bed, and the microspheres were recultured after treatment. After an antibiotic powder was administered, the microspheres cultured were sterile. We found that the Clinitron bed can be safely, easily, and inexpensively sterilized and reused by the administration of antibiotic agent through the air filter system. Furthermore resistant bacteria can be treated with antibiotic agent sparingly used in a clinical setting because of toxicity. 0273-8481 Journal Articlejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=96224703313456l805d 1987 NoveTNA simple method for improving skin graft take in patients on Clinitron therapy 743'VODepartment of Plastic Surgery, Albert Einstein College of Medicine, Bronx, N.Y.t0*Goldstein, R. D. Hall, C. D. Buzard, R. A. 0032-1052 Journal ArticlerPlast Reconstr SurgohbAir *Beds Decubitus Ulcer/*surgery Human *Postoperative Care *Skin Transplantation *Surgical Flapsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3313456 Goldstein, B. Sanders, J.,TNSkin response to repetitive mechanical stress: a new experimental model in pig 1998Arch Phys Med Rehabila793h 265-72:4Using Smart Source Parsing Mar; ( pp Journal ArticleDecubitus Ulcer:*PP Disease Models, Animal:* Skin:*PP Adaptation, Physiological Stress, Mechanical Swine Animal Male Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.OBJECTIVES: To develop a new animal model for investigating the relations between interface stresses at the skin, adaptation, and breakdown. There were two hypotheses. (1) In skin subjected to varying types of repetitive mechanical stress, the tissue response depends on the direction and magnitude of the load. As the shear stress increases, tissue breakdown occurs earlier. (2) In skin subjected to repetitive mechanical stress of longer duration, there will be evidence of tissue adaptation. DESIGN: Multiple case control, single-blind. INTERVENTIONS: Varying combinations of normal and shear mechanical loads are applied to pig's skin for short durations (breakdown studies) or longer durations (adaptation studies). MAIN OUTCOME MEASURES: Gross evidence of breakdown (visual inspection of skin) and microscopic changes (eg, histologic features of breakdown; thickness of epidermis and dermis; the length and shape of the basement membrane; concentration of inflammatory cells, mast cells, and fibroblasts; and quantity of elastin fibers). RESULTS: The instrumentation was reliable and a significant improvement over past models in that shear forces were delivered and measured in a controlled manner. The animal model and tissue methodology provided consistent results, and it was found that skin breakdown occurred earlier as shear forces were increased. Evidence of tissue adaptation occurred in the long-term experiments, although corresponding morphologic changes have been difficult to elucidate. CONCLUSIONS: To address the problem of skin breakdown, new animal models are strongly needed to better understand basic biologic processes related to pressure ulcer development.981819516759553b7n6i 1982 Nov pjA clinical trial of a bead bed system for the prevention of pressure sores in elderly orthopaedic patients 545-8 This paper summarizes the results of the trial of the Beaufort Bead Bed system designed to reduce the incidence and severity of pressure sores. Elderly orthopaedic admissions were allocated alternately to the Beaufort system and to the usual trolley, table and bed surfaces, and followed from admission to hospital until separation. The incidence of pressure sores was 15.6% in the 32 'trial' patients, which was significantly less than the 48.8% in the 43 'control' patients, as was the mean maximum diameter of the pressure sores incurred: 6.4 mm for the 'trials' as against 29.5 mm for the 'controls'. In particular the trial group were free from pressure lesions to the heel, which affected 32.6% of the control group. The groups were well matched on a variety of criteria on admission, and we conclude that the Beaufort system successfully reduces the incidence and severity of pressure sores for elderly orthopaedic patients. The system--renamed recently the 'Neumark-Macclesfield Support System'--is now in regular and satisfactory use.82Goldstone, L. A. Norris, M. O'Reilly, M. White, J..(0309-2402 Clinical Trial Journal Article J Adv NursAged *Beds Clinical Trials Comparative Study Decubitus Ulcer/*prevention & control Femoral Neck Fractures/*nursing/surgery Human Middle Age Polystyrenesjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6759553n&64533258101t 1981 FebTNBed design and its effect on chronic low back pain--a limited controlled trial 87-91kThis study examines the effect of 4 different types of beds on chronic low back pain patients' symptoms and signs. The beds employed were an "orthopedic" hard bed with 720 reinforced coils and a built-in bed board, a softer 500 coil bed, a standard 10 in. thick waterbed, and a hybrid bed of foam and water. Subjectively the majority of patients preferred the hard bed and felt that their back pain improved to a greater extent after 2 weeks on the hard bed as compared to the other beds. The next largest group of patients to show improvement used the waterbed. Limitations in performing the straight leg raising test coincided with the subjective complaints. Significantly improved straight leg raising was observed after use of the hard bed or waterbed in 25% of the patients using those beds. No other objective signs were altered. The 500 coil bed and the hybrid bed proved of no benefit to any patient in this study group. This limited study indicates that hard beds should remain the first choice of patients with chronic low back pain. However, if relief is not obtained for these chronic pain patients, a trial on a waterbed may prove beneficial.Garfin, S. R. Pye, S. A. 0304-3959 Journal Article PainVPBack Pain/*therapy *Beds Comparative Study Human Support, U.S. Gov't, Non-P.H.S.jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=64533257761220u956; 1995 JunpA controlled trial of high-intensity double-surface phototherapy on a fluid bed versus conventional phototherapy in neonatal jaundiceK 914-6K\VOBJECTIVE. To evaluate a simple, relatively inexpensive method using the fluid bed to provide high-intensity double-surface (HIDS) phototherapy and to confirm that the method described is more effective than conventional phototherapy (CPT) in the treatment of neonatal hyperbilirubinemia. DESIGN. Prospective controlled study. METHOD. HIDS phototherapy (26 to 30 microW/cm2 per nanometer) on the fluid bed (n = 22) versus conventional (7 to 10 microW/cm2 per nanometer) phototherapy (n = 28) was used to treat neonates weighing more than 1500 g with hyperbilirubinemia. RESULTS. After 24 hours of therapy, the bilirubin in the group receiving HIDS phototherapy was significantly lower. The mean rate of fall of bilirubin was 5.34 mumol/L per hour in the group receiving HIDS phototherapy versus 0.7 mumol/L per hour in the group receiving CPT. HIDS phototherapy on a fluid bed was well tolerated. CONCLUSION. HIDS phototherapy on the fluid bed is significantly more effective in reducing bilirubin than CPT. It can be easily and economically provided using equipment currently available in most neonatal units.'<6North West Armed Forces Hospital, Tabuk, Saudi Arabia.,&Garg, A. K. Prasad, R. S. Hifzi, I. A.HB0031-4005 Clinical Trial Controlled Clinical Trial Journal Article Pediatrics*Beds Comparative Study Human Infant, Newborn Jaundice, Neonatal/*therapy Phototherapy/*instrumentation/methods Prospective Studies Treatment Outcome jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=77612207827742.7e3u 1994 MaylHAResponse to Mikols' questions about changes in capillary pressure8HGebhardt, K. S.f1076-2191 LetterAdv Wound CarerkBeds/classification/*standards *Blood Pressure *Capillary Resistance Decubitus Ulcer/*physiopathology HumanWjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7827742Gebhardt, K. Bliss, M.R. 1994b[Preventing Pressure Sores in Orthopaedic Patients - Is Prolonged Chair Nursing Detrimental?"Journal of Tissue Viability42 51-54 Gebhardt, K. Preventing pressure soresi 1994 Elder Care62i 23-8>8Using Smart Source Parsing Mar-Apr; ( pp Journal Article*#Decubitus Ulcer:*PC Aged Beds Human950042878826270d5*3i 1996 Mar ,%Pressure-relieving supports in an ICUu 116-21"Intensive care wards have a high incidence of pressure sores. This trial, in an eight-bed unit, aimed to compare the cost-effectiveness of constant-low-pressure and alternating-pressure support systems for preventing pressure sores. Patients without sores with a Norton risk score of < 13 were allocated to either alternating- or constant-low-pressure supports according to their hospital number. The cheapest supports were used initially, and changed for more sophisticated types if the patient's pressure areas deteriorated. None of the 23 patients using low-cost alternating-pressure supports developed open sores and only one had to be transferred to a more sophisticated mattress because of persistent erythema. Eleven out of 20 patients on constant-low-pressure mattresses or overlays developed either persistent erythema (three) or sores (eight). Ten were transferred to more expensive support systems. The mean cost of supports per patient in the alternating-pressure group was 44.50 pounds and in the constant-low-pressure group 86.20 pounds.>8Gebhardt, K. S. Bliss, M. R. Winwright, P. L. Thomas, J.JD0969-0700 Clinical Trial Journal Article Randomized Controlled Trial J Wound CareAdult Aged Aged, 80 and over *Beds/economics/standards Comparative Study Cost-Benefit Analysis Decubitus Ulcer/*prevention & control Female Human *Intensive Care Male Middle Age Risk Factors Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8826270104809588/31 1998 Jul181Pressure sore prevention--past present and futureE 2-4FGebhardt, K. S.d0965-206x EditorialeJ Tissue ViabilityztBeds/*trends Decubitus Ulcer/nursing/*prevention & control Human Primary Prevention/*instrumentation/methods/*trendslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10480958*9677988y7.5r 1998 Maye.(Evaluating alternating pressure overlays 227-30*$This study evaluates 53 overlays (six types of alternating pressure overlays) which were purchased, placed into the hospital pool and examined for mechanical malfunction and mismanagement every working day (excluding 22 days' annual leave) for one year. Reasons for malfunction were recorded and categorised. Results show that 69 mechanical failures and seven cases of physical damage were recorded. There were significant differences between the different types of overlay in performance and the length of time to effect repairs. There were 56 errors in management (mainly units not plugged in or not switched on) and five cases of design features contributing to mismanagement. Although some alternating pressure overlays perform better than others, mechanical unreliability remains a problem for most.'VODepartment of Public Health Sciences, St George's Healthcare NHS Trust, London...(Gebhardt, K. S. Hookway, J. Bland, J. M..(0969-0700 Clinical Trial Journal Article J Wound CareBeds/*standards/supply & distribution Comparative Study Decubitus Ulcer/etiology/*prevention & control Equipment Design Equipment Failure Evaluation Studies Human Risk Factors Time Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9677988JDPanel for the Prediction and Prevention of Pressure Ulcers in Adults 1992b[Pressure Ulcers in Adults: Prediction and Prevention. Clinical Practice Guideline Number 3.  Rockville, MD voAgency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Servicesi63$AHCPR Publication No. 92-00470$AHCPR , Prevention, Prediction$AHCPR guideline Challenge 200077792351411x 1995Jan-Feb.b[Important information to consider regarding previously published tissue interface pressuresn6aAlexander, L. G.0889-5899 LetterOstomy Wound ManageL\V*Beds/standards Decubitus Ulcer/*prevention & control Human Materials Testing Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=777923584012751143o 1993 Augi~xAir-fluidized beds and their ability to distribute interface pressures generated between the subject and the bed surface 359-64|Pressures were measured under five anatomical sites prone to pressures sores for ten subjects, supine and sitting on two different air-fluidized beds. The beds were the Clinitron (trademark, SSI) and the Fluidair Plus (trademark, KCI Mediscus). Mean supine pressures were less than 4 kPa under four sites. The average supine buttock pressure was 2.65 kPa. This increased to 3.71 kPa upon sitting up, though pressures did not rise above the accepted capillary closing pressure, on either bed. Low interface pressures at these sites were due to good moulding between subject and bed. Heel pressures averaging 7.08 kPa, were a factor of 2.67 times greater than buttock pressure, and were higher than expected considering the depth the heels sunk to in both beds. This exceeded the accepted capillary closing pressure and was attributed to covering sheets preventing true floatation at the heels.'VORegional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, UK.k& Allen, V. Ryan, D. W. Murray, A. 0967-3334 Journal Articler Physiol Measb[Adult *Beds Decubitus Ulcer/*prevention & control Female Human Male Support, Non-U.S. Gov'tEjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=84012758361161g154t 1993 Jult82Accuracy of interface pressure measurement systems 344-8.Interface pressure measurement is needed to assess beds designed to prevent pressure sores, so it is therefore important to establish the accuracy of interface pressure measuring systems. In this study, the Talley SA500 pressure evaluator (with 28 mm and 100 mm sensor pads), the DIPE (with 100 mm sensor pad), and a water-filled bladder system (with 0.1 ml and 0.3 ml water) were assessed. Measurement errors were evaluated using a loading system with pressures up to 7.4 kPa (55 mm Hg) in steps of 0.9 kPa (6.9 mm Hg). All systems tested over-measured interface pressure, the error being approximately linearly proportional to the loading pressure. The repeatability for a given system was approximately constant. The mean error (+/- SD) (%) and repeatability (kPa) for the systems were: 28 mm Talley 12 +/- 1%, +/- 0.07 kPa; 100 mm Talley 15 +/- 1%, +/- 0.07 kPa; DIPE 27 +/- 3%, +/- 0.12 kPa; 0.1 ml water bladder 17 +/- 1%, +/- 0.13 kPa; 0.3 ml water bladder 26 +/- 3%, +/- 0.07 kPa. Different interfaces affected accuracy markedly, and repeatability was affected when an inhomogeneous interface was used. The study shows that the errors associated with interface pressure measurement systems can be substantial, and can vary from one system to another.'VORegional Medical Physics Department, Freeman Hospital, Newcastle-upon-Tyne, UK.o0*Allen, V. Ryan, D. W. Lomax, N. Murray, A. 0141-5425 Journal Article  J Biomed Eng`Y*Beds Calibration Pressure Reproducibility of Results Support, Non-U.S. Gov't Transducersljdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8361161 x3N~3852639l8512 1985 Dec.'How is the air-fluidized bed best used?8 1338, 1340Lucke, K. Jarlsberg, C.s 0002-936x Journal Articlet Am J NurstTMBeds/*standards Burns/nursing/*therapy Decubitus Ulcer/nursing/*therapy Humangjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=38526399355602l2136 1997 Fall0)Developing the perfect long-term mattressJ 14-6'0*St. Mary's on the Lake, Kingston, Ontario.Lyle, C. 0831-7445 Journal Article Perspectivesb[Beds/*standards Decubitus Ulcer/*prevention & control Equipment Design Human Long-Term Care jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=93556023446423n125 1987 SeprvoManagement of toxic epidermal necrolysis with a hydrogel dressing and fluidized-bead bed: report of three cases 354-6&Macfarlane, A. W. Curley, R. K.e 0307-6938 Journal ArticleaClin Exp Dermatol-Acrylamides/administration & dosage/*therapeutic use Adult Agar/administration & dosage/*therapeutic use Bandages *Beds Case Report Epidermal Necrolysis, Toxic/*therapy Female Gels Human Male Middle Agejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3446423 Macosko, C.W. 1994Linear viscoelasticity.i  Macosko, C.W.o<5Rheology: Principles, measurements, and applications.s New York VCH Publishers109-133101036411323 1990 Feb*$Pressure reduction: the many choices57 Maddux, C. 8750-9652 Journal ArticleuContemp Longterm CareyhaAged Beds/*standards Decision Making Decubitus Ulcer/*prevention & control Equipment Design HumanClehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10103641sD=Thermal response of skin to application of localized pressure"Mahanty, S. D. Roemer, R. B. 1979NHArchives of physical medicine and rehabilitation [Arch Phys Med Rehabil]6012 584-90:4Using Smart Source Parsing Dec; ( pp Journal ArticleTMPressure* Skin Temperature* Adult Decubitus Ulcer/etiology Human Time Factorse80086906hbThermal and circulatory response of tissue to localized pressure application: a mathematical model"Mahanty, S. D. Roemer, R. B. 1980NHArchives of physical medicine and rehabilitation [Arch Phys Med Rehabil]618h 335-40:4Using Smart Source Parsing Aug; ( pp Journal ArticlePressure* Skin Temperature* Skin/*blood supply Decubitus Ulcer/etiology Energy Metabolism Human Mathematics Regional Blood Flowo80264532RLThermal response of paraplegic skin to the application of localized pressure.'Mahanty, S. D. Roemer, R. B. Meisel, H.o 1981NHArchives of physical medicine and rehabilitation [Arch Phys Med Rehabil]6212 608-11:4Using Smart Source Parsing Dec; ( pp Journal ArticleTemperature* Paraplegia/*physiopathology Skin/*physiopathology Adult Decubitus Ulcer/physiopathology Human Hyperemia/physiopathology Male Pressure Skin/blood supply Support, Non-U.S. Gov't820903767783791133e 1995May-JunM Reducing specialty bed use 174-7, 180Saint Joseph Hospital is a tertiary care teaching facility with 602 licensed beds. In 1992 it was noted that there was a significant rise in the use of specialty beds within the hospital. Guidelines for selection, initiation, and termination were nonexistent. In an effort to reduce high costs associated with specialty bed use a study was conducted to determine appropriate selection criteria and monitor patient outcomes.>7Mahon, D. Jensen, V. Palmer, S. Peterson, M. Vowell, V. 0746-1739 Journal Article Nurs Econ*Beds/economics/utilization Cost Control Cost-Benefit Analysis Decubitus Ulcer/*prevention & control Human Nursing Assessment Outcome Assessment (Health Care) *Patient Selectionjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7783791A biphasic poroelastic analysis of the flow dependent subcutaneous tissue pressure and compaction due to epidermal loadings: issues in pressure sore'HBRehabilitation Engineering Centre, Hong Kong Ploytechnic, Hunghom.$Mak, A. F. Huang, L. Wang, Q.e 1994:4Journal of biomechanical engineering [J Biomech Eng] 116e4f 421-9p:4Using Smart Source Parsing Nov; ( pp Journal ArticleModels, Biological* Connective Tissue/*physiopathology Decubitus Ulcer/*physiopathology Skin/*physiopathology Biomechanics Elasticity Human Hydrostatic Pressure Permeability Rheology Support, Non-U.S. Gov't Surface Properties Time Factors951743363635540,1335 1986May-JunvoPressure relief characteristics of various support surfaces used in prevention and treatment of pressure ulcers0 85-90*Maklebust, J. A. Mondoux, L. Sieggreen, M. 0270-1170 Journal ArticleGJ Enterostomal Ther,Adult *Bedding and Linens *Beds Biomechanics Body Height Body Weight Decubitus Ulcer/nursing/*prevention & control Human Middle Age Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=363554030759261.4 1988 Novd]Pressure ulcer incidence in high-risk patients managed on a special three-layered air cushiona 30-40sMaklebust, J. Brunckhorst, L. Cracchiolo-Caraway, A. Ducharme, M. A. Dundon, R. Panfilli, R. Parzuchowski, J. Sieggreen, M. Y. Walthall, S.h.(0898-1655 Clinical Trial Journal Article DecubitusHAdult Aged *Beds Clinical Trials Cohort Studies Decubitus Ulcer/*epidemiology/etiology/nursing Female Human Male Michigan Middle Age Nursing Diagnosis Prospective Studies Risk Factors,jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3075926t Outcome Assessment (Health Care) *Patient Selectionjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7783791A biphasic poroelastic analysis of the flow dependent subcutaneous tissue pressure and compaction due to epidermal loadings: issues in pressure sore'HBRehabilitation Engineering Centre, Hong Kong Ploytechnic, Hunghom.$Mak, A. F. Huang, L. Wang, Q.e 1994:4Journal of biomechanical engineering [J Biomech Eng] 116e4f 421-9p:4Using Smart Source Parsing Nov; ( pp Journal ArticleModels, Biological* Connective Tissue/*physiopathology Decubitus Ulcer/*physiopathology Skin/*physiopathology Biomechanics Elasticity Human Hydrostatic Pressure Permeability Rheology Support, Non-U.S. Gov't Surface Properties Time Factors951743363635540,1335 1986May-JunvoPressure relief characteristics of various support surfaces used in prevention and treatment of pressure ulcers0 85-90*Maklebust, J. A. Mondoux, L. Sieggreen, M. 0270-1170 Journal ArticleGJ Enterostomal Ther,Adult *Bedding and Linens *Beds Biomechanics Body Height Body Weight Decubitus Ulcer/nursing/*prevention & control Human Middle Age Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=363554030759261.4 1988 Novd]Pressure ulcer incidence in high-risk patients managed on a special three-layered air cushiona 30-40sMaklebust, J. Brunckhorst, L. Cracchiolo-Caraway, A. Ducharme, M. A. Dundon, R. Panfilli, R. Parzuchowski, J. Sieggreen, M. Y. Walthall, S.h.(0898-1655 Clinical Trial Journal Article DecubitusHAdult Aged *Beds Clinical Trials Cohort Studies Decubitus Ulcer/*epidemiology/etiology/nursing Female Human Male Michigan Middle Age Nursing Diagnosis Prospective Studies Risk Factors,jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3075926 T-36, T-38 and -41 are ideally suited for patients weighing up to 35 kg. T-41 may be used for patients weighing up to 70 kg."Koreska, J. Albisser, A. M. 0006-2898 Journal Article Biomed EngBedding and Linens Beds Chemistry Decubitus Ulcer/prevention & control *Disabled Persons Human Immobilization Muscular Dystrophies/rehabilitation *Polyurethanes Stress, Mechanical Temperaturejchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=123162Fp9729951n113 Suppld 1998May-Junr{Prospective study of the incidence of OR-induced pressure ulcers in elderly patients undergoing lengthy surgical proceduresE10'TNSchool of Nursing, University of Virginia Health System, Charlottesville, USA.& Ratliff, C. R. Rodeheaver, G. T. 1076-2191 Journal ArticleCAdv Wound CareAged Aged, 80 and over Beds/adverse effects Decubitus Ulcer/*etiology Female Human Incidence Intraoperative Complications/*etiology Male Middle Age Operating Rooms Prospective Studies Surgical Equipment/adverse effects Time Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9729951104260693e2u 1999Mar-Apr_.(Pressure ulcer assessment and management 242-58A pressure ulcer is an area of localized tissue destruction directly related to prolonged pressure. The loss of skin integrity produces significant consequences not only for the individual, but also for the community, with reported costs of $8.5 billion for pressure-ulcer care. Because of these costs, health care providers should be seeking prevention programs that identify high-risk individuals and implement preventive measures before the ulcer begins. Once the individual develops an ulcer, assessment of healing is critical to determine the appropriate treatment. Successful treatment depends on the principles of debridement, cleansing, bacterial control, wound dressing, and occasionally, surgical intervention.'TMPlastic Surgery Research, University of Virginia, Charlottesville 22908, USA.i& Ratliff, C. R. Rodeheaver, G. T.811088-5471 Journal Article Review Review, Tutorialr"Lippincotts Prim Care PractiAlgorithms Beds Decision Trees Decubitus Ulcer/*diagnosis/economics/etiology/*nursing Geriatric Nursing/*methods Health Care Costs Human Long-Term Care Nursing Assessment/*methods Risk Factors Skin Care/*methods Wound Healingplehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10426069*4124768e2t 7824 1973 Aug 11>7Local pressures with ten types of patient-support sytem  277-80@:Redfern, S. J. Jeneid, P. A. Gillingham, M. E. Lunn, H. F. 0140-6736 Journal Articler Lancet*Beds/standards Body Weight Capillaries Decubitus Ulcer/etiology/*prevention & control *Equipment and Supplies, Hospital Female Human Male Patient Care Planning Pressure/adverse effects Skin/blood supply Surgical Equipment/standardsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=41247684932712d353  1971 MaysThe Utica Crib 202-6c Redjinski, J./2,0025-9284 Historical Article Journal ArticleBull Menninger Clin3Beds/*history History of Medicine, 19th Cent. History of Medicine, 20th Cent. *Immobilization Psychiatry/*history United States jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4932712nXN\104809608r3n 1998 Juli^XA study of the performance of a pressure reducing foam mattress after three years of use 9-13This paper details the follow up clinical evaluation of a pressure reducing foam mattress (PRFM) three years after a randomised controlled trial. The PRFMs involved in the 1993 randomised controlled trial were used constantly for three years and recalled in 1996. In the original trial the control group had consisted of 18 standard NHS mattresses. In 1996 none of these mattresses were still in use which made it impossible to replicate the 1993 randomised controlled trial. Instead a clinical evaluation using the 1993 methods was carried out using the PRFMs only. Recruitment to the evaluation proved difficult because changes in clinical practice between the two studies had resulted in shorter lengths of stay in hospital for the target population. Comparison of the two outcome measures namely pressure sore incidence and the subjects' perception of comfort showed no statistically significant change between 1993 and 1996. With the exception of two damaged mattress covers all of the original foam components and covers remained in working order in 1996. During the time between the two studies, a pressure sore prevention programme was implemented within the research area. This programme has resulted in a year by year drop in the Directorate incidence rate. It is therefore not possible to attribute the low pressure sore incidence rate to the PRFMs alone. The results obtained suggest that the PRFMs appear to be providing a similar level of performance after three years of use.'&Aberdeen Royal Hospitals Trust.,&Gray, D. G. Cooper, P. J. Campbell, M.JD0965-206x Clinical Trial Journal Article Randomized Controlled TrialJ Tissue ViabilityAged Beds/*standards Decubitus Ulcer/*prevention & control Equipment Failure Evaluation Studies Female Follow-Up Studies Human Male Patient Satisfaction Support, Non-U.S. Gov't Treatment Outcomelehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=104809609919140t256t 1998 NoveNGA report card on wound care research: support surface issues and beyond 269-70Gray, M.1071-5754 Editorial$J Wound Ostomy Continence NursBeds/*standards Decubitus Ulcer/*prevention & control Human Publishing/standards/statistics & numerical data *Research Varicose Ulcer/*prevention & controlujdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9919140105318278w7. 1999Apr 8-21B;Pressure ulcer prevention and treatment: the Transair range/ 454-8&The Transair range has been updated as a result of clinical and technical advances. The Transair 500 cushion system utilizes foam and air technology to minimize disturbance to the user. Clinical trials suggest that this cushion is of benefit in both the prevention and treatment of pressure ulcers. The Transair 1001 alternating pressure air overlay and the Transair 2002 mattress replacement have both been revised to provide improved performance and both have been subjected to clinical trials. The results of these trials suggest that both have a role in the prevention and treatment of pressure sores in the individual in the high/very high risk group. This article examines these innovations in the Transair mattress and seating systems.'@9Department of Tissue Viability, Aberdeen Royal Hospitals.mGray, D.810966-0461 Journal Article Review Review, Tutorialn Br J NurseAged Aged, 80 and over *Beds/supply & distribution Clinical Trials Decubitus Ulcer/etiology/nursing/*prevention & control Equipment Design Human Nursing Assessment Risk Factors *Wheelchairs/supply & distribution1lehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10531827u118681889N19 2000 Oct 26-Nov 860The new QUATTRO PLUS mattress replacement system 2100-3Since the early development of alternating pressure air mattresses (APAMs) there have been regular alterations in design. These designs have led to improved reliability and performance. This article outlines the changes made by Talley Medical to the QUATTRO PLUS replacement mattress. Improved safety features and design modifications continue the process commenced many years ago which has seen the use of alternating pressure air mattresses become widespread throughout the UK.t'JCDepartment of Tissue Viability, Aberdeen Royal Infirmary, Aberdeen.rGray, D. 0966-0461 Journal Articlei Br J Nursrlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11868188d112610309n14 2000 Jul 27-Aug 9D=A clinical evaluation of the Transfoam mattress after 4 years 939-42& It is recognized that pressure-reducing foam mattresses can be of benefit in the prevention of pressure sores but it is also recognized that more information is required to demonstrate their long-term efficacy (Cullum et al, 1995). It is therefore necessary to evaluate the pressure-reducing capabilities of this type of mattress some years after purchase to evaluate if in fact it can maintain its initial level of performance. This article presents the results of one such study carried out 4 years after the purchase of Transfoam mattresses.'TNDepartment of Tissue Viability, Grampian University Hospitals Trust, Aberdeen.Gray, D. Palk, M. .(0966-0461 Clinical Trial Journal Article Br J Nurs Aged Aged, 80 and over Beds/economics/*standards Cost-Benefit Analysis Decubitus Ulcer/etiology/nursing/*prevention & control Human Nursing Assessment Risk Factors Support, Non-U.S. Gov'tPlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11261030e108276659 1c 2000 JanLEComparison of a new foam mattress with the standard hospital mattress7 29-314This study evaluates pressure ulcer incidence rates and comfort perceptions in 100 subjects admitted to a district general hospital. Subjects were divided into two groups, Group A using the standard hospital mattress (Transfoam), which had been in use in the hospital for three years, and Group B using the study mattress (Transfoamwave), which was new at the beginning of the trial. Due to the low observed incidence of pressure ulcers, it has not been possible to determine whether there is a difference in the clinical performance of the mattresses. Both appear to provide similar levels of comfort. Seat cushions were provided for each trial subject but staff failed to make good use of them, which suggests that more education is required in this area. '$Aberdeen Royal Infirmary, UK.tGray, D. G. Smith, M.eJD0969-0700 Clinical Trial Journal Article Randomized Controlled Trial J Wound CareAged Beds/*standards/supply & distribution Comparative Study Decubitus Ulcer/etiology/*prevention & control Equipment Design Female Human Incidence Male Middle Age Nursing Assessment Patient Satisfaction Risk Factorslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10827665nBA X @2?,>=2781133145i 1989Sep-OctpiComparison of capillary blood flow using a regular hospital bed mattress, ROHO mattress, and Mediscus bedh 270-2S Jacobs, M. A. 0278-4807 Journal ArticleS Rehabil NursBeds/*standards Blood Flow Velocity Capillaries Comparative Study Decubitus Ulcer/nursing/physiopathology/*prevention & control Human Skin/blood supply jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=27811338239054r214 1993 Auga>8Air-fluidized beds and negative-pressure isolation rooms 217-8 ,&Jacobsen, E. Gurevich, I. Cunha, B. A.0196-6553 LetterAm J Infect Control^X*Beds/classification Equipment Failure Human Infection Control *Patient Isolation Vacuumjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=82390543436160l3461 1987 Dec7d^Transcutaneous oxygen tension measurement over the sacrum on various anti-decubitus mattresses 330-1aTranscutaneous oxygen tension (tcPO2) was measured over the sacrum of 12 healthy, normal-weight volunteers positioned on five different mattresses. TcPO2 was lower (p less than 0.01) in those on a standard hospital mattress (median 0 mmHg), than in those on a sheep skin (median 22 mmHg), water mattress (median 33.5 mmHg), Spenco mattress (median 52.5 mmHg) or ripple air mattress (median 0/62 mmHg). The tcPO2 for the Spenco mattress was higher (p less than 0.01) than for sheep skin and for the water mattress. No significant difference was found in tcPO2 for the latter two named above. TcPO2 for the ripple air mattress alternated between 0, when inflated under the oxygen sensor, to about full oxygenation, when deflated. We believe that the ripple air mattress theoretically is the best mattress to prevent decubitus ulcers, but due to frequent mechanical failure of pump or mattress, the Spenco mattress is perhaps the best for practical use. Clinical comparative studies will be necessary to confirm that.':4Department of Orthopaedic Surgery, Aalborg Hospital.&Jakobsen, J. Christensen, K. S.. 0907-8916 Journal Articleo Dan Med BullAdolescence Adult *Beds *Blood Gas Monitoring, Transcutaneous Decubitus Ulcer/*prevention & control Female Human Male Sacrum/blood supplyojdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=34361609128642e126 Suppl 1997 Mar60Pressure sore prevention in acutely ill patients S8-10tmA wide range of factors affect the skin's ability to withstand pressure, friction and shear. Clinically validated pressure-relieving equipment is essential to prevent pressure sores in acutely ill patients. A successful pressure sore prevention strategy depends on sufficient resource allocation, appropriate levels and types of preventive equipment and evaluation.t James, H.r810266-8130 Journal Article Review Review, Tutoriali Prof NurseyAcute Disease Beds Decubitus Ulcer/etiology/*nursing/*prevention & control Human Primary Prevention/*methods Risk Factorsojdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9128642James, H. Fong, A. 1997:3Implementing and evaluating a pressure sore policy. J of Tissue Viability6V2y 1-29467097o211a 1998 JanrMeasurement of soft tissue strain in response to consecutively increased compressive and distractive loads on a friction-based test bed 19-26PJPURPOSE: To abstract the essential elements of chiropractic prone leg checking and subject them to controlled, experimental parametric testing. DESIGN: Controlled, objective, repeated-measure analysis of the dynamic response of leg positions to distractive and compressive loading conditions. SETTING: Research laboratory in a chiropractic college. PARTICIPANTS: Twenty-five compression and 30 distraction subjects, most of whom were male, asymptomatic chiropractic students. INTERVENTION: The subjects were lowered to the prone position on a table optimized to detect dynamic leg positions, with separate sliding segments supporting each leg. A trial consisted of a 2-min control run, followed by two 2-min experimental runs in which compressive or distractive loads were applied incrementally to the table-leg segments. MAIN OUTCOME MEASURE: An optoelectric system measured real-time absolute and relative leg positions. RESULTS: Right legs showed a greater average response than left legs under both distractive and compressive loads, and tended to respond more proportionately to incremental load increases. The average response to compression exceeded the response to distraction. Both legs showed a greater average response in the second half of the trials. Correlation of weights with responses was about four times greater in traction than compression. CONCLUSION: The functional short leg is confirmed as a stable clinical reality, a multitrial mean of unloaded leg positional differences. The prone leg check may be a loading procedure, albeit unmeasured, that detects non-weight-bearing, functional asymmetry in loading responses. These probably reflect differences in left-right muscle tone, joint flexibility and tissue stiffness. The relatively nonmonotonic, nonlinear quality of left leg responses is consistent with asymmetric neurological responses.'lfPalmer Center for Chiropractic Research, Palmer College of Chiropractic West, San Jose, CA 95134, USA.$Jansen, R. D. Cooperstein, R.n.(0161-4754 Clinical Trial Journal Article"J Manipulative Physiol ThertAdult Beds *Chiropractic Comparative Study Female Friction Human Leg/*abnormalities Male Muscle, Skeletal/*injuries Prone Position Soft Tissue Injuries/diagnosis Sprains and Strains/*diagnosis Support, Non-U.S. Gov't Traction/methodsijdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=94670977882260m805t 1994 Sepf`Dollars and sense. part II: appropriate use of pressure ulcer prevention and management products245, 260Janz, J. Barbour, S. 0887-6274 Journal ArticleeClin Nurse Spec jcBeds/*economics Cost-Benefit Analysis Decubitus Ulcer/*prevention & control Human *Nurse Cliniciansejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7882260\Z h118424681022 Suppl 2001 DecNJDEvaluating pressure-reducing foam mattresses and electric bed framesS23-6, S28, S31eIt could be argued that pressure ulcer prevention is simply a matter of matching those patients at risk of developing tissue damage with suitable pressure-reducing equipment. However, as many authors have identified, this can be complicated because of the lack of reliable evidence to support many products. This article seeks to evaluate the combination of a pressure-reducing mattress with an electric profiling bed frame. The study was conducted in a high-dependency cardiac surgery unit. Forty-four subjects were recruited during a 6-month period and their progress observed. Two outcome measures were used: pressure ulcer incidence and perceptions of comfort. No pressure ulcers developed during the trial and the perceptions of comfort were generally positive. The small sample size restricts the conclusions that can be drawn from the study, but when taken in conjunction with other small studies in this area there appear to be benefits from using such a combination of equipment.'TNDepartment of Tissue Viability, Grampian University Hospitals Trust, Aberdeen..(Gray, D. Cooper, P. J. Stringfellowe, S. 0966-0461 Journal Article Br J Nurslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=118424687721525t236  1994 DeciComparison of heated water-filled mattress and space-heated room with infant incubator in providing warmth to low birthweight newborns1226-33BACKGROUND. Prevention of excessive heat loss is fundamental to survival of low birthweight (LBW) newborns. The use of infant incubators (INC) is beyond the resources of developing countries, and the space-heated room (SHR) has been the only feasible means of providing thermal protection to LBW newborns. Recently a thermostatically controlled, heated, water-filled mattress (HWM) has been developed as a potentially simpler and affordable alternative. METHODS. In a neonatal care ward of a referral hospital in Addis Ababa, 62 < 1 week old newborns, weighing 1000-1999 g, who were well enough to breathe comfortably in room air and tolerate oral feeds, were randomly allocated to INC, HWM or SHR and followed for 3 weeks. The level of cold stress as assessed by core-to-skin temperature gradient and the rate of weight gain were the main outcome measures. RESULTS. The level of cold stress was lowest in the INC, intermediate in the HWM and highest in the SHR. Relative to the INC group, the HWM group exhibited a modest increase in the occurrence of clinically important hyperthermic or hypothermic deviations in core temperature (rate ratio (RR) = 2.3; 95% CI: 0.9, 5.6), and the SHR displayed a definite increase (RR = 4.0; 95% CI: 1.7, 9.3). During the first week, the rate of weight gain was highest in the INC group (3.6 g/kg/day), lowest in the SHR group (-2.3 g/kg/day, P < 0.05 versus INC) and intermediate in the HWM group (1.6 g/kg/day, P > 0.1 versus INC). CONCLUSION. Care in the SHR produced clinically significant thermal stresses and was associated with deficient early neonatal growth, but the use of HWM may constitute a feasible and clinically acceptable alternative in providing warmth to LBW newborns during the neonatal period..'hbDepartment of Paediatrics and Child Health, Faculty of Medicine, Addis Ababa University, Ethiopia.B;Green-Abate, C. Tafari, N. Rao, M. R. Yu, K. Clemens, J. D.cJD0300-5771 Clinical Trial Journal Article Randomized Controlled TrialInt J EpidemioloHB*Beds Body Temperature Comparative Study Ethiopia Heating/*instrumentation/methods Human Hyperthermia, Induced/methods *Incubators, Infant Infant Care/*methods Infant, Low Birth Weight/*physiology Infant, Newborn Infant, Premature/physiology Intensive Care Units, Neonatal Referral and Consultation Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=77215255077302e6838 1972 Sep 21"The low air loss bed system8 1192-4Greenfield, R. A.- 0954-7762 Journal Articles Nurs TimesD=*Air *Beds Decubitus Ulcer/*prevention & control Female Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=50773023060503t156i 1988Nov-Dec5b\Cost-effectiveness and efficacy of air-fluidized therapy in the treatment of pressure ulcers 247-51D=Greer, D. M. Morris, J. Walsh, N. E. Glenn, A. M. Keppler, J.2.(0270-1170 Clinical Trial Journal ArticleJ Enterostomal TherJ|vAdult Aged *Air Beds Clinical Trials Comparative Study Decubitus Ulcer/pathology/*therapy Female Human Male Middle Agejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=30605039015985n5a21 1996 Nov 28-Dec 11aD=Alternating pressure mattresses: comfort and quality of sleepn1303-10sComfort is particularly important for patients with terminal illness where the priority is to maximize quality of life. Equally important is effective pressure area care, as such patients are at high risk of developing pressure sores because of their poor general condition (Bale and Regnard, 1995). The present randomized controlled study set in a hospice focused on the development of methodology for assessing patient comfort and quality of sleep and used this to compare two widely used, alternating air pressure mattresses (the Nimbus II and the Pegasus Airwave). The Nimbus II mattress performed consistently better than the Pegasus Airwave in terms of patient comfort and quality of sleep. Features of the Nimbus II that may explain its better performance include less extreme changes in pressure, lower peak inflation pressures and the ability to automatically vary the pressure to suit the patient's position and weight.'6/Hospice of Our Lady and St John, Milton Keynes.Grindley, A. Acres, J.JD0966-0461 Clinical Trial Journal Article Randomized Controlled Trial Br J NursAdult Aged Aged, 80 and over Beds/*standards Comparative Study Cross-Over Studies Decubitus Ulcer/*prevention & control Female Hospice Care Human Male Middle Age *Patient Satisfaction Pressure *Sleepjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9015985107762228g7n 1999 Julr@9Comparative study of a foam mattress and a water mattressr 333-5rIn order to determine the effectiveness of high-quality foam replacement mattresses in the treatment of pressure ulcers, one such mattress (TheraRest) was compared with a water mattress (Secutex). One hundred and twenty nursing home patients with pressure ulcers were randomised into two groups and nursed on one of the mattresses for four weeks. After four weeks, 45% of the patients using the foam mattress were completely healed, compared with 48.3% of those using the water mattress. This difference is not significant. Since high-quality foam mattresses are cheaper in the long term than water mattresses, and are easier for nursing staff to manage, it is suggested that these mattresses are preferable.'$University Groningen, Holland.0)Groen, H. W. Groenier, K. H. Schuling, J.aJD0969-0700 Clinical Trial Journal Article Randomized Controlled Trial J Wound CareActivities of Daily Living Aged Aged, 80 and over Beds/*standards Comparative Study Decubitus Ulcer/classification/*nursing/physiopathology Human Nursing Assessment *Polyurethanes Severity of Illness Index Time Factors *Water *Wound Healinglehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10776222 JA$ #J | 8474913i8913 1993 Mar 31-Apr 6.'Wound care. Using air fluidised therapy  82-8 Guthrie, J.0 0954-7762 Journal Article0 Nurs Timeshb*Air *Beds Case Report Debridement Decubitus Ulcer/*nursing/therapy Female Human Middle Age Sacrumjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=847491379090371 343 8903 1994 Apr 1681Pressure sores and pressure-decreasing mattresses 980; discussion 981 $Haalboom, J. R. Beerens, R. G.0140-6736 Comment Letter Lancet81*Beds Decubitus Ulcer/*prevention & control Humanejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7909037TMInstruction of compression therapy by means of interface pressure measurements@:Hafner, J. Luthi, W. Hanssle, H. Kammerlander, G. Burg, G. Dermatol Surge 2000265r 481-6adiscussion 487BACKGROUND: Compression therapy of the leg is the cornerstone in the conservative treatment of venous ulcers. The application of compression bandages, however, is largely a matter of personal experience. OBJECTIVE: To evaluate the interface pressure under compression bandages and to improve the technique. METHODS: Six courses on wound healing with 24-28 participants as well as individual training at our hospital were provided. Interface pressure at the distal medial calf was measured using a simple, but accurate pressure sensor that was built for this purpose (accuracy: +/-3 mm Hg). RESULTS: During the wound healing courses, the absolute difference from the target pressure of 35-45 mmHg improved from 8.4 mm Hg (95% CI 0.0-34.1) to 3.5 mm Hg (95% CI 0.0-14.0) (P = .0001). After four sessions, interface pressures greater than 60 mmHg were avoided. During individual training, even nurses with everyday experience in compression therapy improved their accuracy. CONCLUSION: There is a need for objective measurement of interface pressure in the teaching of compression therapy with bandages. The principles can be taught during a few exercises. However, repeated practice over a longer period of time is necessary to reach a certain accuracy.|u*Bandages ; *Education, Continuing; *Leg Ulcer therapy; *Sphygmomanometers ; *Wound Healing physiology Pressure Human d^A comparison of multilayer bandage systems during rest, exercise, and over 2 days of wear time(!Hafner, J. Botonakis, I. Burg, G.  Arch Dermatolt 2000 1367o 857-63 V OOBJECTIVE: To study the interface pressure between the leg and 8 different multilayer bandage systems during postural changes, exercise (walking), and over 2 days of wear time. DESIGN: Comparison of 8 different compression bandages under standardized conditions. SETTING: Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland. PARTICIPANTS: A series of 10 healthy volunteers, 5 females and 5 males, aged 26 to 65 years. INTERVENTION: An electropneumatic device was used to measure interface pressure at 12 points of the leg. MAIN OUTCOME MEASURES: (1) Pressure changes from the standing to the sitting and supine position at rest, (2) pressure amplitude during exercise (200-m treadmill walk at 3.2 m/s, 0 degrees incline), and (3) pressure decrease over 2 days of wear time. RESULTS: Results are given as median with the 10% to 90% confidence intervals. Multilayer bandages of short and medium stretch showed a larger pressure decrease when the patient was supine (eg, 3 short stretch bandages: 18.0 mm Hg [reference range, 15.5-19.5 mm Hg]) than systems of medium and long stretch bandages (eg, 4-layer bandage, 6.0 mm Hg [reference range, 4.5-7.0 mm Hg]) (P=.005). The amplitude of pressure waves during exercise was comparable among most multilayer bandage systems. The pressure loss over time was the smallest in elastic bandages (eg, 4-layer bandage, 6.0 mm Hg [reference range, 0.0-10.5 mm Hg]), compared with short stretch bandages (eg, 3 short stretch bandages, 18.0 mm Hg [reference range, 16.5-20.5 mm Hg]) (P=.005). CONCLUSIONS: Highly elastic multilayer bandage systems showed the smallest pressure loss over several days, but the small pressure decrease when the patient was supine makes them potentially hazardous to patients with arterial occlusive disease. Short stretch bandages and the Unna boot with an inelastic zinc plaster bandage generate large pressure waves while walking and showed a marked pressure decrease when the patient was supine, but they lose a lot of their pressure within the first hours of wear. Multilayer systems composed of short stretch and cohesive medium stretch bandages represent a good compromise between elastic and inelastic bandage systems (moderate pressure loss over time, large pressure decrease on lying down). The clinical effectiveness of the different types of compression still remains to be studied.|*Bandages Adult ; Aged ; Leg ; Middle Age; Posture ; Pressure ; Time Factors; Walking Comparative Study; Female; Human; Male<6Hagisawa, S. Ferguson Pell, M. Cardi, M. Miller, S. D. 1994Assessment of skin blood content and oxygenation in spinal cord injured subjects during reactive hyperemia [published erratum appears in J Rehabil Res Dev 1994;31(2):178]J Rehabil Res Devl311b 1-14^X*Decubitus Ulcer prevention and control; *Hyperemia physiopathology; *Skin physiology; *Skin Physiology; *Spinal Cord Injuries physiopathology Adult ; Decubitus Ulcer physiopathology; Hyperemia blood; Middle Age; Oxygen blood; Skin blood supply; Spectrophotometry ; Spinal Cord Injuries blood Female; Human; Male; Support, Non U.S. Gov't OxygenThis study was undertaken to determine whether the reactive hyperemia response following ischemia in spinal cord injured ( SCI) individuals is different from that which occurs in able-bodied (AB) individuals. The reactive hyperemia response was produced by applying a pressure of 150 mmHg for 300 s, 600 s, and 900 s to the skin over the greater trochanter in 10 SCI and 10 AB subjects using a computer-controlled pneumatic indentation system. The changes in blood content and oxygenation in the superficial vessels of the skin, associated with indentation, were monitored using reflectance spectrophotometry. A brief pressure of 80 mmHg, to simulate finger pressing ( blanching), was applied to the same site to detect changes in reflow behavior during the hyperemic period. The results indicate that the reactive hyperemia response in SCI group was not substantially different from AB group although the reflow rate after load release was slower in the SCI group compared with the AB group.ZSresearch mechanical load reactive hyperemia SCI LDF transcutaneous oxygen TIG annex 21229952176c 1990Nov-DecCXQPressure reduction mattresses versus pressure reduction overlays: a cost analysism 241-3oHale, J. S. Smith, S. H. 0270-1170 Journal ArticleJ Enterostomal Ther |vBeds/*standards Cost-Benefit Analysis Decubitus Ulcer/economics/nursing/*prevention & control Human Nursing Assessmentjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21229956553048i1241 1983 Jul-0*Patients who require Stryker frame therapy 463  Hamilton, M.0147-9563 Letter Heart Lung:3*Beds Human *Resuscitation Spinal Injuries/*therapytjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6553048216F/8090944S175l 1994 OctrPIIntraoperative pressure sore prevention: an analysis of bedding materialsf 333-9rThe relationship between operating room (OR) table surfaces and skin integrity was examined. Preoperatively, patients (N = 505) were rated for pressure sore potential (Hemphill); postoperatively, skin condition was assessed. Skin changes were more likely with a standard mattress only or with surgery longer than 2.5 hr. The overlay was more effective than the foam and gel or standard foam mattresses for preventing pressure sore formation. Factors predictive of pressure sore development included surgery of 2.5+ hr, 40+ years, vascular disease, and a preoperative Hemphill value of 4+. Patient characteristics, surgical experience variables, and OR table surfaces are determinants in pressure sore development.'D=Thomas Jefferson University Hospital, Philadelphia, PA 19107.&Hoshowsky, V. M. Schramm, C. A. 0160-6891 Journal ArticleRes Nurs Health"Adolescence Adult Aged Aged, 80 and over *Bedding and Linens Beds Comparative Study Decubitus Ulcer/epidemiology/etiology/*prevention & control Female Human Intraoperative Complications/epidemiology/etiology/*prevention & control Logistic Models Male Middle Age Prognosis Time Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8090944VODiurnal variations in total forearm and skin microcirculatory blood flow in man'XQDepartment of Internal Medicine, University Hospital Maastricht, The Netherlands.-lfHouben, A. J. Slaaf, D. W. Huvers, F. C. de Leeuw, P. W. Nieuwenhuijzen Kruseman, A. C. Schaper, N. C. 1994^WScandinavian journal of clinical and laboratory investigation [Scand J Clin Lab Invest]t542g 161-8m:4Using Smart Source Parsing Apr; ( pp Journal ArticleCircadian Rhythm/*physiology Forearm/*blood supply Skin/*blood supply Adult Human Male Microcirculation/physiology Regional Blood Flow/physiology Support, Non-U.S. Gov't94255707"Hover, A. E. Krouskop, T. A. 1992b[Pressure relief characteristics of a new foam overlay: a preliminary performance evaluations J ET Nurs 192n 42-7*Beds standards; *Decubitus Ulcer prevention and control; * Monitoring, Physiologic; *Pressure Evaluation Studies Female; Human; Male To evaluate a newly designed foam mattress to be used by patients who are susceptible to pressure ulcers, interface pressures that are produced between body and mattress were measured with the Mini-Texas interface pressure evaluator (Tee- Kay Applied Technology, Inc., Stafford, Texas). Fifteen subjects with builds that ranged from thin to large were measured at four body locations--the scapular area, sacral area, trochanter, and heel. The interface pressure measurements were found to increase with body size in the sacral and heel areas. The pressures under the sacral, scapular, and heel areas remained within a narrow range for a given body type. TIG annexh5209459a7112 1971 Dec-(!The patient on a CircOlectric bedP 2352-3 Hrobsky, A.  0002-936x Journal Articlea Am J Nurse"*Beds Nursing Care Rotationjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=5209459105610493810 1999 Octc81Bockhart's impetigo: complication of waterbed use 769-70'XQDepartment of Dermatology, Baylor College of Medicine, Houston, Texas 77030, USA.fHsu, S. Halmi, B. H. 0011-9059 Journal Article Int J Dermatol("Adult Antibiotics/therapeutic use Beds/*adverse effects Case Report Clindamycin/therapeutic use Folliculitis/drug therapy/etiology/pathology Hair Follicle/drug effects/microbiology/pathology Human Impetigo/drug therapy/*etiology/pathology Male Staphylococcus aureus/isolation & purificationlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10561049y0)Hunter, J. A. McVittie, E. Comaish, J. S.ZSLight and electron microscopic studies of physical injury to the skin. II. Friction 1974 Br J Dermatol905 491-9S:4Using Smart Source Parsing May; ( pp Journal ArticleSkin:*IN/PA Stress, Mechanical:* Adult Aged Basement Membrane Biopsy Blister:PA Cell Membrane Edema Erythema Lanthanum Microscopy, Electron Middle Age Organoids Time Factors HumanM74255388entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=55271775197970u511 1970 MarPIThe air-fluidized bed: a new concept in the treatment of decubitus ulcersm 181-7r"Harvin, J. S. Hargest, T. S. 0029-6465 Journal ArticleNurs Clin North Am,&Air Beds Decubitus Ulcer/therapy Glassjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=51979701930586t36 1991Sep-OctuleA new tool for evaluating patient support surfaces. Part I: A guideline for making practice decisions451-4, 56-7, 59.'Hasty, J. H. Krasner, D. Kennedy, K. L.o 0889-5899 Journal Article,Ostomy Wound Manage Beds/*standards *Decision Making Decubitus Ulcer/*prevention & control Evaluation Studies Human Patient Satisfaction Pressure Temperaturejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19305861908681s35 1991Jul-Aughb\Pressure reduction mattresses. Guidelines for evaluating clinical use and cost effectiveness 52-4 Haugen, V.*#0889-5899 Guideline Journal ArticlecOstomy Wound ManageBeds/economics/*standards Consumer Satisfaction Cost-Benefit Analysis/*methods Decubitus Ulcer/*prevention & control Human Professional Staff Committees/organization & administration Questionnairesrjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1908681 49104123a6o3n 1997 Feb 13-26uJCEvaluation of the new Cairwave Therapy System in one hospital trustl 167-70haThe Pegasus Airwave mattress has been used for many years in the Eastbourne NHS Trust and has proven its efficiency in the prevention of pressure sores. Pegasus has now produced a new, improved, model: the Cairwave Therapy System. This article looks at criteria that may be used to determine whether the new model is suitable for patient care. The evaluation took the form of a randomized controlled study in which 12 mattresses were randomly allocated to patients--six Airwave mattresses and six Cairwave Therapy Systems--over a 4-month period. The results of the evaluation showed that patients found the mattress comfortable. An encompassing cover reduced the risk of cross-infection, rehabilitation was supported by the firm edges of the bed and patient movement was easier due to the soft cover. During the trial all patients remained free from pressure sores.a'&Eastbourne Hospitals NHS Trust.m Hampton, S.oJD0966-0461 Clinical Trial Journal Article Randomized Controlled Trial Br J Nurs,Beds/*standards Decubitus Ulcer/*prevention & control Equipment Design Evaluation Studies Human Infection Control Lifting Patient Acceptance of Health Care Posturerjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=91041239830895s7917 1998 Sep 24-Oct 7BEfficacy and cost-effectiveness of the Thermo contour mattress 990-6uZSUse of air mattresses in reduction of pressure sore incidence is an important part of quality patient care. However, there will never be enough air mattresses to match the demand as increased education and an increase in the general provision of air mattresses can lead to an unrealistic expectation of obtaining air mattresses when required for patients. This raises the demand for air mattresses and increases costs within hospital trusts. This study examined a way to redress the balance through use of an alternative, cost-effective type of mattress (thermoelastic polymer) in the prevention of pressure sores. Prime consideration was given to the comfort of the patient. The claims of the manufacturers, Barrington Healthcare, that 'patients with Waterlow scores of 23 can be nursed safely on this product' were explored as part of the study. A total of 407 patients took part over a 6-month period. Twenty-four Thermo contour mattresses were loaned to one ward for the study and patients were allocated to the mattress through admission to the experimental ward. Patients were then split into two groups on two wards. Group B were allocated to a Thermo contour mattress and group A were nursed on air mattresses and foam mattresses generally used throughout the trust. Results showed that more patients were comfortable on the Thermo contour mattresses than on all other mattresses. Patients with Waterlow scores under 25 did not develop pressure sores on the Thermo contour mattress. However, the sample of patients with a Waterlow score of between 20 and 25 was small and therefore further research is required.n'$Eastbourne Hospital NHS Trust. Hampton, S.a.(0966-0461 Clinical Trial Journal Article Br J NursjAdult Aged Aged, 80 and over Beds/*economics/*standards Cost-Benefit Analysis Decubitus Ulcer/etiology/nursing/*prevention & control Equipment Design Human Middle Age Nursing Assessment Risk Factorslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10711028 *#Hanel, S-V. Dartman, T. Shishoo, R. 1997>7Measuring methods for comfort rating of seats and beds.o,&Int'l Journal of Industrial Ergonomics20163-1728195253o152r 1994Mar-AprrThe use of biobrane II and specialty airflow beds (FluidAir Plus and Kinair for effective coverage of extensive posterior donor site wounds 137-42Posterior skin graft donor sites furnish large areas of skin for wound coverage, but the sites frequently are management problems. The wounds tend to become moist and to develop excessive drainage and fluid accumulation that may interfere with adherence of dressings, including our preferred donor site dressing, Biobrane II (red label, large pore). We studied the use of specialty airflow beds for improving the outcome of posterior donor sites. We evaluated 50 patients aged 1 to 69 years (mean 29.45 years) with posterior skin graft donor sites of the back, thigh, or buttocks that were covered with Biobrane II. Sites ranged in size from 3% to 13% body surface area (mean 8.34%). Forty patients were placed on a FluidAir Plus bed, and 10 were placed on air-filled pillow therapy beds (five on KinAir III, five on Therapulse) (Kinetic Concepts, Inc.) All patients were kept in the supine position. We evaluated six criteria: drainage, fluid accumulation under Biobrane, infection, days until Biobrane separated, days until epithelialization, and days of specialty bed usage. We related these criteria to nursing-care actions that interfere with airflow and prevent the drying action of the bed, such as use of a "linen saver" under the patient in the area of the donor site, a foam wedge under the back, and dressings applied over the Biobrane. Most donor sites had no complications. Donor site infections developed in six patients. Five of these patients had fluid accumulation under the Biobrane, necessitating early removal. Fluid accumulated under the Biobrane in 21 patients; nine of these incidences were related to a nursing-care action that impeded airflow.(ABSTRACT TRUNCATED AT 250 WORDS) 'VPDepartment of Surgery, University of California, San Diego Medical Center 92103.:3Hansbrough, J. F. Dore, C. Hansbrough, W. Trout, S.a 0273-8481 Journal Article J Burn Care RehabiliAdult *Beds *Biocompatible Materials Burns/*surgery Human *Occlusive Dressings Skin Physiology *Skin Transplantation Supine Position Surgical Wound Infection/epidemiology Time Factors Transplantation, Autologous Wound Healing/*physiology-jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8195253 .-,+El*:7906329n 343, 8897 1994 Mar 5rRLPressure sores and pressure-decreasing mattresses: controlled clinical trial 568-71PJPressure sores are a problem, especially in elderly patients. Our study was designed to determine the effectiveness in pressure-sore prevention of a new interface-pressure decreasing mattress. In a prospective randomised controlled clinical trial we tested the Comfortex DeCube mattress (Comfortex, Winona, USA) against our standard hospital mattress in 44 patients with femoral-neck fracture and concomitant high pressure-sore risk score. In addition both groups were treated according to the Dutch consensus protocol for the prevention of pressure sores. On admission and 1 and 2 weeks after admission, pressure sores were graded. The two groups were similar in patient characteristics and pressure-sore risk factors. At 1 week, 25% of the patients nursed on the DeCube mattress and 64% of the patients nursed on the standard mattress had clinically relevant pressure sores (grade 2 or more). At 2 weeks the figures were 24% and 68%, respectively. The maximum score over the several body regions of the pressure-sore grading, measured on a 5-point sale, was significantly different in favour of the DeCube mattress at 1 week (p = 0.0043) and 2 weeks (p = 0.0067) postoperatively. We show that the occurrence of pressure sores and their severity can be significantly reduced when patients at risk are nursed on an interface-pressure decreasing mattress.'HBDepartment of Surgery, Red Cross Hospital, The Hague, Netherlands.VPHofman, A. Geelkerken, R. H. Wille, J. Hamming, J. J. Hermans, J. Breslau, P. J.JD0140-6736 Clinical Trial Journal Article Randomized Controlled Trial LancetAged Aged, 80 and over Beds/*standards Decubitus Ulcer/etiology/*prevention & control Female Femoral Neck Fractures/complications Hospitalization Human Male Middle Age Prospective Studies Risk Factors Single-Blind Method Treatment Outcomejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7906329\V[Standardized decubitus ulcer therapy with special reference to moist wound treatment]d^Standardisierte Dekubitustherapie mit besonderer Berucksichtigung der feuchten Wundbehandlung.Hofmann Rosener, M.Zentralbl Chir 1996 121 Suppl 90-1XR*Colloids ; *Decubitus Ulcer therapy; *Occlusive Dressings Human Colloids; Duoderm5161633h18 1971D>The air fluidized bed utilized for spinal cord injury patients 215-20Hofstra, P. C. 0083-3568 Journal Articlea,&Proc Veterans Adm Spinal Cord Inj Conf~Adult *Air Bedding and Linens *Beds Decubitus Ulcer/*therapy Human Male Middle Age Spinal Cord Injuries/*complications/therapyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=51616336/Holley, L. K. Long, J. Stewart, J. Jones, R. F.e 1979\VA new pressure measuring system for cushions and beds--with a review of the literature Paraplegia174 461-74 Novs 392412Animal *Beds Decubitus Ulcer/etiology/*prevention & control Equipment and Supplies Female Human Male Pressure *Protective Devices Quadriplegia/complications Rabbits Ratsg}An interface pressure measuring device for the assessment of subject-cushion interface pressures at ten points has been described. Preliminary trials using 12 healthy subjects on four cushions and three spinal injury patients on six cushings, has been carried out. It was also found that the water and foam cushion distributed the pressure over a large area than the foam cushions.u& 0031-1758 Journal Article Reviewjchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=392412w*#Holloway, G. A., Jr. Watkins, D. W.u81Laser Doppler measurement of cutaneous blood flows 1977J Invest Dermatols693f 306-9:4Using Smart Source Parsing Sep; ( pp Journal ArticleBlood Flow Velocity:* Doppler Effect:* Lasers:*DU Physics:* Skin:*BS Adult Microcirculation:PH Middle Age Sunburn:PP Xenon Radioisotopes:DU Female Human Male Support, U.S. Gov't, P.H.S.o&This work describes an instrument for the noninvasive measurement of cutaneous blood flow velocity. The system utilizes the Doppler shift of laser light backscattered from moving red blood cells in the cutaneous microcirculation, the shift being obtained by an optical heterodyning technique. Comparison is made between this technique and the 133xenon clearance technique in measuring cutaneous flow in the forearms of normal volunteers. Variations in flow were obtained by inducing different degrees of solar erythema with an ultraviolet sunlamp. A Y on X linear regression yielded a regression coefficient 0.89 (p less than 0.001, n 16) between the two methods. The laser Doppler method appear to represent a practical technique for clinical evaluation of cutaneous blood flow in any skin surface.77250979,&Holscher, T. Goossens, R. Snijders, C. 1995ZSA new low-cost anti-decubitus mattress for home care: requirements and development.\J of Rehab Science7  53-58{,&Holscher, T. Goossens, R. Snijders, C. 1995`YA new low-cost anti-decubitus mattress for home care; a comparison with other mattresses.1"J of Rehabilitation Sciencec8? 72-75@8110896p206e 1993Nov-DecaXQSupport surfaces and their use in the prevention and treatment of pressure ulcerst 251-60Pressure ulcers are an important health concern. A wide range of options are available for their prevention and treatment. Support surfaces are building blocks in the endeavor to reduce or relieve interface pressures. This article examines and classifies support surfaces, provides critical assessment criteria for patient selection, and discusses areas to be evaluated in the selection of support surfaces.HHolzapfel, S. K. 1055-3045 Journal ArticleH J ET Nurs0Beds/classification/*standards Decision Trees Decubitus Ulcer/epidemiology/nursing/*prevention & control Human Nurse Clinicians Nursing Assessment Risk Factors8jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=81108967063819d1418 1982F@Prophylaxis and treatment of decubitus ulcers with a rocking bed 33-7,%Hook, O. Gabrielsson, L. Lagerman, U. 0036-5505 Journal ArticleScand J Rehabil Med *Beds Body Weight Decubitus Ulcer/prevention & control/*rehabilitation Human Movement Pressure/adverse effects Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7063819&db=PubMed&dopt=Citation&list_uids=81108967063819d1418 1982F@Prophylaxis and treatment of decubitus ulcers with a rocking bed 33-7,%Hook, O. Gabrielsson, L. Lagerman, U. 0036-5505 Journal ArticleScand J Rehabil Med *Beds Body Weight Decubitus Ulcer/prevention & control/*rehabilitation Human Movement Pressure/adverse effects Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7063819%`$D#4"!8110894 206r 1993Nov-Dec>7Pressure-reduction products: making appropriate choices  239-44A comparison of the seven most commonly used pressure-reducing products across sacral, trochanter, and heel interface sites was conducted with 15 healthy volunteers. Effects of weight on product were also tested. Products were rank ordered by cost into low-, moderate-, and high-cost groups. A double repeated measures design was used to examine effects of products at interface sites. Mean pressures for all products at the sacral site were acceptably below the guideline. Four of the products had acceptable mean pressure readings at the trochanter site. No product had acceptable readings at the heel site. Significant main effects for product and site were found. A significant interaction between product and site was also found. Weight had no effect, either directly or in interaction with site or product. Moderate-cost products were found to be preferable at sacral and trochanter sites. At the heel site, cost groups did not differ.WD>Hedrick-Thompson, J. Halloran, T. Strader, M. K. McSweeney, M. 1055-3045 Journal Articlen J ET NurssAdult Aged Beds/economics/*standards Body Weight Choice Behavior Comparative Study Cost-Benefit Analysis Databases, Factual Decubitus Ulcer/*prevention & control Evaluation Studies Female Human Male Middle Age Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=81108941944086r1032 1991 OctF@Water bed therapy and cranial molding of the sick preterm infant 53-6$Hemingway, M. M. Oliver, S. K. 0730-0832 Journal Articlen Neonatal NetwQBeds/*standards Evaluation Studies Female Head/growth & development/*pathology Human Infant, Newborn *Infant, Premature Intensive Care Units, Neonatal Male Nursing Care/methods/standards *Watersjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19440864646623O6841 1972 Oct 12 Bed of beads1279-81  Heron, M.P 0954-7762 Journal Article  Nurs Times4-Air Movements *Beds Burns/therapy Glass Human jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4646623>7Herrman, E. C. Knapp, C. F. Donofrio, J. C. Salcido, R. 1999rlSkin perfusion responses to surface pressure-induced ischemia: implication for the developing pressure ulcerJ Rehabil Res Dev362 109-20*Decubitus Ulcer physiopathology; *Ischemia physiopathology; * Skin blood supply Cell Survival; Rats ; Regional Blood Flow; Vasodilation physiology Animal; Male; Support, U.S. Gov't, P.H.S.This study describes alterations in skin perfusion in response to step increases in surface pressure, before and after long-term (5 hr) exposure to pressure-induced ischemia. A provocative test was developed in which surface pressure was increased in increments of 3.7 mmHg until perfusion reached an apparent minimum by a computer-controlled plunger that included a force cell, a laser Doppler flowmeter to determine perfusion, and a thermistor to monitor skin temperature. Force was applied to the greater trochanters of adult male fuzzy rats. Skin perfusion (n=7) initially increased with low levels of surface pressure (up to 13.9+/-1.9 mmHg) and then decreased with further increases in pressure, reaching minimum (zero) perfusion at 58.2+/-3.64 mmHg. After pressure release, reactive hyperemia (3 x normal) was observed, with levels returning to normal within 15-30 min. The provocative test was then applied after a 5-hr ischemic episode (produced by 92 mmHg) and 3 hr of recovery. A comparison of responses between stressed and unstressed skin revealed: elevated (63%) control perfusion levels; loss of the initial increase in perfusion with low levels of increasing pressure; a depression (45%) in the hyperemic response with delayed recovery time; and a decrease (54%) in amplitude of low frequency (<1 Hz) rhythms in skin perfusion. Skin surface temperature gradually increased both during the control period and the period of incremental increases in surface pressure ( total DT=3.3 degrees C). The results suggest a compromised vasodilator mechanism(s). The provocative test developed in this study may have clinical potential for assessing tissue viability in early pressure ulcer development.60temperature laser Doppler flow on file TIG annexB;Pressure measurements in the management of tissue viability Hey, S. J. 199860Journal of tissue viability [J Tissue Viability]8a4x 23-5:4Using Smart Source Parsing Oct; ( pp Journal ArticleDecubitus Ulcer/*nursing Decubitus Ulcer/*prevention & control Nursing Assessment/*methods Case Report Cerebrovascular Disorders/complications Decubitus Ulcer/etiology Female Human Hypokinesia/complications Pressure9940366810595055153o 1999 JunZSCost considerations for the use of low-air-loss bed therapy in adult intensive care5 154-62The aim of this study was to consider the costs of low-air-loss bed therapy in the adult intensive care unit (ICU). A retrospective cost analysis was performed on 269 consecutive patients, 63 of whom had received low-air-loss bed therapy. Patients' APACHE II scores, length of stay (LOS), average daily TISS and ICU outcomes were also collected. Patients' APACHE II and LOS were further studied using odds ratios to test for an association between these factors and likelihood of receiving bed therapy. A prospective 10-week study to identify the amount of nursing time spent repositioning patients was also performed. The results of this study found the bed therapy to represent approximately 3% of the total average cost of care per patient. Patients requiring the bed therapy had higher APACHE II scores on admission, higher average daily TISS points and a longer length of ICU stay. Study of the odds ratios would suggest that the likelihood of patients receiving low-air-loss bed therapy increases if their APACHE II score on admission is between 11 and 20 and they stay > 4.5 days in the ICU. The results of the prospective study found the daily cost of repositioning patients to be 172.80 Pounds per patient.'JDMedical Economics and Research Centre, Sheffield. medeconctr@aol.comPIHibbert, C. L. Edbrooke, D. L. Corcoran, M. Bright, N. N. Kingsley, J. N.  0964-3397 Journal ArticleuIntensive Crit Care NursApache Beds/*economics Cost-Benefit Analysis Decubitus Ulcer/etiology/*prevention & control Human Intensive Care/*economics/*methods Length of Stay/economics Middle Age Odds Ratio Prospective Studies Retrospective Studies Support, Non-U.S. Gov'tJlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10595055 3845559y 160013 1985 Mar 27Taking off the pressure  iii-vi Hibbs, P.a 0029-6511 Journal Articlei Nurs MirrorrRKBeds Decubitus Ulcer/*prevention & control Diet Human Patient Care Planning jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3845559 Garfin1981 Garg1995h Gary19919 Gaspoz19989o Geary2000 Geary2000Gebhardt1994Gebhardt1994Gebhardt1994Gebhardt1996Gebhardt1998Gebhardt1998Gebhardt1998Gebhardt2002 Geden1984* Geelkerken1994 Gelbart1988 Germs1994? Gerner1978sGerngoss1999~ Geva19999^ Geyer2000= Ghajar19989\Giardino19988\ Giavaresi1998~ Gilad1999 Gilbert1990Gilbert-Barness1988= Gilcreast1998 Gill19979 Gillingham1973/ Gillingham1974_ Gilroy1989Glasofer19989hGlasofer20006 Glenn1988 Glicksman1998 Godbey19977= Goitom19989k Gola1976+ Golbranson1990aGoldfarb1987 Goldstein1987 Goldstein1998 Goldstone1982 Goller19729h Gong19919 Gonsalkorale1992 Gonsalkorale1998^ Gonsalkorale1998s Gonsalkorale2000  Gonsalkorale2000Gonzalez1990 Goode1982 Goode1997 Goode1997= Goodwin1983Goossens1993Goossens1994Goossens1995Goossens1995Goossens1995Goossens1995Goossens1997 Goovaerts1989 Gordon19779 Gorton1992 Gorton1993 Gottrup1987 Gould1993 Gould1994 Gould1994t Gould2000 Graber19909 Graber19939Grabosch1987 Graebe1991 Grahame1972Y Grahame1972 Grahame1973 Grahame1974 Grant1967 Grant1985 Grant1990 Gray1997 Gray19989 Gray1998 Gray1998 Gray1999 Gray2000 Gray2000 Gray2000 Gray2001a Green1987 Green1990< Green1992 Green-Abate1994 Greenfield19729 Greenough1998Greenway1965 Greer1988;Grendahl19655 Grender1993! Griffin2001M Grimm1999Grindley1996 Groen1999Groenier1999 Group1988 Grubb1982" Grypdonck2000 Gueho1985Guilbaud19919Guillory1984 Guin19909@ Guin19917Gunnewig1987  Gunningberg2001 Gunther1996  Gunther2000  Gupta1979 Gupta1979>Gurevich1993 Gustavsson1985 Gustavsson1987  Guthrie1993 Haalboom1994* Haddow1987 Haelen19808d Haffner1975# Hafner2000$ Hafner2000Hagisawa1988AHagisawa1994Hagisawa1994Hagisawa2000 Hagler1996 Hale1990 Hale19949Y Halfens2001 Hall1987Halliday1987!Halloran1993s2 Halmi1999Hamilton1983* Hamming1994 Hampton1997 Hampton1998 Hampton1999 Hampton2000 Hanel1997 Hankinson1986 Hansbrough1994 Hansbrough1994B Hansen1975lH Hansen19958; Hansen1995 Hanson19999# Hanssle2000C Hardin2000e Harding1995! Harding1999 Harding1999 Hargens1980 Hargest1969 Hargest1970F Hargest1971 Hargest1972 Hargest1972G Hargest1973 Hargest1980y Hargest1980 Hargest1981 Hargest1995 Harper1975r Harrington1989 Harrington1990 Harris19787 Harris19966i Harris20010j Harris20010Harrison1966Harrison1970 Hart19878 Harvin1970 Hasty1991K Hatzidoulis1975 Hauge1993 Hauge1994 Haugen1991Haughton1998Hauswald2000} Hawley19939B Hayes1996 Hayes1997 Hayne1990 Haynes19944- Hayoz1997  Health)1995 Heath2000  Heatherly1993 Hedrick-Thompson1992!Hedrick-Thompson1993 Heerens1997 Heitman1989H Held19959 Heliot19989" Hemingway1991Henderson-Smart2000Henderson-Smart2000* Hermans1994# Heron1972D Herrman1999 Herskowicz1982f Herszkowicz1985 Hey1998 Hraud19949$ Hibbert1999% Hibbs1985& Hibbs1988 Hickerson1997 Hifzi1995 Higashi1999b Higashidani1997 Hill20000'Hinojosa1990 Hobson1992( Hocking1999Hoek van Dijke1993Hoek van Dijke1994) Hoffman19964) Hoffman1996 Hoffman1996) Hoffman1996) Hoffman1996) Hoffman19961987 Goldstein1998 Goldstone1982 Goller19729h Gong19919 Gonsalkorale1998^ Gonsalkorale1998s Gonsalkorale2000  Gonsalkorale2000Gonzalez1990 Goode1982= Goodwin1983Goossens1993Goossens1994Goossens1995Goossens1997 Gordon1977 Gottrup1987 Gould1993 Gould1994 Gould1994t Gould2000 Graber19909 Graber19939Grabosch1987 Graebe1991 Grahame1972Y Grahame1972 Grahame1973 Grahame1974 Grant1967 Gray1997 Gray19989 Gray1998 Gray1998 Gray1999 Gray2000 Gray2000 Gray2000 Gray2001a Green1987 Green1990 Green-Abate1994 Greenfield19729 Greenough1998 Greer1988;Grendahl19655 Grender1993! Griffin2001M Grimm1999Grindley1996 Groen1999Groenier1999 Grubb1982" Grypdonck2000 Gueho1985Guilbaud19919Guillory1984 Guin19909@ Guin19917Gunnewig1987  Gunningberg2001  Gunther2000  Gupta1979  Gupta1979>Gurevich1993 Gustavsson1985 Gustavsson1987  Guthrie1993 Haalboom1994 Haelen19808d Haffner1975# Hafner2000$ Hafner2000Hagisawa1988AHagisawa1994Hagisawa1994Hagisawa2000 Hagler1996 Hale1990Y Halfens2001 Hall1987Halliday1987!Halloran1993s2 Halmi1999Hamilton1983* Hamming1994 Hampton1997 Hampton1998 Hampton1999 Hampton2000 Hankinson1986 Hansbrough1994 Hansbrough1994B Hansen1975lH Hansen19958 Hanson19999# Hanssle2000C Hardin2000e Harding1995! Harding1999 Harding1999 Hargens1980 Hargest1969 Hargest1970F Hargest1971 Hargest1972 Hargest1972G Hargest1973 Hargest1980y Hargest1980 Hargest1981 Hargest1995 Harper1975r Harrington1989 Harrington1990̛ Harris19787i Harris20010j Harris20010Harrison1966Harrison1970 Hart19878 Harvin1970 Hasty1991K Hatzidoulis1975 Haugen1991Haughton1998Hauswald2000} Hawley19939B Hayes1996 Hayes1997 Hayne1990- Hayoz1997  Health)1995  Heath2000 Hedrick-Thompson1992!Hedrick-Thompson1993 Heerens1997 Heitman1989H Held19959 Heliot19989" Hemingway1991Henderson-Smart2000Henderson-Smart2000* Hermans1994# Heron1972D Herrman1999 Herskowicz1982f Herszkowicz1985 Hraud19949$ Hibbert1999% Hibbs1985& Hibbs1988 Hifzi1995b Higashidani1997 Hill20000'Hinojosa1990 Hobson1992( Hocking1999Hoek van Dijke1993Hoek van Dijke1994) Hoffman1996wvtutnVPLe, K. M. Madsen, B. L. Barth, P. W. Ksander, G. A. Angell, J. B. Vistnes, L. M.RLAn in-depth look at pressure sores using monolithic silicon pressure sensors 1984Plast Reconstr Surg746 745-56:4Using Smart Source Parsing Dec; ( pp Journal ArticleDecubitus Ulcer:*ET/PP Meat Methods Needles Pressure Surface Properties Swine Transducers, Pressure Animal In Vitro Support, U.S. Gov't, P.H.S.Three-dimensional scalar pressure distributions were measured in solid tissue near bony prominences in vitro in meat and in vivo in pigs using silicon pressure sensors. Data are in accord with previous theoretical models and indicate that pressure is three to five times higher internally near a bony prominence than it is at the skin over the prominence. Pressure sores are thus thought to begin internally; by the time they are evident at the skin, the sore has worked its way completely from bone to skin. This conclusion is in accord with previous clinical data. Future measurement of local vector forces is needed to fully characterize the force distribution in vivo.85064280 451464131e 1979HAUse of the low air loss bed system in treatment of burns patients 159-61When a person is confined to bed, whatever the reason, small areas of soft tissues are compressed between the skeleton and the supporting surfaces. Transient circulatory disturbances resulting in epidermis to dermis damage or finally deep penetrating necrosis involving subcutaneous tissues, fascia muscle and bone may result. In the case of the severely burned patient who has already sustained gross trauma, any further destruction of tissues is to be avoided at all costs. The Low Air Loss Bed System offers many advantages in the care and management of the burns patient. There is a definite saving of nursing time by rendering unnecessary constant attention to the patient for preventative skin care, positioning, bed pan etc. The nurse is then able to devote her time positively to the more involved needs of the patient and family. It will also provide for periods of rest that are so often lacking, especially in the initial stages of treatment. The patient does not have to be kept on a rigid regime of Q2H turning. He is turned only for wound care, physio- and general body cleansing. His position may be contoured without having to touch him circumferentially. Any lifting and positioning necessary is easier for staff members due to the design of the unit, and more comfortable for the patient. Over a period of two years, eighteen patients with varying extent and degree of burn injuries were treated on the bed. This paper will describe the mechanical operation of the bed and experiences with nursing management and monitoring of the system. Leeder, C. J.  0036-5556 Journal Articleo"Scand J Plast Reconstr Surgh6/Air *Beds Burns/nursing/*therapy Human Pressure jchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=451464L8045158t228 1994 AugrD>Outcome of critically ill patients using lateral rotating beds 1341-3Leininger, P. A.0090-3493 Letter Crit Care MedMBeds/*standards *Critical Care Human *Outcome Assessment (Health Care) Reproducibility of Results Research Design/*standards *Rotationjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=80451582818827s294D 1989 Nov->7Interface pressure: can blood pressure be the equation?l8o Leung, K. H.0898-1655 Letter DecubitusMXQ*Beds *Blood Pressure Decubitus Ulcer/physiopathology/*prevention & control Human-jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=28188277889252d7 5a 1994 Sep^XA historical perspective on specialty beds and other apparatus for treatment of invalids51-2, 54The bed environment and support surface have long been recognized as important in the care of the chronically ill. A review of specialty beds from the 19th and early 20th century was done from the collection of medical trade catalogs at the New York Academy of Medicine. It has been said "Past Is Prologue." Whether or not this is true, examination of selected examples of these historical beds can provide an unique and interesting perspective on contemporary practice. Levine, J. M.2,1076-2191 Historical Article Journal ArticleAdv Wound CareBeds/*history Decubitus Ulcer/history/prevention & control History of Medicine, 19th Cent. History of Medicine, 20th Cent. Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7889252ntrol Human Risk Factorslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10076399A1760125n4H4l 1991 NovpiPrevention of pressure ulcers in elderly nursing home residents: are special support surfaces the answer?r 42-4, 46, 48,%This article describes a research study that compared the effectiveness of two pressure-reducing devices in a group of elderly nursing home residents. The results obtained revealed no significant differences between the two devices--an air-filled overlay and a gel mattress--in terms of pressure ulcer incidence, severity, and healing. Several factors contributed to these results and illustrate the problems encountered when preventing pressure ulcer development in a group of elderly, debilitated nursing home residents. These factors include ease of use of the pressure-reducing device, caregiver and facility characteristics, and critical patient variables. Until these variables are addressed, it is impossible for any device to be effective in preventing pressure ulcer development in nursing homes.-&Lazzara, D. J. Buschmann, M. T.i 0898-1655 Journal Articlet DecubitusyAged Beds/economics/*standards Comparative Study Cost-Benefit Analysis Decubitus Ulcer/epidemiology/nursing/*prevention & control Evaluation Studies Female Human Male Middle Age Nursing Assessment *Nursing Homescjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1760125SS|||TTTTTVVVVVVWWWWXXXXXZZZZYYYYYYYYYYYYrrr[[]]]]]\\\^^^^^^^^______````aaaaaabbbbbboocccdeeeggghhhjjjjjiiiiiikkkkkkkkkkkkllllllmmmmmnnpcqPvvvww[x?n FJ\#)1;=?NML]im 4;=CRp~ White, L. 2002HBViscoelastic foam mattresses: marketing hype or molecular miracle.Urethanes Technology6565735l109l 1984 Sep& Do mattresses make a difference? 20-5.(Whitney, J. D. Fellows, B. J. Larson, E. 0098-9134 Journal ArticlecJ Gerontol Nurs ~Adult Aged *Bedding and Linens Comparative Study Decubitus Ulcer/*prevention & control Human Middle Age Polyurethanes Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6565735<5Whittemore, R. Bautista, C. Smith, C. Bruttomesso, K.9 1993tnInterface pressure measurements of support surfaces with subjects in the supine and 45-degree Fowler positions J ET Nursm203m 111-5*Beds standards; *Decubitus Ulcer prevention and control; * Pressure Adult ; Evaluation Studies; Middle Age; Posture ; Supine Position Human("In the past 20 years there has been a dramatic increase in different types of support surfaces to reduce the incidence of pressure ulcers. The purpose of this study was to determine the effect of static air overlays (Sof-Care and Tendercloud), replacement mattresses (Dermarest and Therarest), and a standard hospital mattress on tissue interface pressures in healthy subjects. A convenience sample of 25 subjects had tissue interface measurements obtained under the sacrum and heel bony prominences on the five support surfaces in the supine and 45-degree Fowler's positions. A repeated measures analysis of variance (p < 0.05) indicated that the Dermarest, Therarest, Sof-Care, and Tendercloud support surfaces reduced pressure significantly under the sacral bony prominence compared with the standard hospital mattress. Heel interface pressure measurements were significantly higher than sacral interface pressure measurements. There was no significant difference between supine and 45-degree Fowler's positions with respect to tissue interface pressures. TIG annexa9481284*251o 1998 JanyF?Pressure-reduction support surfaces: a review of the literature6 6-25This review of the literature summarizes research completed during the past 10 years with regard to pressure-reduction support surfaces. Data are summarized within Tables, focusing on each type of support surface (foam overlays, air overlays, and replacement mattresses) with the corresponding tissue interface pressure research and clinical trials. The review is intended to provide an evidence-based platform for selecting a support surface in clinical practice.'LFUniversity of Connecticut School of Nursing, Storrs, Connecticut, USA.Whittemore, R.821071-5754 Journal Article Review Review Literature$J Wound Ostomy Continence NursBeds/classification/*standards/supply & distribution Decubitus Ulcer/nursing/*prevention & control Evidence-Based Medicine Human Pressure jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9481284s have been used in an attempt to decrease prolonged pressure on skin, especially over bony prominences, and thus prevent pressure sores in immobilized patients: turning frames, circle beds, flotation beds, and special mattresses. Bridging is one means of relieving pressure on bony prominences which is both simple and inexpensive. Through the proper positioning of pillows, a patient is supported above the surface of the bed with free space between the bony prominences and the bed surface. Several different positions for pressure relief are possible. Advantages of the technic include its low cost, patient acceptance, lack of mechanical components which can fail, and ease of training personnel or family members to carry it out.  Stewart, P. Wharton, G. W. 0038-4348 Journal Article- South Med J d^Decubitus Ulcer/*prevention & control Human *Immobilization Preventive Health Services/methodsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1019647L0*Kvernebo, K. Staxrud, L. E. Salerud, E. G. 1990ZTAssessment of human muscle blood perfusion with single-fiber laser Doppler flowmetry Microvasc Res,393 376-85Laser Doppler flowmetry (LDF) is a technique for continuous monitoring of microvascular perfusion. Commercially available flowmeters in general are equipped with probes constructed for performing measurements on superficial tissue surfaces, but small (phi 0.45 mm) metallic needle probes for in-tissue measurements are also available. In this study a flexible single-fiber LDF probe with a total diameter of 0.5 mm has been inserted into human tibial muscle and used for assessment of local muscle blood flow. Local muscle perfusion shows a considerable spatial variation. If the probe position is not changed between consecutive measurements, reproducible curve parameters are obtained. Vasomotion was not observed in any measurement. The hyperemic blood flow response was recorded after tourniquet deflation. Time to reach peak magnitude as well as duration of the hyperemic blood flow response was increased significantly (P less than 0.01) with prolonged occlusion time. The response was found in both skin and muscle blood flow recordings. Increasing occlusion time from 3 to 5 min did not significantly enhance the results. Comparison of skin and muscle responses with respect to time to reach peak magnitude showed a significant difference (P less than 0.02) for the 1-min occlusion. A significant increase (P less than 0.01 and 0.05 for muscle and skin, respectively) in peak flux was seen in muscle and skin when tourniquet occlusion was increased from 1 to 3 min. Further increases in occlusion time did not produce significant increases in peak flux. The technique is easy to use, and may be of value in studies of disturbances of perfusion in muscle and possibly in parenchymatous organs (transplantation surgery) and central nervous system circulation.<6Using Smart Source Parsing May; ( pp on file TIG annexYXWVU\T^S*Rf5581426.515 1971 MaynPJA ventral contour bed: a new concept in the management of decubitus ulcers 535-81 Kaufman, M.l 0031-9023 Journal Article Phys Ther*$*Beds Decubitus Ulcer/*therapy Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=558142610396124396i 1999 Jun7@:Hypothermia bed system for stroke patients. Technical note466-9; discussion 469-70A new hypothermia bed system was used to induce mild hypothermia (33-35 degrees C) in six patients with stroke due to subarachnoid hemorrhage, hypertensive intracerebral hemorrhage, or embolic internal carotid artery occlusion. The system bed contained all necessary equipment including a respirator, a cooling unit, physiological monitors, and a storage battery. Surface cooling of the patients was performed using water-circulating blankets, and core temperature was maintained based on bladder temperature and a feedback computer program. During hypothermic therapy, patient transfer and radiological examination including computed tomography and positron emission tomography could be easily and safely performed. Differences between the measured bladder temperature and the target temperature were approximately +/- 0.1 degree C. The proposed hypothermia system bed may be useful for serial radiological examination of patients with stroke.'VODepartment of Strokology, Research Institute for Brain and Blood Vessels-Akita.o2,Kawamura, S. Suzuki, E. Suzuki, A. Yasui, N. 0470-8105 Journal ArticleeNeurol Med Chir (Tokyo)dAdult Aged *Beds Cerebrovascular Disorders/etiology/*radiography/*therapy Female Human Hypothermia, Induced/*methods Male Middle Age Subarachnoid Hemorrhage/complicationslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10396124)78626831103 1994 DecWjcA means of tying provision with need. Audit of pressure-relieving aids in community-based hospitalsa 161-4i1. The use of pressure-relieving mattresses should be agreed with the multidisciplinary team according to specific criteria. 2. Criteria led to appropriate mattress being used, with standardised practice based on patients' individual clinical needs. 3. Nurses ensure pressure area care is prescribed, delivered and documented. 4. The audit tools could be amended for use in the community setting and other hospital specialties.Keal, J. 0266-8130 Journal Article Prof NurseZT*Beds Decubitus Ulcer/*prevention & control Hospitals, Community Human Nursing Auditjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=78626835434949 774D 1970 Feb- Roto-rest- 254-8  Keane, F.4 0031-1758 Journal Articleb Paraplegiab[*Beds Equipment and Supplies, Hospital Home Care Services Neurosurgery Orthopedic Equipment jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=54349497541526i9122 1995 May 31-Jun 6&Wound care. Easing the pressurea 72-6*$Kella, M. Coverdale, S. Williams, S. 0954-7762 Journal Article Nurs TimestmBeds Clinical Nursing Research Comparative Study Decubitus Ulcer/*prevention & control Human *Palliative Care jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=75415263590257m183 1987May-JunopjEvaluation of kinetic therapy in the prevention of complications of prolonged bed rest secondary to stroke 638-42zsWe performed a prospective, controlled study of kinetic therapy in acute, severe stroke. This therapy involved continuous mobilization of a bedridden patient by means of a specially designed rotating bed. All patients with acute stroke presenting to the Neurology Service over an 18-month period were screened, and those that qualified were assigned to confinement in either a routine hospital bed or a rotating bed. We found that the most common complication of stroke with bed confinement of 4 days or longer was bacterial infection consisting of either pneumonia, sepsis, or urinary tract infection. The two variables found to be of greatest significance in affecting the rate of infection were length of bed confinement, especially for greater than 13 days (2.3-fold increased risk, p less than 0.04), and placement in a routine hospital bed (2.9-fold increased risk, p = 0.023).f:4Kelley, R. E. Vibulsresth, S. Bell, L. Duncan, R. C. 0039-2499 Journal Articlen StrokeBed Rest/*adverse effects *Beds Cerebrovascular Disorders/mortality/*therapy Comparative Study Human Infection/etiology Length of Stay Regression Analysis Risk *Rotation Support, Non-U.S. Gov'tHjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=35902572108501r834 1990 AprTMCost analysis of kinetic therapy in the prevention of complications of stroke 433-4b<5We prospectively evaluated the costs of medical care in a group of 43 patients with acute severe stroke. Patients were assigned to either a routine hospital bed or a rotational bed. The rotational study bed (kinetic therapy) is designed to prevent complications of prolonged bed confinement by keeping patients in continuous slow rotation. The average number of acute care days was 11.2 in the study group and 16.4 in the control group. Study patients had similar costs per day for laboratory testing, x-ray studies, respiratory therapy, total acute care expenses, and total hospital expenses. Among study patients, reduction in medication costs per day did approach statistical significance, by unpaired t test, at P = .014, with a corrected significance level of .008. Overall, the average acute care costs per day were $544 in the study group verus $410 in the control group. This difference was approximately the average per day charge for the rotational bed ($130). We conclude that therapy designed to prevent complications of prolonged bed confinement is cost effective.'LEDepartment of Neurology, University of Miami School of Medicine, Fla.,&Kelley, R. E. Bell, L. K. Mason, R. L. 0038-4348 Journal Article South Med JAcute Disease Aged *Beds Cerebrovascular Disorders/mortality/*therapy Cost-Benefit Analysis Human *Infection Control Kinetics Length of Stay/*economics Middle Age Prospective Studies *Rotationjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=210850146464871118n 1972 Nov VPTreatment of severe decubitus ulcers using the Beaufort-Winchester flotation bed 401-2 <5Kemp, W. A. Grahame, R. Burry, H. C. Broomhead, I. W.  0003-4908 Journal ArticleARheumatol Phys Med|v*Beds Capillaries Decubitus Ulcer/etiology/nursing/surgery/*therapy Human Pressure Skin/blood supply Temperature Waterjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4646487<f;:98`7 :10326359122a 1999 Marl|uPressure ulcer prevention: a randomized controlled trial of 2 risk-directed strategies for patient surface assignment9 72-80OBJECTIVE: To compare the clinical utility, in terms of incidence of pressure ulcer (PU) development, and economic impact of 2 programs of patient surface assignment for PU prevention. DESIGN: Randomized controlled clinical trial with economic evaluation. SETTING: 30-bed multidisciplinary intensive care unit (ICU), serving as the regional trauma center. PATIENTS: 144 consecutive eligible patients at risk for the development of PUs. INTERVENTION: PU risk was assessed on admission using the Skin Ulcer Risk Evaluation (SURE) Score, and patients were randomized to either the experimental (purchase) or control group (purchase/rent). Based on their SURE Score, patients were assigned a specialty surface if needed. Patients received head-to-toe skin assessments twice weekly, new PUs were documented, a new SURE Score was calculated, and specialty surfaces were upgraded or downgraded as necessary. OUTCOMES: The incidence of PUs by site and severity, and cost. ANALYSES: Multivariate logistic regression and decision modeling. RESULTS: No significant differences were detected between groups with respect to baseline population characteristics, nor in the development of PUs. Predictors of PU development were ICU length of stay and SURE Score. The experimental (purchase) group was the less costly strategy. Under baseline assumptions, surface costs per at-risk patient were $76 CDN and $171 CDN in the experimental and control groups, respectively. The savings of $95 CDN per at-risk patient translates into conservative annual savings of $47,500 CDN. CONCLUSIONS: Using an objective, risk-based method of patient surface assignment, the authors compared the clinical and economic outcomes of 2 programs of PU prevention. In a direct comparison of alternatives, the strategy that emphasized purchased rather than rented products proved to be the more economical. Finally, this approach illustrates how by prospectively capturing data on both the costs and consequences of competing alternatives, a more objective and informed decision-making process can result.'6/London Health Sciences Centre, Ontario, Canada.sRKInman, K. J. Dymock, K. Fysh, N. Robbins, B. Rutledge, F. S. Sibbald, W. J.sJD1076-2191 Clinical Trial Journal Article Randomized Controlled TrialAdv Wound CareAged Beds/economics/*standards Comparative Study Cost Savings Decision Trees Decubitus Ulcer/economics/nursing/*prevention & control Female Human Incidence Logistic Models Male Middle Age Nursing Assessment/methods *Patient Selection Risk Factors Support, Non-U.S. Gov'tlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=103263593638659n8232 1986Aug 6-12.'Pressure sores. An eradication campaign 59-62y Isles, J.7 0954-7762 Journal Articlei Nurs TimesD>Beds Decubitus Ulcer/*prevention & control Human *Nursing Carejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=36386599605022t 184N2  1998 Feb LEEffect of rolling bed on decubitus in bedridden nursing home patients 153-72Decubitus is one of the most difficult management problems encountered in bedridden elderly patients. Relief of pressure over decubitus is the most important principle of the management. We developed a rolling air cushion bed which turns the patient to a 15-degree inclined lateral position with an inflating ripple mattress, a longitudinally aligned air inflatable tube. The position of the patients was changed between right and left laterals and to supine every 15 minutes automatically. Nineteen bedridden patients with decubitus used the rolling air cushion bed for 3 months and 12 bedridden patients with decubitus used a conventional bed and had their position changes every 2 hours by care givers. Severity of decubitus was divided into 4 grades and the decubitus significantly improved from 2.8 (S.E. 0.2) to 2.0 (S.E. 0.3) after 3 months in patients using the rolling air cushion bed, while in patients with conventional beds it changed from 3.0 (S.E. 0.2) to 3.2 (S.E. 0.2) (not statistically significant). We suggest that the rolling air cushion bed would be beneficial to decubitus relief in bedridden elderly and may relieve labor by care givers.'*$Miki Hospital, Maesawa-Machi, Japan.:4Izutsu, T. Matsui, T. Satoh, T. Tsuji, T. Sasaki, H. 0040-8727 Journal ArticleTohoku J Exp MedAged *Beds Decubitus Ulcer/pathology/*therapy Equipment Design Female Human *Inpatients Male *Motion *Nursing Homes Pelvis Treatment Outcomejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=96050229205393t433y 1997 Apred]Pressure ulcer prevalence and prevention of nosocomial development: one hospital's experiencen 32-6, 38-40s,&A 500 bed acute care facility needed to replace their old medical-surgical patient beds and reduce the costly use of specialty beds and overlays. After a review of the literature, the facility focused on the 44-bed AIDS/Oncology unit, first trialing a new therapeutic bed, then replacing all the beds. A prevalence survey was conducted 5 days before the placement of the new beds and monthly thereafter for 6 months. It was hypothesized that (1) incidence of nosocomial pressure ulcers would decrease, (2) use of specialty beds would be reduced, resulting in significant cost savings within a few months, and (3) there would be a learning curve regarding use of the beds and proper "zoning" of patients. From April through November 1995, 256 patients were surveyed. Pre-survey, the average range on the unit for pressure ulcer prevalence was 7.5 to 15% (both nosocomial and admitted). Post-survey, the range was 3 to 16% (admitted ulcers only). Zero nosocomial pressure ulcers developed during the study period. Use of foam overlays and low air loss surfaces decreased, resulting in a savings of 83%. There were no problems with using the beds or zoning patients. These survey results suggest that other institutions could achieve similar clinical and financial outcomes by converting rental dollars to capital assets.'>7Santa Clara Valley Medical Center in San Jose, CA, USA.hJacksich, B. B.tHB0889-5899 Clinical Trial Controlled Clinical Trial Journal ArticleOstomy Wound Manage Beds/economics/*standards Cost Savings Decubitus Ulcer/*prevention & control Human Incidence Nursing Staff, Hospital/education Prevalence jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=92053933204209N156e 1988Nov-Dec0PJThe effects of a therapeutic bed on pressure ulcers: an experimental study 220-6s6/Jackson, B. S. Chagares, R. Nee, N. Freeman, K. 0270-1170 Journal ArticleJ Enterostomal TherU|uAged *Beds Decubitus Ulcer/*nursing/pathology/therapy Female Human Male Retrospective Studies Support, Non-U.S. Gov'tgjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=320420910595057153o 1999 Jun>8The revised Jackson/Cubbin Pressure Area Risk Calculator 169-75'NGIntensive Care Unit, Royal Liverpool & Broadgreen University Trust, UK.B Jackson, C.  0964-3397 Journal Article Intensive Crit Care NursBeds/economics/supply & distribution Decubitus Ulcer/*etiology/*nursing/prevention & control Human *Intensive Care Nursing Assessment/*methods Patient Selection Reproducibility of Results Risk Assessment Risk Factorslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10595057-JIHGG|F H9095813e8n4i 1996 DecrBalloons, beds, and breakdown. Effects of low-air loss therapy on the development of pressure ulcers in cardiovascular surgical patients with intra-aortic balloon pump supportr 423-40D=There is limited research related to pressure ulcers in the ICU patient population and even less has focused on patients who have undergone cardiovascular surgery and IABP support. The objective of this article was to determine the incidence of pressure ulcers in the postoperative CVS patient with IABP support and to determine if LAL therapy was more effective in the prevention of pressure ulcers in this patient population. In a quasiexperimental design, a convenience sample of 36 adults was used. Patients who were placed on IABP support the day of surgery were enrolled into the study within 24 hours of admission to the cardiovascular recovery room. Data collection was daily for 4 days and continued if the patient developed a pressure ulcer. Final measurements were obtained on the day of hospital discharge. Instruments used were demographic data form, APACHE II, Patient Identification for Rotation Therapy, and the Braden Scale. The most common surgical patient in this pilot underwent aortocoronary bypass with IABP support. Pressure ulcers developed in 9 of 36 (25%) patients for a total of 17 ulcers. Patients who developed pressure ulcers were generally older, had a history of cerebrovascular disease, renal insufficiency, a higher APACHE II score, and Braden score of 9 on POD 1. In addition, these patients generally had a lower hemoglobin level, higher serum creatinine level, and an altered level of consciousness on POD 1. The results suggest that LAL therapy does make a difference in the prevention of pressure ulcers in the aortocoronary bypass patient with IABP support.l'JCSt. Luke's Episcopal Hospital, Texas Heart Institute, Houston, USA.p2,Jesurum, J. Joseph, K. Davis, J. M. Suki, R.JD0899-5885 Clinical Trial Journal Article Randomized Controlled Trial"Crit Care Nurs Clin North AmAged Beds/*standards Critical Care Decubitus Ulcer/*etiology/*prevention & control Female Human Incidence Intra-Aortic Balloon Pumping/*adverse effects Male Middle Age Pilot Projectsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=90958134484258u 135 4 1972 Jul 28<5Problems involved in the prevention of pressure sores3 39-41mJohnson, M. L. 0143-2524 Journal ArticleaNurs Mirror Midwives JB8Johnson, J. M. Taylor, W. F. Shepherd, A. P. Park, M. K. 1984TMLaser-Doppler measurement of skin blood flow: comparison with plethysmographyeJ Appl Physiol563o798-80384161552Lasers:*DU Plethysmography:* Skin:*BS Ultrasonics:*DU Adult Body Temperature Forearm Regional Blood Flow Regression Analysis Comparative Study Human Male Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. We compared laser-Doppler velocimetry with plethysmographically determined changes in skin blood flow (SkBF) in five studies on four men. Increments in SkBF were induced by raising whole-body skin temperature to 39 degrees C for 50-70 min. We found laser-Doppler blood flow (LDF) to correlate well with total forearm blood flow (FBF) within each study (r 0.94-0.98), but the relationship varied among studies. Thus the slopes for the LDF vs. FBF relationship varied from 40 to 122 mV X ml-1 X 100 ml X min. The value for LDF at zero FBF, extrapolated from the regression relationships, ranged from 246 to 599 mV above the value for LDF set with the probe on a stationary object. The value for LDF when blood flow to the arm was mechanically occluded ranged from 110 to 230 mV. In a second series, we measured the LDF values from six sites on forearms of each of four normothermic men. There was marked regional variation, with 1.8- to 5.7-fold ranges in LDF within a given subject. Values for LDF during occlusion of the forearm were more consistent within and between subjects. Thus LDF appears to provide a good indicator of the response pattern of SkBF from the region of illuminated skin. However, variability in the relationship to total SkBF (probably arising from variation in the number of perfused capillaries in the small volume of tissue) and uncertainties in the value of LDF at zero SkBF make quantitative use difficult.LFUsing Smart Source Parsing Mar; ( pp Journal Article on file TIG annex1892945c185i 1991Sep-Oct/:3A clinical study of hospital replacement mattressesi 153-7l*#Johnson, G. Daily, C. Francisus, V.6.(1055-3045 Clinical Trial Journal Article J ET Nurs\VBeds/*standards Decubitus Ulcer/nursing/*prevention & control Human Nursing Assessmentjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18929451558632)3825 1992 Marlf_Choosing a hospital replacement mattress: issues to consider when selecting an HRM for purchased 22-7 Johnson, G. 0889-5899 Journal ArticleeOstomy Wound ManageBeds/*standards Costs and Cost Analysis Decubitus Ulcer/etiology/*prevention & control Economics, Hospital Human Nursing Care United Statesjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=155863249444692u24 1971 Dec 11,%The water bed in a spinal injury unit1215-21$Jones, R. F. Burniston, G. C.2,0025-729x Historical Article Journal Article Med J AustBeds/history/*standards Body Weight Decubitus Ulcer/*therapy Female History of Medicine, 19th Cent. History of Medicine, 20th Cent. Hospital Departments Human Male Obesity/complications Spinal Injuries/nursing Water jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4944469 Q*P0ONM d4016544 727t 1985 JuldDemonstration of a reduction in postoperative body protein breakdown using the Clinitron fluidized bed with an ambient temperature of 32 degrees C 574-8VPatients managed at an elevated ambient temperature after major surgery have a less pronounced rise in postoperative urinary nitrogen excretion. To investigate the mechanism involved, body protein breakdown was assessed, using a tracer dose of labelled amino acid, in patients following aorto-bifemoral bypass surgery nursed on either a Clinitron fluidized bed at 32 degrees C or a hospital bed at 22 degrees C and correlated with urinary total nitrogen excretion. Results showed a small reduction in measured body protein breakdown on the second postoperative day in patients managed on the Clinitron fluidized bed at 32 degrees C (2.92 +/- 0.91 versus 3.23 +/- 0.84 g protein kg-1 day-1; mean +/- s.d.), which was equivalent to the mean protein sparing (0.29g protein kg-1 day-1) demonstrated by the significant improvement in urinary total nitrogen excretion (9.20 +/- 2.0 versus 12.48 +/- 3.9 g N day-1; mean +/- s.d.: P less than 0.05). Urinary total nitrogen excretion (N) and body protein breakdown (B) showed a weak though significant positive correlation (B = 1.25 + 13.13N; r = +0.55: P = 0.05), whereas no correlation existed between urinary total nitrogen excretion and the derived rate of body protein synthesis. There was also a significant decrease in postoperative stress, measured during the isotope infusion, in patients managed on the Clinitron fluidized bed at 32 degrees C (12.3 +/- 2.2 versus 16.1 +/- 3.2 per cent activity incorporated into plasma proteins; mean +/- s.d.: P less than 0.05). These results show the beneficial effect of managing postoperative patients on a Clinitron fluidized bed at 32 degrees C in conserving body nitrogen through a reduction in body protein breakdown, probably as a consequence of decreased postoperative stress.u<6Jones, G. A. Clague, M. B. Ryan, D. W. Johnston, I. D. 0007-1323 Journal Article Br J SurgAged *Beds Heat/*therapeutic use Human Kinetics Middle Age Nitrogen/urine Postoperative Care/*methods Postoperative Complications/prevention & control Proteins/*metabolism Stress/metabolismjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=40165448718143s9229 1996 Jul 17-23uReducing the pressured 59-60, 64A Jones, B.n 0954-7762 Journal Articles Nurs TimesBeds Decubitus Ulcer/*prevention & control *Education, Nursing, Continuing Human Nurses' Aides/*education Nursing Assessment Nursing Audit *Residential Facilitiesjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8718143(!Justham, D. Michael, C. Harris, De 1996d^A healthy volunteer study of skin-surface interface pressure experienced in X-Ray departments.J of Tissue Viabilitye6 4107-110,&Kabagambe, M Swain, I. Shakespeare, P. 1994An investigation of the effects of local pressure on microcirculation of the skin ( reactive hyperaemia) in spinal cord injured patients.J of Tissue Viability4110-123@ Kabagambe, M 1994`ZEffects of loading pressure on microcirculation in spinal cord injured patients (Abstract)J of Tissue Viabilityi4\3s946740259d1811 1984ngClinical results of treatment of patients in the air-fluidized bed (Clinitron) during a one-year period 153-4pBeside the nursing difficulties in using the Clinitron bed we have experienced further technical difficulties during the introduction period which are described. However, the beds have been most effective from a bacteriological point of view and have reduced the infection rate. Kalaja, E. 0036-5556 Journal Articleu"Scand J Plast Reconstr Surg2b[Bacterial Infections/etiology/prevention & control *Beds Burns/complications/*therapy Humanijdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6740259(!Kang, J-W. Chang, G.L. Chou, Y-L. 1992PJStudy on surface and tissue pressures related to pressure sores (abstract)J of Biomechanics\25 801fjdA method for testing the effect of pressure-relieving materials in the prevention of pressure ulcers&Karlsmark, T. Kristensen, J. K.  19876/Acta dermato venereologica [Acta Derm Venereol]y673b 260-3n6/Using Smart Source Parsing ( pp Journal ArticleapjBandages* Decubitus Ulcer/*prevention & control Adult Human Pressure Regional Blood Flow Skin/blood supply873221029464694r4016 1998 JanvpA new postoperative management scheme for preventing sacral pressure sores in patients with spinal cord injuries 39-43|uAlthough the reliability of pressure sore surgery has improved with the advent of many different types of flaps, it is well known that the recurrence rate of pressure sores is still remarkably high in spinal cord-injured patients. This article reports the very low relapse rate of postsurgical pressure sores using air mattresses, which also helps relieve manpower requirements for care. We measured interface pressures at the sacrum for 18 spinal cord-injured patients with a ROHO air mattress (ROHO International, Inc, Belleville, IL). Based on the results, we used this mattress immediately after surgery for 19 spinal cord-injured patients with sacral pressure sores. Minimal repositioning was performed for each patient during the hospital stay. Minimal repositioning was similarly performed at home. All pressure sores healed, regardless of the type of surgical procedure, size, and degree of sore. No relapse has been found, with an average of 33.4 months after surgery. With this management, we could achieve a very low recurrence rate, require less manpower for postoperative management, as well as minimize stress for the patients.'\VDepartment of Plastic and Reconstructive Surgery, Chubu Rosai Hospital, Nagoya, Japan."Kato, H. Inoue, T. Torii, S. 0148-7043 Journal ArticleAnn Plast SurgAdult *Beds Decubitus Ulcer/epidemiology/*prevention & control/*surgery Female Follow-Up Studies Human Male Middle Age Postoperative Care Recurrence Sacrococcygeal Region Spinal Cord Injuries/*complications Time Factors-jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=94646944076592 6251 1985 MayMedical devices-25Katz, L. Singh, G.0317-7645 LetterDimens Health Serv("Beds/*standards *Equipment Failurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4076592a`_^N]15965281193 1992May-JunhHBResults of therapeutic bed monitoring: justification of ET nursing 95-70*Therapeutic beds are used frequently at St. Vincent Medical Center, a 640-bed tertiary care hospital. The beds are designed to reduce body surface pressures for patients with potential for or actual pressure injury related to mechanical forces (pressure, friction, and/or shear). A monitoring system for therapeutic bed usage was initiated by the Enterostomal Therapy Department in March 1990 because of concerns about prolonged and sometimes unnecessary use of the beds. In this article, the monitoring system is described with the results after 1 year. Kerschbaum, B. Murray, M.o 1055-3045 Journal Articleo J ET Nurs/zsBeds/economics/*utilization Costs and Cost Analysis Decubitus Ulcer/*prevention & control Economics, Hospital Humanujdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1596528105319228e1- 1998 Jan*$Guide to flexible polyurethane foams 19-21, 24-5l'JDRecticel Limited, Clover Nook Industrial Park, Alfreton, Derbyshire. King, D. A.C810965-206x Journal Article Review Review, TutorialeJ Tissue ViabilityBeds/*standards/supply & distribution Compressive Strength Decubitus Ulcer/*prevention & control Elasticity Flame Retardants Great Britain Hardness Tests Human Materials Testing *Polyurethaneslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1053192222649525e162r 1989Mar-AprehaEvaluating mattress overlays and pressure relieving systems: a question of perception or reality?l 58-60oKlein, L. Gilroy, K..(0270-1170 Clinical Trial Journal ArticleJ Enterostomal Therib\*Beds Clinical Trials Comparative Study Decubitus Ulcer/etiology/*prevention & control Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=26495254528729s211o 1974tmSome clinical sleep parameters with Innerspace Flotation Bed: a preliminary report with reference to insomniah 3-9i2+Kline, M. V. Sullivan, P. A. Coleman, L. L. 0003-1194 Journal Article."J Am Soc Psychosom Dent Med |uAdult *Beds Comparative Study Female Human Male Middle Age *Sleep Sleep Initiation and Maintenance Disorders/*therapynjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=45287292,Pressure ulcers and pressure relief surfaces'^XDepartment of Cell Biology, Duke University Medical Center, Durham, North Carolina, USA.<6Klitzman, B. Kalinowski, C. Glasofer, S. L. Rugani, L. 19982,Clinics in plastic surgery [Clin Plast Surg]253n 443-50VOUsing Smart Source Parsing Jul; ( pp Journal Article; Review; Review Literaturead^Decubitus Ulcer/*prevention & control Decubitus Ulcer/economics Decubitus Ulcer/etiology Human983622309274265 6o6n 1997 Jun@:Managing pressure relief in a special needs nursing scheme 282-6 RKPeople admitted to the Royal Devon and Exeter Hospital, who require continued long term nursing care and fulfil at least one of seven identified criteria, can be referred to a special needs scheme for placement in a private local nursing home supported by education, free loan of electronic pressure-relieving equipment and visits to monitor progress. A clinical nurse specialist in tissue viability is also available for advice and the supply of equipment to any residents with tissue viability problems who are referred by nursing home staff. From a total of 293 referrals during the first four years of this scheme, 155 patients have been supported in nursing homes through the scheme. At the time of placement, 71 patients (46%) had pressure sores, all of whom received the free loan of an electronic mattress. A further 21 patients, whose skin integrity was at high risk, also received mattresses. The sores ranged from Grade 2 to Grade 4 (Stirling grading scale). During the study period, only four patients placed under the scheme suffered deterioration in their sores (all immediately prior to death). Over the three years before the scheme began, 14 patients per year were admitted from private nursing homes to an acute hospital with a primary diagnosis of pressure sore. Since the introduction of the scheme this figure has been reduced to nil.'2,Royal Devon and Exeter Healthcare NHS Trust. Knowles, C.  0969-0700 Journal Articled J Wound CareAged Aged, 80 and over Beds Decubitus Ulcer/*nursing Human Middle Age Nurse Clinicians Nursing Assessment *Nursing Homes Outcome Assessment (Health Care) *Patient Admission *Patient Selection Referral and Consultation Retrospective Studiesnjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9274265 fNI ZeZd1080560t563 1975 SepJHAEffects of waterbed flotation on premature infants: A pilot study0 361-7rTwo types of waterbeds were developed to impart compensatory vestibular-proprioceptive stimulation to premature infants. Twenty-one infants ranging in gestational age from 27 to 34 weeks and birthweights from 1,050 to 1,920 gm were included in this pilot study. Assignment to experimental and control groups was made by random design. The experimental group consisted of ten infants who were placed on a gently oscillating waterbed before the sixth postnatal day, where they remained for seven days. Their clinical progress was compared with that of a control group of 11 similar babies. Waterbed flotation was found to be a safe procedure; there was no significant effects on the infants' vital signs, weight, or frequency of emesis. Highly significant differences were found in the incidence of apnea between the two groups, with infants on the oscillating waterbed having significantly fewer apneic spells. Infants placed on the waterbed during the first four postnatal days benefited more than those placed later. A non-oscillating waterbed was found clinically useful for very small prematures with severe skin problems, for infants recovering from abdominal surgery, and for infants receiving parenteral nutrition.@9Korner, A. F. Kraemer, H. C. Haffner, M. E. Cosper, L. M.JD0031-4005 Clinical Trial Journal Article Randomized Controlled Trial PediatricsApnea *Beds Human Incubators, Infant/*instrumentation Infant, Newborn *Infant, Premature Pilot Projects *Proprioception Vestibule/*physiology-jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1080560@:Kosiak, M. Kubicek, W.G. Olson, M. Danz, J.N. Kottka, F.J. 1958LFEvaluation of pressure as a factor in the production of ischial ulcers60Archives of Physical Medicine and Rehabilitation3910623-629i Kosiak, M. 19590)Etiology and pathology of ischemic ulcers4.Archives of Physical Medicine & Rehabilitation40 62-69 Kosiak, M. 1961"Etiology of decubitus ulcers60Archives of Physical Medicine and Rehabilitation 19-2911198791489i 2000 Sep1&The foam mattress-back syndromew 901-2i BACKGROUND: Many medical residents used to sleeping on cotton mattresses at home complain of mild to moderate back pain after sleeping on foam mattresses provided in the hospital and hostel rooms. OBJECTIVE: To determine the relationship of sleeping on foam mattress with the appearance of back pain in a 500 bedded multispecialty tertiary care hospital. METHODS: One hundred medical residents were interviewed for the appearance of backache after sleeping on 10 cm thick foam mattress provided to them in the hostels. Pain was scored over a visual analog scale of 10 cm. Effect of sleeping on a regular cotton mattress was assessed. RESULTS: Sixty-three (5 female residents) developed back pain on the morning of a night of sleep over the foam mattress. The pain was mostly of lower back and was not associated with any objective neurodeficit. Four residents on account of the backache reported thirteen episodes of absenteeism. Sixty-one residents had a relief of the pain on going home where they would sleep on regular cotton mattresses, only to recur after sleeping again on the foam mattress in the hospital/hostel. CONCLUSION: Sleeping on foam mattress is associated with the appearance of backache in medical residents which is reproducible and gets relieved after using regular cotton mattresses.'nhDepartment of Internal Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.@9Koul, P. A. Bhat, M. H. Lone, A. A. Koul, A. N. Wahid, A.e 0004-5772 Journal ArticletJ Assoc Physicians India|vAbsenteeism Adult Back Pain/*etiology Beds/*adverse effects Female Human India *Internship and Residency Male Syndromelehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11198791d Kramer, J. D. Kearney, M. 2000^XPatient, wound, and treatment characteristics associated with healing in pressure ulcersAdv Skin Wound Care131 17-24<6*Decubitus Ulcer nursing; *Decubitus Ulcer physiopathology; *Wound Healing Aged ; Aged, 80 and over; Decubitus Ulcer classification; Middle Age; Nursing Assessment; Nursing Homes; Predictive Value of Tests; Regression Analysis; Retrospective Studies; Risk Factors; Severity of Illness Index Female; Human; Male.(OBJECTIVE: To examine the associations among selected patient, wound, and treatment factors and healing in pressure ulcers. DESIGN: Nonexperimental, retrospective study using data extracted from charts of patients having a Stage II, III, or IV pressure ulcer between July 1994 and November 1996. SETTING: A long-term-care facility associated with a major metropolitan medical center. RESULTS: Evidence of healing was significantly associated with patient weight (P < .05) and negatively associated with body temperature (P < .05), time on a pressure-relieving bed (P < .05), amount of exudate (P < .001), and stage of pressure ulcer (P < .001). In a regression analysis, pressure ulcer stage, patient weight, and mean body temperature explained 25% of the variability in healing; specifically, lower pressure ulcer stage, higher patient weight, and lower mean body temperature predicted improved healing. Healing was not predicted by chronologic age, pressure ulcer location, number of illnesses, use of tube feedings, use of pressure-relieving beds, mean arterial pressure, or Braden Scale score. In a regression analysis of patient factors alone, lower body temperature and higher weight together predicted 9% of the variance in healing. When wound variables were analyzed, 19% of the variability in healing was explained by the stage of the pressure ulcer. Of the treatment variables, only shorter time on a pressure-relieving bed predicted healing, explaining 6% of the variance. CONCLUSIONS: Strategies for healing pressure ulcers in nursing home patients should include programs for early recognition of pressure injury and prevention of pressure ulcer progression to higher stages; attention to weight gain and/or weight maintenance in at-risk patients; and early recognition and treatment of infections and febrile episodes.0)treatment predictors of healing TIG annex Krouskop, T.A. 1980b[An evaluation of the load distribution characteristics of selected therapeutic bed surfacess Houston, Texas .'Texas Rehabilitation Engineering Centera60Krouskop, T. Herskowicz, I. Goode, B. Garber, S. 1982Interface pressure CARE Science and Practiceu12 30-323835267o223  1985 JulZTEffectiveness of mattress overlays in reducing interface pressures during recumbency 7-10PIThis study evaluates the pressure-reduction characteristics of seven mattress overlays. Thirty subjects were evaluated on each support surface to determine the interface pressures that are generated under the most common pressure sore sites. The results of this study indicate that there is great variability in the effectiveness of traditional mattress overlays. The most effective overlays are the Roho and Akros DFD mattresses; whereas 2-inch thick convoluted foam provides no significant protection for the trochanter when the subjects were lying on their sides (lateral position).rHAKrouskop, T. A. Williams, R. Krebs, M. Herszkowicz, I. Garber, S.t 0748-7711 Journal ArticleeJ Rehabil Res Deve|u*Beds Body Height Body Weight Comparative Study Female Hip Human Male *Posture Pressure Sacrococcygeal Region Scapula jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3835267  o MethodsMicrocirculation Microcirculation/physiologyMicroscopy, Electron Middle AgeModels, BiologicalModels, Biological*Models, Statistical$ Monitoring, Physiologic/*methods,'Monitoring, Physiologic/instrumentation Movement*Muscles/blood supplyMuscles/physiopathologyNecrosis/etiologyNursing Assessment Nursing Assessment/*methodsNursing Care/*methodsOrthotic Devices*Oxygen/*analysis Oxygen/*bloodPallor/nursingParaplegia/*complications Paraplegia/*physiopathologyParaplegia/complicationsPartial PressurePatient Education Permeability Pilocarpine/diagnostic usePilot ProjectsPlethysmography/methodsPoisson Distribution Poliomyelitis/rehabilitationPolyethylenes* Polymers*Polyurethanes* Posture Posture*Posture/physiology Pressure Pressure*Pressure/*adverse effectsPressure/adverse effectsProspective Studies Quadriplegia/complicationsRats Reaction TimeRegional Blood FlowRegional Blood Flow*$Regional Blood Flow/physiology Reproducibility of ResultsRespiration, Artificial Rheology Rheology*Risk Risk FactorsSacrococcygeal RegionSeverity of Illness Index Sex FactorsSheepShoes Shoes*SkinSkin Care/instrumentationSkin Care/methodsSkin Care/nursingSkin PhysiologySkin Physiology*Skin TemperatureSkin Temperature* Skin Temperature/*physiology Skin Temperature/physiologySkin Ulcer/*etiology$ Skin Ulcer/*prevention & control Skin Ulcer/physiopathologySkin*Skin/*blood supplySkin/*physiopathologySkin/*ultrasonographySkin/blood supplySkin/pathologySkin/physiopathology Skull/*growth & development Sleep*Sodium/metabolismSpinal Cord Injuries*(#Spinal Cord Injuries/*complications(%Spinal Cord Injuries/*physiopathologyStress, MechanicalStress/*physiopathologySupport, Non-U.S. Gov't$Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S.Surface PropertiesSweat/*metabolism Temperature Temperature* Thermography Thermography* Time Factors TransducersTreatment OutcomeUltrasonography*("Vascular Diseases/*physiopathology$Vascular Diseases/complicationsVasoconstrictionVasodilation/*physiologyWeights and Measures* Wheelchairs*Wound Healing*(#Wounds and Injuries/physiopathology(#Xenon Radioisotopes/*diagnostic usecontrol Equipment Design Human Information Services Orthotic Devices/*supply & distribution Pressure Waterlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11075023r102908021311 1988 NoveD=Prices fall 10%-25% amid battle for therapeutic bed contractsf 8-10Brightbill, T. 0888-3068 Journal ArticlenHosp Mater ManageBeds/*economics Costs and Cost Analysis/*statistics & numerical data Data Collection Leasing, Property/economics Purchasing, Hospital/*economics United Stateslehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10290802n692168017831 1982Aug 4-10 The Mecabed- 1307-8 Brislen, W.  0954-7762 Journal Article  Nurs TimesJD*Beds Decubitus Ulcer/*prevention & control Evaluation Studies Humanjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6921680Q(.'Mayrovitz, H.N. Regan, M.B. Larsen, P.B\ 1993nhEffects of rhythmically alternating and static pressure support surfaces on skin microvascular perfusion Wounds51: 47-55d:3Mayrovitz, H. N. Smith, J. Delgado, M. Regan, M. B.e 1997PIHeel blood perfusion responses to pressure loading and unloading in womenOstomy Wound Manage43716-20, 22, 24 passim*Decubitus Ulcer physiopathology; *Heel blood supply Adult ; Decubitus Ulcer etiology; Heel ultrasonography; Laser Doppler Flowmetry; Middle Age; Pilot Projects; Pressure ; Regional Blood Flow physiology Female; Human; Support, Non U.S. Gov't>7Heel pressure ulcers are significant and costly problems causing suffering and potential limb loss from infection and compromised blood flow. Heel blood perfusion (HBP) deficits accompanying loading likely affect the skin breakdown process, but little is known about the loading and off-loading changes. To clarify this issue, combined laser-Doppler Imaging (LDI) and Fluxmetry were used to assess HBP before, during, and after 40 minutes of continuous heel loading in 11 female volunteers (32-60 years). During loading, an initial decrease in HBP was followed by a gradual small recovery (p < 0.001). Off-loading resulted in a significant hyperemic response with HBP exceeding baseline by a factor of 4.72 +/- 0.63 (p = 0.001) and remaining elevated for about 10 minutes. Spatial LDI data showed that hyperemic responses are maximum near the pressure center and diminish radially. These results suggest a localized, pressure-related tissue trauma, which is compensated for by a substantial hyperperfusion. The dependence (and adequacy) of this response on clinical variables including heel pressure and duration, limb vascular status, and patient health are unknown. The present seminal data and associated methods provide a platform from which these and other important clinical parameters can be systematically studied and compared.ton file TIG annexiSn,PIPolyurethane foam wheelchair cushions: retention of supportive properties$McFadyen, G. M. Stoner, D. L., 1980NHArchives of physical medicine and rehabilitation [Arch Phys Med Rehabil]615e 234-7d:4Using Smart Source Parsing May; ( pp Journal Article\UPolyurethanes* Wheelchairs* Compliance Human Pressure Support, U.S. Gov't, Non-P.H.S.r80197260(!McGovern, T. Reger, S. Waters, K. 1989,&Digital interface pressure evaluation. J of Clinical Engineering14 63-67t81108876205- 1993Sep-OctwD>Pressure reduction or pressure relief: making the right choice 211-5aPrevention of pressure ulcers is the preferred management strategy. Manufacturers have responded with a proliferation of products designed to prevent or minimize skin breakdown. To select the proper pressure-reduction product for an individual patient or a given patient population, the ET nurse should be familiar with the indications for and the advantages and disadvantages of various support surfaces.( McLean, J. 1055-3045 Journal Articlei J ET NurstBeds/classification/economics/*standards Cost-Benefit Analysis Decubitus Ulcer/nursing/physiopathology/*prevention & control Human Support, Non-U.S. Gov'tjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8110887 McLeod, A. G. 19972+Principles of alternating pressure surfacessAdv Wound Care107J 30-6rl*Beds supply and distribution; *Beds standards; *Decubitus Ulcer prevention and control Air ; Pressure HumanAlternating pressure air mattresses (APAMs) have been in clinical use for nearly 50 years, yet little has been published on their design rationale. Although early systems were recognized as an effective tool in preventing pressure ulcers, serious quality and reliability problems hampered their use. Today, several types of APAMs, including overlays and mattress replacements, are routinely used in the prevention and treatment of pressure ulcers in many clinical settings. Caution must be exercised, however, when comparing interface pressure measurements on APAMs and static surfaces. This paper discusses some of the characteristics of alternating surfaces that may have an effect on the body. TIG annex 3802861S152 1987 Febi>7Effect of an air-fluidized bed on insensible water loss 161-21Air-fluidized beds are increasingly used for patients with burns, decubitus ulcers, trauma, and generalized debility. Fluidized beds provide a medium that is more dense than water for patients to float on by pumping air through silicone-coated microspheres separated from the patient by a monofilament polyester sheet. A continuous stream of warm air flowing across the patient increases insensible evaporative water loss and may lead to dehydration. The air-fluidized bed has a wide range of operating temperatures (82 degrees to 102 degrees F), but surprisingly few data are available on the amount of water loss at different bed temperatures. This lack of information is probably secondary to difficulties in obtaining accurate fluid balance measurements in patients. Our objective was to construct a nomogram of insensible water loss for the fluidized bed using healthy volunteers under controlled conditions. We then prospectively compared this nomogram to data obtained from hospitalized patients. McNabb, L. J. Hyatt, J.n 0090-3493 Journal Articleh Crit Care MedaAdult *Air *Beds Comparative Study Female Human Male Microspheres Middle Age Prospective Studies Support, Non-U.S. Gov't *Temperature *Water Loss, Insensible jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3802861  `Gunther, R. Clark, M. 1996piCan an Airwave mattress counter the lymphatic insufficiency associated with standard hospital mattresses?d >8Leaper, D. Cherry, G. Dealey, C. Lawrence, J. Turner, T.RKProceedings of the 6th European Conference on Advances in Wound Management.  Amsterdam Macmillan Magazines Ltd. 1941129957410 3 su 2000 JulrlThe effect of a dynamic pressure-redistributing bed support surface upon systemic lymph flow and composition 10-5.'INTRODUCTION: It has been postulated that lymphatic insufficiency may have a key role in pressure ulcer development. Our hypothesis is that the particular dynamic action of the Airwave mattress directly improves lymphatic circulation compared to conventional hospital mattresses. METHODS: Seven anesthetized sheep (40-48 kg) prepared with chronic prefemoral lymph fistulas and vascular catheters were first placed on a standard hospital mattress. Following 30 minutes of equilibration, a 2 hr control period was started measuring lymph flow and vascular pressures. The standard mattress was then exchanged for an active Airwave mattress (Pegasus Egerton, Ltd.) and after 30 minutes of equilibration monitored as above. After 2.5 hr, the support surface was then switched back to the standard mattress and monitored as before. Data are mean +/- sem. RESULTS: Initially, on the standard mattress, lymph flow was 1.0 +/- 0.2 ml/30 min and increased significantly more than 3 fold on the Aireave mattress to 3.7 +/- 0.7 ml/30 min. Upon return to the standard mattress, lymph flow decreased to 1.2 +/- 0.2 ml/30 min. Hemodynamic variables and arterial blood gases were constant. Lymphatic protein transport increased significantly from 1.3 +/- 0.3 micrograms/min to 4.3 +/- 1.0 micrograms/min when placed on the test mattress and decreased when returned to the standard mattress to 1.3 +/- 0.2 micrograms/min. Similar rates of lymph flow were seen upon a variant of the Airwave mattress (Cairwave Therapy System). CONCLUSIONS: Results support the hypothesis that the Airwave's action increased the lymph flow compared to a standard hospital mattress. The dynamic cycle may act to aid the pumping action of lymphatics by reducing pressure which would otherwise collapse and compress lymphatics leading to local edema and tissue swelling.s'Department of Surgery, School of Medicine, University of California, Davis, 2221 Stockton Blvd, Sacramento, California 95817-2214, USA.Gunther, R. A. Clark, M. 0965-206x Journal ArticleJ Tissue ViabilityAnimal *Beds Blood Proteins/metabolism Decubitus Ulcer/etiology/*physiopathology Immobilization/adverse effects/physiology Lymph/*physiology Sheeplehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11299574 52109870 1979 Aug@9Modified water-air mattress in the management of bedsoresr 289-98,%Gupta, R. C. Nathani, D. Gupta, K. K. 0971-5916 Journal ArticleIndian J Med Resf_Adult Aged Air *Beds Decubitus Ulcer/*prevention & control/therapy Human India Middle Age Water jchttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=521098 X~z}rM| {Zzypx6569674t1021 1984 SpringD>Beds used to treat patients with pressure sores: an assessment12Lewallen, J. R.4 0888-8299 Journal ArticlelSCI NursVO*Beds Decubitus Ulcer/*prevention & control Human Spinal Cord Injuries/*nursingcjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6569674 Lewis, D. W.XQA device designed to approximate shear forces on human skin (a preliminary study) 1978Bull Prosthet Res 36-46:3Using Smart Source Parsing Fall; pp Journal ArticleBiomechanics:* Biomedical Engineering:*IS Skin:*PH Skin Physiology:* Manometry:IS Mathematics Pressure Human Support, U.S. Gov't, P.H.S.7908343869299381766y 1980 Junu60A ten year case history of air fluidized support 283-84&Lieberman, A. D. Hargest, T. S.  0038-3139 Journal ArticledJ S C Med AssocAir *Beds Case Report Child Child, Preschool Decubitus Ulcer/prevention & control Female Human Hydrocephalus/*therapy Infant Meningomyelocele/*therapyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=69299381158122(3094 1975 SepHAFlotation mattresses for preventing and treating tissue breakdown 71-54-Lilla, J. A. Friedrichs, R. R. Vistnes, L. M.n 0016-867x Journal Article GeriatricsHA*Beds Decubitus Ulcer/*prevention & control Human Pressure *Waternjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1158122680923186- 1982 JulhbInvestigation of hospital infection from a damaged mattress and the demonstration of its mechanism 408-13("Lilly, H. A. Kidson, A. Fujita, K. 0305-4179 Journal ArticleBurns Incl Therm InjAdult Beds/*standards Burn Units Cross Infection/*transmission *Disease Reservoirs Female Human Male Middle Age Pseudomonas Infections/*transmission Pseudomonas aeruginosa/isolation & purification Silver Nitrate/pharmacologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6809231 Lindan, O. 1961:3Etiology of decubitus ulcers: An experimental study60Archives of Physical Medicine and Rehabilitation774-783("Lindan, O. Greenway, R. Piazza, J. 1965Pressure distribution on the surface of the human body: I evaluation in lying and sitting positions using a bed of 'springs and nails'.@4.Archives of Physical Medicine & Rehabilitation46378-38510105481157 1990 Jul 2+Bed rental costs flat or down. Price surveyo1, 12-3s Litsikas, M. 0888-3068 Journal ArticleHosp Mater ManageBeds/*economics Fees and Charges/statistics & numerical data Financial Management/*trends Industry/trends Leasing, Property/*trends Materials Management, Hospital/*economics United States lehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10105481iLELiu, M. H. Grimm, D. R. Teodorescu, V. Kronowitz, S. J. Bauman, W. A. 1999xqTranscutaneous oxygen tension in subjects with tetraplegia with and without pressure ulcers: a preliminary reportJ Rehabil Res Dev363 202-6A*Blood Gas Monitoring, Transcutaneous methods; *Decubitus Ulcer etiology; *Oxygen blood; *Quadriplegia complications; *Quadriplegia metabolism Adult ; Aged ; Analysis of Variance; Biological Markers; Blood Gas Monitoring, Transcutaneous instrumentation; Body Surface Area; Case Control Studies; Disease Susceptibility; Middle Age; Predictive Value of Tests; Reproducibility of Results; Time Factors; Wound Healing Comparative Study; Human; Male; Support, Non U.S. Gov't Biological Markers; OxygenThis study compared transcutaneous oxygen tension (TcpO2) in subjects with paraplegia and pressure ulcers (PU), those with paraplegia and no pressure ulcer (NPU), and ambulatory controls. TcpO2 was measured using a surface-electrode monitoring system, recorded at 1-min intervals for 5 min and averaged. Mean TcpO2 was significantly lower in the PU than the NPU and control groups (23.53+/-1.83 vs. 58.93+/-2.53 and 79.70+/-6.77 mmHg, respectively, p<0.05). In a PU subgroup (n=4) mean TcpO2 of the pressure ulcer and nonpressure ulcer sides (trochanter or ischium) were significantly different (21.05+/-2.98 vs. 67.65+/-2.11 mmHg, respectively, p<0.001). Additionally, the NPU group demonstrated significantly lower TcpO2 than the controls. PUs had a greater reduction in TcpO2 levels relative to controls than NPUs. No association was found between TcpO2 and duration of injury, completeness of lesion, or smoking history. Thus, TcpO2 may be an effective method to identify individuals who are susceptible to pressure ulcers. The further attenuation of TcpO2 observed in the PU group may be useful to help predict whether ulcers will heal with local care or will require additional treatment.@:spinal cord injury transcutaneous oxygen on file TIG annex363866118232 1986Aug 6-120*Pressure sores. Airwaves take the pressure 67-714 Livesley, B. 0954-7762 Journal Article8 Nurs TimesRKAged *Beds Decubitus Ulcer/physiopathology/*prevention & control Human RiskAjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=36386613688406t4210 1987 Octx@:Treatment of accidental hypothermia with the Clinitron bed 1121-2 Lloyd, E. L.0003-2409 Letter AnaesthesiaeVPAccidents Aged Beds Critical Care Human Hypothermia/*therapy Respiratory Therapyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=36884068008767i9o8o 1994 MayHvpA developing information base for purchasing decisions. A review of pressure-relieving beds for at-risk patients 534-42Purchasers of pressure-relieving equipment have little clinical data on which to base purchasing decisions. A selection criteria which includes gathering all available product information and assessing the technical benefits prior to purchase can help fill this information gap.Lockyer-Stevens, N.  0266-8130 Journal Article  Prof NurseXQBeds/*standards Decubitus Ulcer/*prevention & control Human *Purchasing, HospitalNjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=80087672362997?535D 1990 May-(!Put your patient on the right bedg 66-72$Lovell, H. W. Anderson, C. L. 0033-7021 Journal ArticleRn:3Beds/classification/*nursing Equipment Design Human jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23629970,rv8288357.2410 1993 Dec3D=Evaluation of the conventional stretcher as a support surface9 660-1 zsThe conventional wood and canvas stretcher was evaluated with regard to comfort and risk of pressure and ischaemic damage. Sixty subjects were evaluated and results were found to be similar to other support surfaces. A mean sacral interface pressure of 40.7 mmHg was noted. Subjects found the stretchers cold and uncomfortable, particularly over the heels and lower back.f'2,208 General Hospital RAMC(V), Liverpool, UK. Lovell, M. E. Bradshaw, P.JD0020-1383 Clinical Trial Journal Article Randomized Controlled Trial Injuryf`Beds/adverse effects/*standards Body Mass Index Human Military Medicine Pressure Supine Positionjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=82883577580086a4e17 1995 Sep 28-Oct 11& Pegasus Airwave and Bi-Wave Plus 1020, 1022-4The Pegasus Airwave and the Bi-Wave Plus are examples of alternating-pressure air mattress (APAM) systems that are more reliable than the older generation of APAMs. The Pegasus Airwave is useful for managing severe pressure sores, as well as for preventing sores in 'high-risk' patients. The Bi-Wave Plus is more suitable for patients with a 'fairly high risk' of developing sores and some patients may find it more comfortable than the Pegasus Airwave. Lowthian, P. 0966-0461 Journal Article Br J Nurs}Air *Beds/classification Comparative Study Decubitus Ulcer/*prevention & control Equipment Design Human Pressure Risk Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=75800868992888m254d 1996 Juln\VPreventing pressure sores in elderly patients: a comparison of seven mattress overlays 334& Lowthian, P.0002-0729 Comment Letter Age AgeinghbAged *Beds Decubitus Ulcer/etiology/*prevention & control *Geriatric Assessment Human Risk Factorsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8992888871648315o9i 1996May 9-222,The Modular Propad and the Softform mattress 575-6, 578-808leConstant low-pressure supports such as soft mattresses can feel comfortable because they conform well to the shape of the body. When such mattresses are provided with a highly convoluted surface made up of contiguous foam pillars, their efficacy is improved. The Modular Propad is a highly convoluted, but shallow, foam mattress. It is used as an overlay for an ordinary mattress and seems to be superior to earlier forms of convoluted foam overlay. The Softform is a new mattress which has replaceable sections. The outermost sections of the Softform are convoluted foam sheets similar to the Modular Propad. This article discusses the advantages and disadvantages of these products and some potential problems with their covers. It also suggests that the use of a pressure sore risk assessment tool can facilitate the allocation of patients to these special supports. Lowthian, P. 0966-0461 Journal Article Br J Nurs~wBeds/classification/economics/*standards Decubitus Ulcer/*prevention & control Equipment Design Human Materials Testingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=87164838680245u5o2* 1996 Jan 25-Feb 7<5The Egerton Convertible II and the Elite 3 bed system  118, 120-3tmLow air loss bed systems have proved successful in the management of severe pressure sores but they tend to be expensive. The Convertible II promises to provide many of the features of a low air loss bed at a much reduced cost. It is essentially a mattress replacement that can be used for various beds, including contouring-base beds. It is a component of the Elite 3 bed system which comprises an electrically powered contouring bed (with its own air pump) and three different mattresses: the mattress of the Convertible II is Mattress 3 of this system; Mattress 2 is an alternating-pressure air mattress; and Mattress 1 is a static air mattress with a foam envelope. The advantages and disadvantages of these products are discussed and it is suggested that the allocation of patients to the various supports can be facilitated by using a pressure sore risk-assessment score. Lowthian, P. 0966-0461 Journal Article Br J Nurs~Beds/economics/*standards Decubitus Ulcer/*prevention & control Equipment Design Health Care Rationing Human Patient Selectionjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8680245928330916/14 1997 Jul 24-Aug 133<6Alternating-pressure air mattresses: the Quattro range 827-33Alternating-pressure air mattresses (APAMs) have a long history, and after some advances in their design, which began in the 1980s, have become widely used for pressure sore prevention. A recent variation in the inflation/deflation cycle of a 'large-cell' APAM, which allows the use of lower (peak) pressures for inflating the air cells, is used in the Quattro range of APAMs. This should make the new products more comfortable, more versatile, and more durable than earlier large-cell APAMs. This article discusses both the theoretical and practical advantages and disadvantages of these products. It also suggests a simple method of checking the suitability of a given support for promoting a healthy skin for highly dependent patients. Lowthian, P.810966-0461 Journal Article Review Review, Tutoriall Br J NursvoAir Beds/*standards/supply & distribution Decubitus Ulcer/*prevention & control Equipment Design Human Pressurehjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=928330919542981186a 1991Nov-DecXQPressure sores and specialty beds: cost containment and ensurance of quality care* 190-7The monitoring of specialty bed use by the certified ET nurse and the NQAC has been in full implementation since June 1989 with significant yearly cost reductions in the use of specialty care beds. The $238,000 costs from fiscal year 1987 (July 1986 to June 30, 1987) were reduced to $60,000 in fiscal year 1989 with an approximate cost savings of 75%. Additional cost savings have been achieved through the implementation of the other recommendations in this study. Although cost savings would have resulted from a stricter policy in specialty bed approval and utilization alone, such savings probably would have affected the quality of patient care. This project allowed nursing and medical staff members to work with the departments of Administration and Finance to ensure that patient care would not be significantly affected. Significant cost savings were obtained through use of the five interventions that are indicated in the introduction. Nursing was permitted to examine its own practice and implement changes in documentation, nursing standards, skin-care products, policies and procedures, and in other areas to strive for clinical excellence as monitored through its quality assurance plan. The addition of a certified ET nurse to coordinate a hospital-wide multidisciplinary approach that is consistent with and clinically relevant to current practice standards is essential to a successful program for pressure-sore prevention and management within the current reimbursement systems.Lubin, B. S. Powell, T.i 1055-3045 Journal Articlet J ET Nurs Beds/economics/*standards Clinical Protocols/standards Cost Control Cost Savings Decubitus Ulcer/economics/nursing/*prevention & control Enterostomy/nursing Human Nurse Clinicians Quality Assurance, Health Care/*organization & administration Rolejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1954298H3250579121 1988 WinterLFPressure relief capabilities of the Sof.Care bed and the Clinitron bed 32, 36-41, 44tThe number of support surfaces marketed as pressure relieving devices has escalated during recent years and objective measures are needed to evaluate those that are effective. The purpose of this study was to compare the pressure relief capabilities of a special three-layered plastic air mattress (Sof.Care Bed Cushion--Gaymar), an air-fluidized bed (Clinitron--Support Systems International) and a standard hospital mattress. Sixty-four volunteers served as their own control as they were rotated onto the three sleep surfaces. Tissue interface pressure measurements were taken over bony prominences where pressure ulcers are most likely to occur: the sacrum, the greater trochanter of the femur and the heels. A one-way analysis of variance was computed for interface measurement scores by type of surface and a statistically significant difference was found among the three surfaces. A Newman-Keuls test was employed to compare the mean scores between two groups at a time. Both the Sof.Care Cushion and the Clinitron Bed differed significantly from the hospital mattress in the ability to relieve pressure. There was no statistical difference between the Sof.Care Cushion and the Clinitron Bed in the ability to relieve pressure over the sacrum, trochanter, or heels. However tissue pressure readings under the heels were greater than 32 mm Hg on both the Clinitron and Sof.Care surfaces. The data from this study, by looking at a larger sample supports our prior findings.0)Maklebust, J. Siggreen, M. Y. Mondoux, L.e 0889-5899 Journal Article Ostomy Wound ManagerAdult Aged *Beds Comparative Study Decubitus Ulcer/*prevention & control Equipment Design Female Human Male Middle Age Pressuretjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=32505798971240;2612 1996 Decd>7Attacking on all fronts. How to conquer pressure ulcerso 34-9; quiz 40$Maklebust, J. Sieggreen, M. Y.810360-4039 Journal Article Review Review, TutorialkNursingpiBandages Beds Debridement Decubitus Ulcer/etiology/*nursing/prevention & control Human Nursing Assessment jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=89712408716383i8v2d 1996 Junm@:Using wound care products to promote a healing environment 141-58hbHealing is characterized by the synthesis of new tissue and scar formation. Despite the complexity of healing with full-thickness injury, the repair process occurs in a predictable manner. There are four basic principles of wound care: (1) debride necrotic tissue and cleanse the wound to remove debris, (2) provide a moist wound healing environment through the use of proper dressings, (3) protect the wound from further injury, and (4) provide nutritional substrates essential to the healing process. Most importantly, any underlying pathophysiology must be treated or the wound will not heal. Products selected to create a healing environment must be chosen thoughtfully and scientific rationale must support their use. Intensive care nurses have the opportunity to get the patient off to the right start by attending to the basic principles elucidated in this article. Accurate wound assessment and appropriate product choices can promote a healing environment. Intensive care of patients includes differentiating wound types and making appropriate wound care product decisions that ultimately affect patient outcomes. Maklebust, J.810899-5885 Journal Article Review Review, Tutorial"Crit Care Nurs Clin North AmBandages Beds Debridement *Decision Trees Human *Nursing Assessment Patient Education *Wound Healing Wounds and Injuries/*nursingjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8716383|103824371742 1999 Apr60Preventing pressure ulcers in home care patients229-37; quiz 237-8A large proportion of home care patients present with pressure ulcers, and many more patients are at risk. Home care nurses have an opportunity to manipulate favorably certain environmental factors that can prevent pressure ulcers from forming and to develop effective treatment plans for ulcers once they occur. This article discusses the current practice for pressure ulcer prevention. Next month, a companion article will explore treatment strategies for these wounds./'VOHarper Hospital/Detroit Medical Center, Michigan 48201, USA. JMaklebust@aol.com  Maklebust, J. 810884-741x Journal Article Review Review, Tutorial Home Healthc NurseAlgorithms Beds Community Health Nursing/*methods Decision Trees Decubitus Ulcer/etiology/*nursing/*prevention & control *Home Care Services Human Nursing Assessment/methods Primary Prevention/methods Risk Factors Skin Care/methods/nursingplehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10382437t10085977451A Suppl 1999 Janr60An update on horizontal patient support surfaces70S-77S; quiz 78S-79SSjcHorizontal patient support surfaces play an important role in the prevention and development of pressure ulcers. This article reviews the literature published on these support surfaces since the release of the Agency for Health Care Policy and Research (AHCPR) Clinical Practice Guideline Number 15: Treatment of Pressure Ulcers. The purpose of this review is twofold: One, to see if any new evidence is available to assist the clinician in making scientifically based decisions in the use of support surfaces, and two, to determine if new knowledge about support surfaces would change the AHCPR recommendation.o'<6Harper Hospital/Detroit Medical Center, MI 48201, USA. Maklebust, J. 810889-5899 Journal Article Review Review, TutoriallOstomy Wound Manageh*Beds/standards/supply & distribution Decubitus Ulcer/etiology/nursing/*prevention & control Human Nursing Assessment Patient Selection Postureelehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10085977d11786859 109f1 2002 JanD=Can operating room tables be made safer and more comfortable? 407cMan, D. Plosker, H.00032-1052 LetterPlast Reconstr Surg*Beds Human Immobilization/adverse effects *Operating Rooms Pain/etiology/prevention & control Pressure Safety *Surgical Equipmentlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=117868597655384117924 1983 Jun 15-21>7Pressure sores. 2. Mattresses to prevent pressure soreso 54, 56, 57 Marshall, M. Overstall, P. 0954-7762 Journal Article. Nurs TimesF?Aged *Beds Decubitus Ulcer/*prevention & control Human Pressureejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6553841vB Lavery19969s Lazzara1991 Le1984= Le Devehat19981 Le Gulluche1991 Le Gulluche1991= Leaper19999 Lee1979 Lee1981 Lee1984 Lee1985 Lee1988 Lee1989| Lee1990t Leeder1979> Leftheriotis1997a LeGrand1995> Legrand1997u Leininger1994H Leland19958; Leland1995v Leung1989w Levine1994p Levy19955i Levy20010j Levy20010xLewallen1984 Lewis1972 Lewis1975 Lewis1978 Lewis1981 Lewis1984 Lewis1984 Lewis1985 Lewis1987 Lewis1992 Lewis1993D Lewis1993 Lewis1995a Liang1995 Lichtenstein2000y Lieberman1980 Lien1984z Lilla1975 Lilly1981{ Lilly1982 Lim1989 Lin1984 Lindan1961 Lindan1965f Linden20011 Lindholm20010|Litsikas1990M Liu1999}Livesley1986~ Lloyd1987= Lobig1998Lockyer-Stevens1994 Lohman20011 Lomax1993e Lone2000, Long19797 Longe1988A Look1983 Lovell1990 Lovell19930Lowthian1982Lowthian1995Lowthian1996Lowthian1996Lowthian1996Lowthian19975 Loyant19966C Lubbers1991Y Lubbers2001 Lubin1991 Lucke19850 Ludman19828 Lukasiewicz1996Lundberg1995 Lunn1973m/ Lunn19747# Luthi2000 Lyle1997 Lyons1995 Macfarlane19873 Macosko19944 Macosko1994 Maddux1990 Madsen1984 Magee1990Magliaro1997c Magnano1988f Magnano1990 Mahanty1979 Mahanty1980 Mahanty1981 Mahon1995 Mak1994 Maklebust1986 Maklebust1988 Maklebust1988 Maklebust1996 Maklebust1996 Maklebust1999 Maklebust1999 Man2002 Mance1990 Mance1990J Mann-Distaso1985 Mansell1979g Marburger1986W Marburger1988Marshall1980Marshall1983Marshall1991 Martin1991 Martin19977 Martin19991Masiello1994X Mason1990 Mason1997 Mason1998d Mason2000& Materials.1996r Matsen19891 Matsen199019 Matsui19982Matthews1993Z Matthiesen1993 Mawson1993O Mawson19938P Mawson19933 Maxwell1997w Mayer1999x Mayer2000 Mayrovitz1993Q Mayrovitz1997 Mayrovitz1997 Mayrovitz1998R Mayrovitz1999* McCance1995 McCausland1998 McClelland2001 McClemont1978 McClennan1942 McClennan1942 McConachie1990 McCooey1993 McCooey1996McCubbin1977McCubbin19788McCubbin19925 McDannold1997 McElvenny1997 McElvenny1998d McElvenny2000McFadden1997,McFadyen1980[ McFarland1994McGarrah1990 McGarry1991McGovern1988McGovern1989McInness2001f McKay1990f McKenna2001F McLaren1966 McLean1993B McLeod19969S McLeod19979 McMyn1995 McNabb1987pMcNamara19955^ McNees1998e! McSweeney1993McVittie1974Mehrholz20022 Meijer1989 Meijer1994 Meijer19979m Meijer20020 Meisel1975 Meisel19811Meissner20022 Melcher1988Meletiou1991Meletiou1993 Melland1999 Merlino19694 Mewis1994e Meyer1998C Meyjes19919 Michael1996Micheels1983Micheels1983[ Micucci1994 Mikols1990 Mikols1990 Miles1987 Miles1995= Miles1998 Miller1972 Miller1991A Miller1994l Millman1998 Millman1998 Min1997 Mion19919 Mion19919 Mita1997Mitchell2000Mollison1998 Mondoux1986 Mondoux1988 Moody1998 Moody1998 Moore1992< Moore1992 Morgan1994! Morgan1999 Morison1989 Morris19739 Morris1980 Morris19884 Morris1994Morrison1980Morrison1994= Moss19988} Motloch1978 Motta1990 Motta1991 Motta1991 Motta1992 Motta1996~ Mottola1992 Mottola1993 Moxness1997 Moxon1995, Muir19676& Muir19707 Mulder1988 Munro19898 Munster1986 Muriel1984 Murphy2000I Murray1979] Murray19921 Murray1993 Murray1993 Murray1993ng19797 Longe1988A Look1983 Lovell1990 Lovell19930Lowthian1982Lowthian1995Lowthian1996Lowthian1996Lowthian1996Lowthian1997 Loyant19965 Loyant19966C Lubbers1991Y Lubbers2001 Lubin1991 Lucke19850 Ludman19828 Lukasiewicz1996Lundberg1995 Lunn1973m/ Lunn19747# Luthi2000 Lyle1997 Lyons1995 Macfarlane1987 Maddux1990 Madsen1984 Magee1990c Magnano1988f Magnano1990 Mahon1995 Maklebust1986 Maklebust1988 Maklebust1988N Maklebust1988 Maklebust1996 Maklebust1996 Maklebust1999 Maklebust1999 Man2002 Mance1990 Mance1990J Mann-Distaso1985 Mansell1979g Marburger1986W Marburger1988Marshall1980Marshall1983Marshall1991 Martin1991 Martin19991X Mason1990 Mason1998d Mason20009 Matsui19982Matthews1993Z Matthiesen1993 Mawson1993 Mawson1993 Mawson1993 Maxwell1997w Mayer1999x Mayer2000 Mayrovitz1993 Mayrovitz1999* McCance1995 McCausland1998 McClelland2001 McClemont1978 McClennan1942 McClennan1942 McConachie1990 McCooey1993 McCooey1996McCubbin1977McCubbin19788McCubbin19925 McDannold1997 McElvenny1998d McElvenny2000McFadden1997[ McFarland1994McGarrah1990 McGarry1991McGovern1988f McKay1990F McLaren1966 McLean1993B McLeod19969 McLeod1997 McMyn1995 McNabb1987pMcNamara19955! McSweeney1993McVittie1974Mehrholz20022 Meisel1975Meissner20022 Melcher1988Meletiou1993 Melland1999 Merlino1969H Meyer1998C Meyjes19919Micheels1983Micheels1983[ Micucci1994 Mikols1990 Mikols1990 Miles1987 Miles1995= Miles1998 Miller1972 Miller1991A Miller1994l Millman1998 Millman1998 Min1997 Mion19919 Mion19919 Mita1997Mitchell2000Mollison1998 Mondoux1986 Mondoux1988N Mondoux1988 Moody1998 Moody1998 Morgan1994! Morgan1999 Morison1989 Morris19739 Morris1980 Morris19884 Morris1994Morrison1980Morrison1994= Moss19988 Motta1990 Motta1991 Motta1991 Motta1992 Motta1996~ Mottola1992 Mottola1993 Moxness1997 Moxon1995, Muir19676& Muir19707 Mulder1988 Munro19898 Munster1986 Muriel1984I Murray1979] Murray19921 Murray19930J $4Mewis, J. Macosko, C.W. 1994Suspension rheology.  Macosko, C.W.m<5Rheology: Principles, measurements, and applications.l New York VCH Publishers425-4746871750p9 5, 1983 May VPWater and sodium balance: the effect of the air-fluidized bed on burned patients 305-11Five patients with burned areas from 20 to 40 per cent BSA were studied in the air-fluidized bed during the first 2-week period post burn. Patients with abnormal renal and intestinal functions and with previous pathological history were not incorporated in the study. The patients were treated by the exposure method, and no surgical procedure was carried out during the study. The water and sodium balances were calculated from intravenous and oral intakes, urine-outflow, urinary sodium excretion and weight changes. In addition measurements of the sodium space were performed in two patients, using Sodium. Evaporative water loss was calculated during the first week, the sodium loss during the first and second weeks. As a result of the study the average daily evaporative water loss could be defined as: 0.81 ml/cm2 burned area +/- 0.07 ml. We compared the actual evaporative water loss with two classical formulas: --Davies, Lamke, Liljedahl (1974) (D.L.L.) min: 0.3 ml X cm2 burned area = ml/day = D.L.L. (0.3) Max: 0.45 ml X cm2 burned area = ml/day = D.L.L. (0.45) --Scott, McDougall, Slade, Pruitt (1978) (S.M.S.P.) (25 + %) X BSA = ml/h = S.M.S.P. --Scott, McDougall, Slade, Pruitt (1978) (S.M.S.P.) (25 + %) X BSA = ml/h = S.M.S.P. The average calculated daily evaporative water was: D.L.L. (0.3) + 5 litre/m2 burned area D.L.L. (0.45) + 3.5 l/m2 burned area S.M.S.P. + 4 litre/m2 burned area. This 'extra' evaporative water loss was closely related to the body burned surface. Correlation coefficient: D.L.L. (0.3) = 0.99 D.L.L. (0.45) = 0.98 S.M.S.P. = 0.97. Day 2 and day 3 showed the most important water loss per cm2 burned area. On the other hand, the sodium loss was found to be as expected: daily average: 0.02 mmol/cm2 burned area. Micheels, J. Sorensen, B. 0305-4179 Journal ArticleBurns Incl Therm InjAdolescence Adult *Beds Body Water/*metabolism Burns/metabolism/*therapy Human Infant Male Middle Age Natriuresis Sodium/*metabolism Support, Non-U.S. Gov't Time Factors Water Loss, Insensible Water-Electrolyte Imbalance/*therapy/jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=68717506831280t9 3o 1983 JanHBThe physiology of a healthy normal person in the air-fluidized bed 158-68 Micheels, J. Sorensen, B.i 0305-4179 Journal ArticlebBurns Incl Therm InjAcid-Base Equilibrium Adult *Beds Body Temperature Energy Intake Environment, Controlled *Homeostasis Human Male *Metabolism Nitrogen/metabolism Support, Non-U.S. Gov't Water Loss, Insensible jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=68312803592160p4241 1987 AprrHBTreatment of severe accidental hypothermia using the Clinitron bed 415-856/Two cases of severe accidental hypothermia (core temperature less than 28 degrees C) rewarmed employing the Clinitron system are described. The physiological changes during hypothermia and rewarming are discussed and the current concepts of rewarming (active external versus internal) outlined. It is suggested that severely hypothermic patients can be successfully treated by rapid external rewarming using the Clinitron heated fluidised-bead bed. This method combines the advantages of rapid rewarming, minimal physiological disturbance and is non invasive.y"Miles, J. M. Thompson, G. R. 0003-2409 Journal Articlet AnaesthesiaivoAged Aged, 80 and over *Beds Case Report *Critical Care Female Heat/*therapeutic use Human Hypothermia/*therapynjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=359216050608371 1289 1972 Mar@:Treatment of insomniac patients with the air-fluidized bed 1147-9(!Miller, W. C., Jr. Shurley, J. T.r 0002-953x Journal Article Am J PsychiatryeAdult *Air Air Movements *Beds Fantasy Female Human Humidity Male Middle Age Sleep Sleep Initiation and Maintenance Disorders/*therapy Temperaturejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=50608379444514s83p 1997^XPhysical characteristics of a new synthetic fiber mattress in relation to pressure sores 221-30The purpose of the present investigation was to develop a mattress which was made of the new synthetic fibers called 'Shin-Gosen', and to determine its physical characteristics associated with pressure sores such as pressure distribution, temperature and humidity. The Shin-Gosen mattress consisted of three layers of elastic fibers made of polyester multifilaments, which were mediated by four layers of wave-like fabrics made of nylon monofilaments. The physical characteristics of the mattress were compared with (a) the conventional cotton hospital mattress and (b) the SORELESS MAT made of vacuole gel which effectively eliminated compression forces. The Shin-Gosen mattress was found to provide pressure relief effects similar to that of the SORELESS MAT the desired thermal insulation as well as that of the cotton mattress and a higher level of moisture vapor permeability. These excellent features will not only contribute to preventing pressure sores, but will also enable comfortable resting and sleeping.'XQInstitute for Developmental Research, Aichi Human Service Center, Kasugai, Japan.gF@Mita, K. Akataki, K. Itoh, K. Yoshida, M. Shinoda, T. Ishida, Y. 0921-3775 Journal ArticlesFront Med Biol EngxrAged *Beds Comparative Study *Decubitus Ulcer Equipment Design Human Humidity Male Middle Age Pressure Temperaturejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=94445149830917t7018 1998Oct 8-21@9Review of the STM range of pressure distribution products 1078-80lxqSTM Healthcare is a division of the Recticel Group which has been actively involved in the production and use of polyurethane foams for the past 40 years, and is now one of Europe's leading manufacturers of polyurethane foam for insulation, packaging, filtration, aerospace, the automotive and furniture industries, domestic and specialist bedding and seating products. STM Healthcare is able to draw upon the wealth of experience and expertise of the manufacturing facilities, enabling products to be developed using the latest environmentally friendly specification foams best suited to the requirements of pressure-reduction technology. All STM Healthcare mattresses, cushions and Linknurse mattresses are manufactured with Safeguard combustion modified high resilience foams. (Linknurse is a licensed product name; products are manufactured by Recticel and distributed by STM).k Moody, M.3810966-0461 Journal Article Review Review, Tutorial4 Br J NursipjBeds/*supply & distribution Decubitus Ulcer/*nursing/*prevention & control Human Polyurethanes Wheelchairsjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9830917 nzPIMethod for the measurement of susceptibility to decubitus ulcer formationHjdMeijer, J. H. Schut, G. L. Ribbe, M. W. Goovaerts, H. G. Nieuwenhuys, R. Reulen, J. P. Schneider, H. 1989HBMedical & biological engineering & computing [Med Biol Eng Comput]275o 502-6s:4Using Smart Source Parsing Sep; ( pp Journal ArticleDecubitus Ulcer/*physiopathology Skin/*blood supply Adult Aged Aged, 80 and over Body Temperature Disease Susceptibility Female Human Male Middle Age Pilot Projects Pressure Regional Blood Flow Reproducibility of Results Support, Non-U.S. Gov't Time Factorse901576012+Susceptibility to decubitus ulcer formations'lfDepartment of General Practice and Nursing Home Medicine, Free University, Amsterdam, The Netherlands.<5Meijer, J. H. Germs, P. H. Schneider, H. Ribbe, M. W.o 1994NHArchives of physical medicine and rehabilitation [Arch Phys Med Rehabil]753o 318-23:4Using Smart Source Parsing Mar; ( pp Journal ArticlejcBlood Flow Velocity* Skin Temperature* Decubitus Ulcer/*etiology Decubitus Ulcer/*physiopathology Activities of Daily Living Aged Aged, 80 and over Decubitus Ulcer/epidemiology Disease Susceptibility Female Follow-Up Studies Geriatric Assessment Human Male Middle Age Models, Statistical Pressure Rheology Risk Factors Support, Non-U.S. Gov't Time Factors941757443336611a831c 1988 JanHBPressure sores in the elderly. A systematic approach to management299-308 Pressure sores are a serious but often avoidable problem. The best management plan focuses on early identification of high-risk patients, appropriate allocation of resources, and adequate techniques of pressure relief. A standardized treatment plan that is familiar to care givers should be followed. The clinician must correct all conditions that retard the healing process, including nutritional deficits and underlying medical problems. Multiple-drug therapy must be eliminated, and only established skin care protocols should be followed. Use of systemic antibiotics is reserved for complications, such as osteomyelitis, cellulitis, and sepsis.'haDepartment of Family Medicine, Medical College of Georgia School of Medicine, Augusta 30912-5470.,0*Melcher, R. E. Longe, R. L. Gelbart, A. O. 0032-5481 Journal Articlel Postgrad MedAged Beds Debridement Decubitus Ulcer/prevention & control/*therapy Disinfectants/therapeutic use Human Wound Healing Wound Infection/etiologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=333661111052043184i 1999Jul-Augi6/Clinical evaluation of an automated turning bedd 65-70onhPURPOSE: The purposes of this study were to assess client comfort and sleep quality, client physiologic response (skin and respiratory status), the effect on the need for caregiver assistance, and cost when using an automated turning bed. DESIGN: Nonexperimental, evaluative study. SAMPLE: Twenty-four adult home or long-term care resident subjects who had a degenerative disease, spinal cord injury, stroke, cerebral palsy, or back surgery. METHODS: Each subject agreed to use the automated turning bed for four weeks. Researchers completed a demographic survey and skin assessment, and assessed each subject for pressure ulcer risk and for the need of assistance of a care giver for turning before and after the four weeks of using the turning bed. Subjects rated the turning bed in terms of comfort and sleep quality. FINDINGS: Subjects rated the turning bed as more comfortable than their own bed and expressed satisfaction at the pain relief attained when on the turning bed. While using the turning bed, there was a significant improvement in sleep quality. No skin breakdown or deterioration in respiratory status occurred. Fewer subjects required the assistance of a caregiver for turning when on the turning bed. CONCLUSION: This automated turning bed shows great promise in meeting a need for patients with limited mobility whether they are homebound or in a residential community. IMPLICATIONS FOR NURSING RESEARCH: Future studies that further investigate use of the turning bed for postoperative back patients while still in the acute care setting are indicated. Replicative studies with a larger sample size are also indicated.'HACollege of Nursing, University of North Dakota, Grand Forks, USA.s@:Melland, H. I. Langemo, D. Hanson, D. Olson, B. Hunter, S. 0744-6020 Journal Articlet Orthop Nurs `ZAdult Aged Aged, 80 and over *Bed Rest/adverse effects/nursing/psychology *Beds Decubitus Ulcer/etiology/prevention & control Female Follow-Up Studies Health Care Costs/statistics & numerical data Human Male Middle Age Motion Therapy, Continuous Passive/economics/*instrumentation/psychology *Patient Satisfaction Rotation Support, Non-U.S. Gov'tlehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11052043l48855530243y 1969 Marh82Decubitus ulcers: cause, prevention, and treatment 119-24Merlino, A. F. 0016-867x Journal Article GeriatricsBedding and Linens Beds *Decubitus Ulcer/etiology/prevention & control/surgery/therapy Human Hygiene Nutrition Paraplegia/complications Skin Transplantation Transplantation, Autologousjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=4885553X?.'Schregel, W. Hube, M. Finsterwalder, H. 1993F@Static and dynamic anti-decubitus systems for ITU care patients.J of Tissue Viability{34108-113ajdLocal skin pressure and its effects on skin microcirculation as evaluated by laser-Doppler fluxmetry'd^Karolinska Institutet, Department of Geriatric Medicine, Huddinge Hospital, Stockholm, Sweden.Schubert, V. Fagrell, B. 1989("Clinical physiology [Clin Physiol]9 6a 535-45:4Using Smart Source Parsing Dec; ( pp Journal ArticlehbLasers* Ultrasonography* Skin/*blood supply Adult Aged Blood Flow Velocity/physiology Buttocks Decubitus Ulcer/diagnosis Decubitus Ulcer/etiology Decubitus Ulcer/physiopathology Female Human Male Microcirculation/physiology Middle Age Pressure/adverse effects Sacrococcygeal Region Skin/physiopathology Skin Temperature/physiology Support, Non-U.S. Gov't90091365\VHypotension as a risk factor for the development of pressure sores in elderly subjects'piDepartment of Geriatric Medicine, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.x Schubert, V. 1991"Age and ageing [Age Ageing] 204  255-61:4Using Smart Source Parsing Jul; ( pp Journal ArticleDecubitus Ulcer/*etiology Hypotension/*complications Aged Aged, 80 and over Blood Pressure Decubitus Ulcer/physiopathology Female Human Male Middle Age Regional Blood Flow Risk Factors Skin/blood supply Support, Non-U.S. Gov't92025583|vPostocclusive reactive hyperemia and thermal response in the skin microcirculation of subjects with spinal cord injury'XRKarolinska Institute, Department of Geriatric Medicine, Huddinge Hospital, Sweden.Schubert, V. Fagrell, B. 1991LEScandinavian journal of rehabilitation medicine [Scand J Rehabil Med]r231s 33-40d6/Using Smart Source Parsing ( pp Journal Articlee*#Decubitus Ulcer/*etiology Hyperemia/*etiology Skin/*blood supply Spinal Cord Injuries/*complications Adult Buttocks Comparative Study Female Human Lumbosacral Region Male Microcirculation Middle Age Paraplegia/complications Quadriplegia/complications Skin Temperature Support, Non-U.S. Gov't91240238 "9759692r 158i17 1998 Sep 28TMHospital-acquired pressure ulcers: risk factors and use of preventive devicese 1940-5BACKGROUND: Pressure ulcers are a frequent complication of bed rest. We examined risk factors for hospital-acquired pressure ulcers, the use of preventive devices, and the impact of case-mix adjustments on between-ward comparisons. METHODS: We conducted 3 cross-sectional surveys in a teaching hospital of 2373 patients who had no pressure ulcer on admission. We assessed the presence of pressure ulcer, dates of admission and ulcer occurrence, hospital ward, patient age and sex, appetite and route of nutrition, surgery during stay, hospitalization for fracture, comorbidities, use of low-pressure devices (special mattresses, cushions, and pressure-reducing beds), and the Norton Pressure Ulcer Prediction score (physical condition, mental condition, activity, mobility, and incontinence). RESULTS: Two hundred forty-seven new pressure ulcers occurred (5.7 per 1000 person-days). In multivariate analysis, the risk for pressure ulcer increased with age (risk gradient across 5 categories was 1:4.5; P<.001) and Norton score (across 5 categories, risk gradient was 30-fold; P<.001); other risk factors (all relative risks, 1.5-1.8; P<.002) were hospitalization for fracture, surgical intervention, reduced appetite, and nasogastric tube or intravenous nutrition. Adjustment for case mix substantially modified differences between hospital wards. Use of preventive devices was associated with Norton score, but not all high-risk patients benefited. CONCLUSIONS: Pressure ulcers were seen in every 10th hospitalized adult. Patient age and Norton score were the strongest risk factors for pressure ulcers. Use of preventive devices was suboptimal. Adjustment for case mix is essential if pressure ulcer incidence is to be used as an indicator of quality of care.'leInstitute of Social and Preventive Medicine, University of Geneva, Switzerland. perneger@cmu.unige.chD=Perneger, T. V. Heliot, C. Rae, A. C. Borst, F. Gaspoz, J. M. 0003-9926 Journal ArticleArch Intern MedRLAdolescence Adult Aged Aged, 80 and over Confounding Factors (Epidemiology) Cross-Sectional Studies Decubitus Ulcer/epidemiology/*etiology/*prevention & control Female Hospital Departments/statistics & numerical data *Hospitalization Human Incidence Male Middle Age Risk Risk Factors Support, Non-U.S. Gov't Switzerland/epidemiologyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=97596921878117135 1991Jul-Aug4"Collaboration with a vendor630-1, 34Peters, D. Strunk, B.o 0889-5899 Journal ArticletOstomy Wound Manage/Beds/*standards *Consultants Decision Making, Organizational Human *Industry *Interprofessional Relations Nursing Staff, Hospital/*psychology jdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18781178718367f1191 1996 Jun 6/An audit of mattresses in one teaching hospitali 623-4, 626The poor state of some hospital mattresses has been associated with the formation of pressure sores and the spread of infection. Nurses need to be aware of potential problems with old, faulty or poor-quality mattresses. Mattresses must be checked regularly.rPeto, R. Calrow, A.u 0266-8130 Journal Articlea Prof NurseXRBeds/*standards *Hospitals, Teaching Human *Management Audit Organizational Policyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=87183672212246r175i 1990Sep-OctIPJA study of interface pressure for pressure reduction and relief mattresses 212-6o& Petrie, L. A. Hummel, R. S., 3rd 0270-1170 Journal ArticleJ Enterostomal Ther vpBeds/*standards Decubitus Ulcer/etiology/physiopathology/*prevention & control Evaluation Studies Human Pressurejdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22122468991729a184m 1996Jul-Aug34-The operating table: a historical perspective 30-4Operating tables evolved rapidly from 1860 through 1920. By 1920, the operating tables were well-designed for a wide variety of operations. Today, our operating tables resemble those developed in the early 20th century.T Petty, W. C.2,1087-1667 Historical Article Journal ArticleTodays Surg Nurse1Beds/*history Equipment Design History of Medicine, 19th Cent. History of Medicine, 20th Cent. Human Posture Surgical Equipment/*historyjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=89917297569523l993 1995ZSBeds used at a university hospital--a study of functions, problems and requirementsu 181-6n~The comfort and functional features of hospital beds are of fundamental importance to both the patients and staff on the ward. This study investigates the types and functions of the beds used at a large university hospital in Sweden, how the head nurses experienced and valued the hospital beds in their wards, and whether the nurses were familiar with standards, regulations and purchasing routines. An inventory of all the beds for adult patients was carried out in all 55 somatic wards. Interviews were conducted with 49 head nurses, and, for comparison purposes, with one purchaser as well as one expert nurse at the Gothenburg Medical Service Administration. The inventory reveals that the different wards have very similar kinds of beds regardless of specialty or caring needs. The head nurses stated that the beds were seldom ideal and that they themselves have little influence when new purchases are made. It is concluded that the head nurses have a considerable knowledge of the functions of hospital beds, which ought to be put forward in stronger terms and which should also be taken into account when new beds are purchased and designed.,%Petzall, K. Berglund, B. Lundberg, C. 0283-9318 Journal ArticleScand J Caring SciAdult *Attitude of Health Personnel Beds/classification/*standards Health Services Needs and Demand Hospitals, University Human *Nursing, Supervisory Purchasing, Hospitaljdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7569523518794416811 1968 Nov2,Flotation, displacement, and decubitus ulcer 2351-5 Pfaudler, M. 0002-936x Journal Articles Am J Nursdd]*Beds Biophysics Decubitus Ulcer/*prevention & control Human Methods New York Pressure *WaterTjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=5187944HDv1558630s382  1992 Mar.TNAuthors respond to questions regarding pressure measurements in recent article14 Motta, G.o0889-5899 LetterOstomy Wound ManageQ<5*Beds Equipment Design Human Pressure Research DesignAjdhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15586309016148429T 1996 Oct4-Reimbursement challenges and how to meet themh 50-6, 58-9xrHow we deliver healthcare in the U.S., and how that care is paid for, is evolving. Reimbursement and payment issues now directly impact patient care and clinical decisions. Comprehensive documentation is essential to receiving reimbursement. Therapeutic positioning used by therapists is considered a skilled service. The key to Medicare reimbursement for therapeutic positioning and other services is documentation which clearly outlines the required skills of the professional, the medical necessity and reasonableness of the service, and the significant functional and safety goals that have been met, along with the progress over time. Medicare coverage and payment policies for surgical dressings and support surfaces have been revised in the last few years. The current surgical dressings policy has a number of points that must be understood: X1 modifiers, border versus non-border dressings, wound fillers and covers, solutions (saline), wound fillers (amorphous), dressing kits, staging, sterile versus non-sterile gauze, and normal utilization parameters. Many restrictions in both surgical dressings and support surfaces policies are efforts to curb fraud and abuse. The future of reimbursement depends of the involvement of healthcare professionals by developing research-based protocols, comprehensive documentation, education of both peers and patients, and political empowerment.'B8Using Smart Source Parsing May; ( pp. 56 Journal Article@:Data Collection:*IS/MT/ST Reproducibility of Results HumanThe validity of an instrument is another important issue for the clinician to consider when selecting a tool for use in data collection. Broadly defined, validity refers to the extent to which an instrument measures what it is supposed to be measuring. Although validity is a unitary concept, this article explores three common categories of validity: content, criterion-related, and construct validity.933494313261