(CR-024) A Comparative Analysis of Three Surgical Support Surfaces: A Preliminary Analysis

Denny Dawn, PhD (Nursing), University of North Dakota, Grand Forks, ND – Assistant Professor nursing at the University of North Dakota, College of Nursing and Profesional disciplines at the Univeristy of North Dakota; Md Hasib Fakir, PhD Student at the University of North Dakota – Graduate Research Assistant, Biomedical Engineering Program; Darlene Hanson, PhD, Teaching and Learning, Higher Education Emphasis, University of North Dakota, Grand Forks, ND – Clinical Professor Emeritus, Nursing at University if North Dakota, College of Nursing and Profesional disciplines at the Univeristy of North Dakota; Kristi Jean, PhD in Chemical Engineering at Georgia Institute of Technology – Quality Engineer at ComDel Innovation; Mary Labuhn, Masters Student in the college of Nursing at the University of North Dakota – Graduate Research Asst Education, Health & Behavior at the University of North Dakota, College of Nursing and Profesional disciplines at the Univeristy of North Dakota; Rhoda Owens, PhD Teaching and Learning - Higher Education, University of North Dakota, Grand Forks, ND – Assistant Professor nursing at the University of North Dakota, College of Nursing and Profesional disciplines at the Univeristy of North Dakota; Kouhyar Tavakolian, Ph.D. Engineering Science, 2010 Simon Fraser University, British Columbia, Canada – Director, Biomedical Engineering Program, College of Engineering & Mines, Biomedical Engineering Program, University of North Dakota; Pantea Tavakolian, Ph.D. in Mechanical Engineering from the University of Toronto – Assistant Professor College of Engineering & Mines at the University of North Dakota, Biomedical Engineering Program, University of North Dakota; Charisse Vetsch, Major in the college of nursing, at the University of North Dakota – Temp Research Assistant at the Univeristy of North Dakota, College of Nursing and Profesional disciplines at the Univeristy of North Dakota

Introduction:             Pressure injuries, known as pressure ulcers, can be a serious healthcare concern for patients undergoing long surgeries due to the extended period of time they spend lying in one position. The occurrence of perioperative pressure injuries in patients is costly and negatively impacts patient outcomes. With a prevalence rate of 8.5%, treating perioperative pressure injuries can cost healthcare systems an average range of $21,000 to $152,000 per person. One approach to preventing pressure injuries is through the use of pressure-relieving support surfaces to reduce the risk of tissue damage. 

Methods:

This research study aimed to compare the effectiveness of three different types of support surfaces in terms of pressure relief.  The small cell alternating pressure mattress is designed with a series of thin air cells that alternate in pressure to redistribute pressure away from the patient’s body and increase blood perfusion to those areas. This is achieved by inflating some cells and deflating adjacent cells within the support surface every 5 minutes.  To compare the support surfaces, we placed a thin pressure mapping sensor mat on the support surface, and we measured the pressure exerted by the patient's coccyx area at various points for a period of 5 minutes. This experiment was conducted with a sample size of 11 participants. The pressure map data was analyzed to identify the most effective support surface in reducing average pressure over the experiment time.

Results:             The alternating pressure support surface was effective in reducing average pressure over the 5 minutes experiment by 10% in comparison to the gel pad and 4% with respect to the standard hospital foam surgical support surface. In addition, the alternating pressure support surface provided a higher coefficient of variation (48%) than gel (2%), and the 3-inch standard hospital foam mattress (2%), providing pressure relief of 5 minutes time, which shows the efficiency of the offloading in the alternating pressure support surface.

Discussion:              Pressure ulcers have significant implications for individual patients and the healthcare system. The alternating pressure support surface provided a higher level of pressure relief, compared to the Gel and standard hospital foam support surface. The study found that the alternating pressure overlay, through periodic offloading of the sacrum, consistently reduced pressures on the sacrum compared to the Gel and foam support surfaces. These findings highlight the importance of using different cycles of pressure relief times and indicate the potential superiority of alternating pressure support in preventing pressure ulcer development. 

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