Mattresses costing £1,000 ‘only marginally better at preventing bed sores’

A study has examined how effective different mattresses are at helping patients to avoid getting the pressure ulcers while in hospital.

More isn't always better

Expensive high-tech air mattresses are only marginally better at preventing pressure sores than a specialist foam mattress, according to a new study.

The research found only one in every 50 patients allocated to an air mattress, which cost at least £1,000 each, would benefit from it.

Known as an alternating-pressure mattress, the high-tech devices contain air pockets that inflate and deflate to constantly change pressure points on the skin.

Foam beds versus air beds

In comparison, a specialist foam mattress costs around £200 and is made up of high-quality polyurethane and viscoelastic foam designed to cradle the patient to reduce pressure.

The specialist foam mattresses are widely used across the NHS while the air mattresses are used on approximately 10% of NHS hospital beds and are given to patients considered to be at high risk of developing pressure ulcers.

Researchers found 6.9% of patients on the high-tech air mattresses developed a pressure sore that was grade two – a blister or break in the skin – or worse compared with 8.9% on the specialist foam mattress.

Jane Nixon, Professor of Tissue Viability and Clinical Trials at the University of Leeds, who led the study, said: “The outcome of this study provides the evidence that specialist foam mattresses are appropriate for most patients who are at high risk of developing pressure ulcers.

“But staff should be free to exercise clinical discretion in provision of either mattress, informed by patient preference, comfort or rehabilitation needs, as well as specific risk factors such as being completely immobile, being confused, having nutritional deficits or early signs of pressure damage.”

How the study was conducted

The study involved more than 2,000 patients at high risk of developing pressure ulcers in hospital and NHS community units.

Patients who agreed to take part were randomly allocated either a high-tech air or specialised foam mattress for two months or until discharge, whichever came sooner.

They were then assessed by a nurse for a final time 30 days after discharge. The median length of time it took for the ulcers to develop for the patients on a high-tech air mattress was 18 days compared to 12 days for those on the specialist foam mattress.

Researchers found an economic advantage to using the high-tech air pressure mattresses as, although they cost more to buy, the patients who were nursed on them had, on average, a slightly shorter stay in hospital, which reduced the overall cost of care.

They said more research is needed to fully understand the correlation between mattress type and length of hospital stay.

Professor Andrea Nelson, dean of the School of Health and Life Sciences at Glasgow Caledonian University, was also involved in the research.

She said: “This study, the largest one worldwide, shows that we can make a fair test of the two of the main types of mattresses, a specialised foam mattress or an air bed with a pump that varies the pressure on the skin.

“Previous work has shown that the air pressure mattresses are uncomfortable for some patients.

“This new research means that nurses can make their decision about which mattress to use with the benefit of the most reliable evidence about what works.”

The study is published in the journal EClinicalMedicine.

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