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Pressure area care

  • The Benefits Of Using Hybrid Mattress Surfaces In Nursing Home Care

    Pressure area care surfaces have long been used in nursing homes and the community but a lack of understanding and confusion around the products have seen many of the new support surfaces and new technologies under utilised.

    What Are The Different Types Of Support Surfaces Available

    There are two main approaches to preventing pressure ulcers using support surfaces which are commonly utilised in nursing homes. These are known as active/ dynamic surfaces and static/ reactive surfaces.

    Each has a different function and capability for use according to different care needs of individuals. This is where confusion can set in, especially when using mattresses that are already in use within a nursing home setting. It may mean that a different surface is required but the right surface has not been specified, or the price of the specified surface may prohibit the purchase.

    Static /Reactive Surfaces

    Static systems may comprise of foam, foam and air, gel or layers of different foam densities. Some air-filled support surfaces allow air to escape through small holes and require a continuous pumped air supply. These are called low-air loss systems and are still classed as a static system.

    A reactive/static mattress works on the principle of distributing the individual's weight over a maximum body surface area. It does this by conforming to the patient’s body contours to increase the area in contact with the support surface. It provides a constant low-pressure profile whereby the pressure at every contact point is reduced. This alleviates localised internal tissue loads to help prevent the development of a pressure ulcer. These can also be called ‘reduction surfaces.’

    Active/Dynamic Surfaces

    Active/dynamic systems, (also known as alternating or airwave mattresses) require a power supply to mechanically alter the pressure beneath a person, using a regulated cycle of inflation and deflation of cells of the support surface. This allows pressure to be taken from parts of the person and then reapplied, reducing the duration of pressure on the body. These can also be called ‘relief surfaces.’

    NB: Repositioning of the person is still required on alternating support surfaces as on static surfaces


    Hybrid support surface technology is now being recommended by Tissue Viability nurses in both community and nursing home settings and combines foam and air to maximise the benefits offered by both static and alternating surfaces. This makes choosing a mattress simpler and is one piece of equipment that is suitable for a much broader range of people.

    This has reduced some confusion and enables the surface to be used in a ‘step-up’ or ‘step-down’ approach regards to an individual’s care pathway. However, there is still a lack of clarity about what these products are, how they work and which patients they are suitable for, as there are two different types of hybrid support surfaces - those with a pump and those without a pump. The systems are designed to be suitable for a range of pressure ulcer risk levels and categories of tissue pressure damage.

    It is essential to check the information provided by the manufacturer to ensure that the correct mattress is used up to the appropriate risk level and category of pressure ulcer for individuals.

    Hybrids Without A Pump

    Non-powered hybrids work on the principle of air displacement. When a person repositions their weight, air moves within the mattress to surrounding cells for optimum pressure redistribution. This allows the mattress to conform to the shape of the person’s body as he or she moves, increasing the surface area in contact with the mattress and reducing the patient/support surface interface pressures. This minimises the potential for cell and tissue breakdown.


    Hybrids With A Pump


    Powered hybrids also consist of foam and air cells, most typically configured as a layer of foam (this may be simple foam or a castellated foam) at the top surface against the body, with a series of air cells beneath.

    The mattress has air cells around the foam inserts, which provide a layer of alternating air cells above the foam.


    All of the powered hybrids in the non-powered mode function much like the non-powered hybrid mattresses. With the attachment of a powered pump, the mattress can inflate and deflate alternate air cells at regular intervals. Depending on where the air cells are in relation to where the individual touches the mattress, this can offer increased pressure redistribution or even intermittent offloading of pressure.

    How To Select The Correct Hybrid System For You

    When selecting a powered hybrid system, it is important to consider whether it offers both pressure redistribution in the static mode and pressure relief in the alternating mode. Hybrid systems where there is a layer of foam above the air cells provide active redistribution at a constant low pressure. Where the foam is positioned inside the air cells the system functions as an alternating pressure system, providing additional pressure relief in the powered mode. The presence of a foam core within the air cells means that air movement is not restricted by a top layer of foam and less air is required to inflate the cells, allowing the pump to be smaller and more efficient.


    The Top Benefits of Using Hybrid Surface Technology

    Clinical Benefit

    The option for both static and alternating pressure therapy means a hybrid surface can work to prevent and treat a wider range of pressure ulcer categories than either static or alternating surfaces alone. This removes the concern of transferring individuals from a static surface to an alternating one or vice versa – Stepping -up or Stepping-down. Instead, they can have the best of both by incorporating the powered pump. In the event of a power cut, hybrid mattresses still offer support so there’s no risk of finding your resident sinking through the mattress onto the bed frame, causing more damage and upset.

    Comfort Benefit

    Comfort is vital for rest, recovery and aid in the prevention of pressure ulcers. The air cells are encased by foam which moulds to the contoComfort is vital for rest, recovery and to aid in the prevention of pressure ulcers. The air cells are encased by foam which moulds to the contours of the body. When the mattress is in static mode the air cells remain full but with the layer of foam on top, this creates a soft and supportive flat surface for the patient. Part of being comfortable is also being able to lay in a quiet environmenturs of the body.

    Active Dynamic surface pumps can often be loud and create buzzing noises and vibrations that can affect a resident's sleep and in turn, their mood and wellbeing. Hybrid pumps, in contrast, are remarkably quiet, creating a more calming environment for the user. Utilising SSKIN 3 will also aid in the comfort of the resident and cut down on pressure ulcer formations.

    Cost Benefit

    Due to the hybrid system incorporating both sets of technology you can use the mattress in 2 ways, saving on buying additional equipment and servicing. Hybrid technology surfaces still require cleaning and maintenance to make sure they are always in working order and hygienically clean for the next person who requires the equipment. Decontamination and service work can be carried out all at the same time cutting down on pre-planned maintenance and Pat testing. They also save on space as you only need to store one mattress and not two.

    You can view our range of hybrid mattresses on our website here

    If you would like a full hybrid mattress demonstration at your home to understand how they can benefit your home why not get in touch call Belinda on 07968 994 660 or email [email protected]

    Watch the video on the benefits of a hybrid mattress here

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