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Preventative Aids

Pressure Reducing Aids

Preventative aids cover a wide spectrum of specialist features. Efficacy should be judged, if possible, on the basis of independent evidence.

Special Mattress/Beds:

Warelow Score 10+ Specialist memory foam mattresses.
Warelow Score 15+ Alternating pressure overlays, mattresses and bed systems
Warelow Score 20+ Bed systems: Fluidised bead, low air loss and alternating air mattresses (also known as dynamic mattresses)

Bed/Mattress Automatic Pressure Relieving Systems

These are very expensive sophisticated products which, in the case of high and very high risk patients, can make all the difference to the patient’s susceptibility to pressure ulcer damage. Some are for general use, others for specialised purposes where, for example, there may be a high exudates problem.

Various independent studies have been conducted on the efficacy of these systems and due to their high cost, purchasers should make every effort to ensure that their choice is cost effective and based on independent clinical evidence.


Warelow Score 10+ 100mm pressure relieving foam cushion
Warelow Score 15+ Specialist Gell and/or foam cushion
Warelow Score 20+ Specialised cushion, adjustable to individual person.

No person should sit in a wheelchair without some form of specialist cushioning. If nothing else is available - use the person’s own pillow. (Consider infection risk)

Bed Clothing

Avoid plastic draw sheets, inco pads and tightly tucked
in sheet/sheet covers, especially when using specialist
bed and mattress overlay systems, as they increase pressure, especailly on the feet.

Use duvet - plus vapour permeable membrane.

Mattress Testing

Within a Pressure Ulcer Prevention Policy there should be a separate Mattress Policy setting out the time intervals for testing and replacement.

It has been found, particularly since the introduction of fire resistant materials, that the life of a standard UK Standard Hospital mattress is only 9 – 18 months. After this time they ‘bottom out’. This can be tested for by spreading the hands and pushing down on the middle third of the mattress. The bed base should not be able to be felt. Though a very simplistic test, it is one that is easily carried out, and gives you a very good idea of the state of the mattress.

Mattresses and mattress covers should be examined for damage or staining, which will create a risk of cross infection. All covers should be made of 2 way stretch material, to reduce the risk of adding to the shearing forces on a patients sacral area, in particular.

All mattresses should be dated at the time of first use. The ends of the bed should be identified – from 1- 4 to give an easy reference to systematic turning, end to end, and top to bottom. Some companies supply pressure mattresses already marked with this information.

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