Effects of absorbent incontinence pads on pressure management mattresses.
OBJECTIVE
The aim of this paper is to report a study to determine the effects of absorbent pads on the pressure-relieving properties of 'standard' and pressure management mattresses.


BACKGROUND
Pressure ulcers and incontinence often co-exist. There is a strong association between poor mobility and continence problems and patients using pressure management products are therefore also likely to be using absorbent pads.


METHODS
An instrumented articulated anthropometric phantom with simulated soft body 'tissues' in the gluteal and sacral areas was used as the 'subject'. The phantom was raised and lowered on to three mattresses (standard foam, visco-elastic foam and surface-cut foam) in three states: naked, wearing a dry pad (Tena Super, SCA Hygiene AB) and wearing a wet pad. The pressure mapping device Xsensor was used to record the distribution of pressure over the sacral and ischial areas of the phantom. Peak pressure was used as the primary outcome variable and 10 repeats were made on each mattress under each condition.


RESULTS
There were substantial and significant differences for all three mattresses in recorded peak pressures between the naked buttocks and the buttocks wearing a dry pad. There were no significant differences between measurements made using the dry vs. wet pad. Peak pressures frequently occurred over areas of pad folds. Additional testing showed that pads that were 'smoothed' by hand had significantly lower peak pressures than 'unsmoothed' pads.


CONCLUSIONS
Absorbent pads have a substantial adverse effect on the pressure redistribution properties of mattresses. Pad folds appear to contribute to this effect, which can be ameliorated slightly by smoothing. Absorbent pad manufacturers should consider engineering pads that minimize disruption to pressure management. Further examination of continence and pressure management products is necessary to establish optimum combinations for nursing care.
Fader
Mandy
M
Department of Medicine, Continence and Skin Technology Group, University College London, London, UK. m.fader@ucl.ac.uk
Bain
Duncan
D
Cottenden
Alan
A
D000368:Aged; D001512:Bedding and Linens / Q000009:adverse effects*; D004867:Equipment Design; D006801:Humans; D016496:Incontinence Pads / Q000009:adverse effects*; D008348:Manikins; D011312:Pressure; D003668:Pressure Ulcer / Q000517:prevention & control*; D014549:Urinary Incontinence / Q000451:nursing*