title: Use of alternatives to air-fluidized support surfaces in the care of complex wounds in postflap and postgraft patients.
abstract: Air-fluidized support surface therapy has many drawbacks, such as dehydration, in an already difficult recovery for those wound patients who have undergone flap and graft surgery. In addition, patient care and handling are also problematic. Patients complain of discomfort, and the instability of the surface interferes with patient stability in side lying and semi-Fowler's positions. Alternative support surfaces can be considered for postflap or postgraft patients. Such technologies as alternating pressure, low-air-loss, and therapeutic nonpowered, advanced, and lateral rotation surfaces are widely used for pressure management in high-risk patients and those with existing pressure ulcers. These surfaces must be used within a total pressure ulcer management program that includes frequent turning and repositioning, skin and ulcer care according to evidence-based protocols, patient and caregiver instruction, nutrition, and offloading and positioning. The proposed recommendations require more research on the relative effectiveness of less expensive and more user-friendly support surfaces such as low-air-loss and nonpowered advanced support surfaces and is necessary in order to conclusively recommend one type of surface over another. However, at this time the available clinical studies and opinions remain positive.
authors: Medline Industries, Inc, St. Louis, MO.
authors: Cynthia A
authors: CA
authors: Fleck
authors: Cytomedix Regenerative Biotherapies, Rockville, MD, USA.
authors: Laurie M
authors: LM
authors: Rappl
authors: Sycamore Wound Center, Sycamore hospital, Kettering Health System, Dayton, OH, USA ; Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
authors: Richard
authors: R
authors: Simman
authors: CHRISTUS Schumpert, Shreveport, LA, USA.
authors: Virginia
authors: V
authors: Titterington
authors: Corpus Christi Medical Center, Corpus Christi, TX, USA.
authors: Jill
authors: J
authors: Conwill
authors: Shepherd Spinal Center, Atlanta, GA, USA.
authors: Cathy
authors: C
authors: Koerner
authors: Swedish Medical Center, Denver, CO, USA.
authors: Pam
authors: P
authors: Locke
authors: Avera McKennan Hospital, Sioux Falls, SD, USA.
authors: Dawn
authors: D
authors: Bechtold
authors: Levindale Hebrew Geriatric Center and Hospital, Baltimore, MD, USA.
authors: Cathie
authors: C
authors: Papantonio
authors: Skyline Medical Center, Nashville, TN, USA.
authors: Deborah P
authors: DP
authors: Gray
authors: Rutland Regional Medical Center, Rutland, VT, USA.
authors: Kathleen
authors: K
authors: Lawrence
keywords: Air-fluidized therapy; Alternating pressure; Alternative support surfaces; Fasciocutaneous flap; High air loss; Low air loss; Myocutaneous flap; Postsurgical care; Pressure ulcer management; Split-thickness skin graft; Support surface; Therapeutic nonpowered advanced and lateral rotation