Interface pressure mapping pilot study to select surfaces that effectively redistribute pediatric occipital pressure.
OBJECTIVE
The aim of this pilot study was to better inform clinical decisions to prevent pediatric occipital pressure ulcers with quantitative data to choose an appropriate reactive support surface.


METHODS
A commercially available capacitive pressure mapping system (XSENSOR, X3 Medical Seat System, Calgary, Canada) was used to evaluate a standard pediatric mattress and four commercially available pressure-redistributing support surfaces.


METHODS
The pressure mapping system was validated for use in the pediatric population through studies on sensitivity, accuracy, creep, and repeatability. Then, a pilot pressure mapping study on healthy children under 6 years old (n = 22) was performed to determine interface pressure and pressure distribution between the occipital region of the skull and each surface: standard mattress, gel, foam, air and fluidized.


RESULTS
The sensor was adequate to measure pressure generated by pediatric occipital loading, with 0.5-9% error in accuracy in the 25-95 mmHg range. The air surface had the lowest mean interface pressure (p < .005) and lowest peak pressure index (PPI), defined as the peak pressure averaged over four sensels, (p < .005). Mean interface pressure for mattress, foam, fluidized, gel, and air materials were 24.8 ± 4.42, 24.1 ± 1.89, 19.4 ± 3.25, 17.9 ± 3.10, and 14.2 ± 1.41 mmHg, respectively. The air surface also had the most homogenous pressure distribution, with the highest mean to PPI ratio (p < .005) and relatively high contact area compared to the other surfaces (p < .005).


CONCLUSIONS
The air surface was the most effective pressure-redistributing material for pediatric occipital pressure as it had the lowest interface pressure and a homogeneous pressure distribution. This implies effective envelopment of the bony prominence of the occiput and increasing contact area to decrease peak pressure points.
Department of Mechanical Engineering, Tufts University, 200 College Avenue, Medford, MA, USA. Electronic address: Samantha.higer@alumni.tufts.edu.
Samantha
S
Higer
Department of Mechanical Engineering, Tufts University, 200 College Avenue, Medford, MA, USA. Electronic address: Thomas.james@tufts.edu.
Thomas
T
James
D001513:Beds; D006801:Humans; D007223:Infant; D009778:Occipital Lobe; D010865:Pilot Projects; D011312:Pressure; D003668:Pressure Ulcer / Q000517:prevention & control*
Occipital; Pediatric; Pressure mapping; Pressure ulcer; Support surface