Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Pressure Redistributing Surface

Static Surfaces

Dynamic Surfaces

Bariatric Surfaces

Static Surfaces

Surface Thick foam mattress 
Description Overlay or mattress replacement
Advantage May be difficult to clean, may be single use
Disadvantage May be difficult to clean, may be single use
Indications Patient is able to shift weight, no pressure ulcers

[back to top]

Surface Water mattress 
Description Waterfilled mattress or overlay
Advantage Re-distribution of pressure secondary to emersion into water surface
Disadvantage Difficult to maintain, heavy, difficult to transport
Indications Patient is able to shift weight, free of pressure ulcers

[back to top]

Surface Air floatation mattress 
Description Inflatable plastic or nylon mattress overlay
Advantage Inexpensive, portable, easy to store, moderate emersion into surface
Disadvantage Air leaks, risk of bottoming out, require regular monitoring
Indications Patient is able to shift weight, no pressure ulcers or low stage pressure ulcer

[back to top]

Surface Low air loss mattress/ bed 
Description Multiple inflated fabric pillows, may be attached to a bed frame
Advantage Lightweight, re-distribute peak pressures via emersion into air surface
Disadvantage Expensive, warm, risk of bottoming out
Indications Functionally dependent patients with large, deep or multiple ulcers

[back to top]

Dynamic Surfaces

Surface Alternating air pressure mattress 
Description Multiple air filled compartments, air pressure levels fluctuate within and between compartments
Advantage Light weight, re-distribute pressure via emersion into air compartments and by alternating pressure levels within and between compartments
Disadvantage Expensive, noisy, complex to setup, risk of bottoming out, warm
Indications Functionally dependent patients with large, deep or multiple ulcers

[back to top]

Surface Air fluidized mattress/ bed 
Description Contains beads which are fluidized by a flow of warm pressurized air, covered in polyester
Advantage Feces and urine pass through the sheet into the beads. Frequent turning unnecessary
Disadvantage Very expensive and heavy, generate heat, causes insensible water loss, decreases patient mobility, noisy
Indications Functionally dependent patients with large, deep or multiple ulcers

[back to top]

Bariatric Surface

Surface Bariatric bed 
Description For clients over 250 lbs. May be static or dynamic
Advantage Designed to fit body shape and weight of bariatic population
Disadvantage Expense and availability
Indications For patients over 250 lbs and up to 850 lbs

Reproduced with permission. Hutchinson, B., and Orsted. H. (2003). Pressure management: Assessment, prevention, intervention and evaluation, Skills Lab #1. Skin and Wound Assessment and Treatment, Calgary Health Region, Calgary, AB.

[back to top]