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Thread: Bedsores vs. Wrinkles

  1. #1

    Bedsores vs. Wrinkles

    Hi,

    I am between a rock and hard-place right now and was wonder if there was any extra conventional wisdom for solving a wrinkle crisis on a new low air loss mattress.

    I had one that was two and a half years with one setting and one bladder with 3 sections. I solved that wrinkle problem by putting string thru the snaps and stretching it and tying it to my bed.

    The concern about 1 bladder without control of the sections and age was my motive for trying a bed with adjustable sections, as this would reduce the pressure on my shoulders and hip bone caused by the hammocking effect.

    I have had my new bed for a month now. After the first three days I had to stretch my old mattress cover over the new mattres. The new mattress has a very thin loose cover; plus has many tube like air cells. (approx. 12 - 14). This is not good because even the bladders or cells seem to be less stout and to migrate inward.

    In this type mattress (many bladders), the compromise of less pressure from not hammocking vs. the wrinkles still caused by the better mattress cover.

    This is still not much better and is probably worse than the one bladder mattress, because there are still some wrinkles.

    I can take out the 4 inch foam pad currently between the bottom of the mattress and on top of the bed frame.

    It is there for the reason that a power failure will put me on the hard frame.

    I can also try stretching the mattress cover better possibly.

    The idea of removing the 4 inch foam mattress is to see if not sinking so far down into the mattress will cause less wrinkles, hopefully.

    A bed with one bladder with adjustable cells inside - is perhaps the better bed.

    Does anyone have some extra tips about my current bed (12 bladders)or knows personally what bed works well for them?


    Sincerely,

    David65

    [This message was edited by david65 on 07-31-03 at 10:45 PM.]

    [This message was edited by david65 on 07-31-03 at 10:49 PM.]

    [This message was edited by david65 on 07-31-03 at 10:54 PM.]

  2. #2
    David, it would help to know the brand names of the mattresses you are talking about.

    A tight cover over a low air loss mattress may take away the pressure reducing effect that is desired. It should have wrinkles in it when you are not on the mattress, otherwise it will hammock you and not allow you to sink into the air sacks. In my experience, the 3 section mattresses (like the Microair 3500S) are less desirable as people tend to fall through the cracks, esp. in the sitting position, and risk bottoming out.

    Multiple sacks will work as long as there is something built into the mattress to prevent the sacks from separating too much (such as is done with the TxCair).

    These mattresses should be used only with the cover that is provided for the specific mattress. Linens (sheets) should not be used between you and the mattress. Any Chux used should be air permeable (not plastic backed) and should also be used as little as possible.

    I would also not remove the foam at the base. This is integral to the design of the mattress and without it it is likely that the pressure reducing qualities will be altered for the worse. It is also there for a reason, which is to prevent you from laying directly on the bed frame in the case of an extended power outage. Of course if you have a back-up generator that is dependable, this is less of a concern.

    I don't know of any one section (bladder) mattress that gives adjustable pressure for different areas...this is why multiple sections or bladders are preferable and a better design.

    (KLD)

  3. #3
    Nurse,

    Do you know very much about the Clinitron bed.
    OR any other air fluidized bed. Do they really help the most. Wrinkles seem to be my biggest enemy at the same rate as pressure reduction.

    david tippitt

  4. #4
    The Clinitron is not a prevention bed...it is a treatment bed and should be limited to that. It is not practical for most home use...it cannot be cleaned in the home, and it weighs several tons (more than a waterbed per square foot). It also takes huge amounts of electricity. We had to have our unit specially wired to put more than one in a room. It also generates a lot of heat in the room.

    In addition, air-fluidized therapy causes a large amount of insensible fluid loss. This can be as much as 1-2 liters daily, and can result in dehydration and constipation.

    If you get a hole in the top sheet, beads are blow all over the room and are tiny enough to inhale. Any beads on the floor act like tiny ball bearings for any walkers in the area...we have seen several bad falls amoung our staff.

    Unless you have a ceiling track lift, transfers in and out of a Clinitron or even a Rite-Hite are nearly impossible without someone lifting you.

    A good way to get rid of wrinkle problems is to look at a product that offers a knit top sheet, or to make you yourself. The knit prevents a lot of wrinkles, reduces shear, and stretches to prevent bad hammocking.

    This is the so-called home version of the Rite-Hite (note that it is only air fluidized in the bottom half, and it has no wheels):

    Home Clinitron

    Note that this is a used one, and it costs $13,000.

    Here is the users manual:

    Rite Hite Users Manual

    What brand and models of LAL mattresses are you talking about in your original post?

    (KLD)

  5. #5
    Senior Member alan's Avatar
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    I have a Turnsoft mattress, and haven't had any problems (knock wood.)

  6. #6
    Nurse,

    I'M sorry, I have a Hil-Rom Flexicare eclipse. It caused wrinkles whereas on my old mattress I was using the Micro Air 3500 S. it didn't, but has one variable control for the entire mattress. It has a thicker quilted cover and did not get wrinkles after tightening down the mattress. I did get red spots and they would last for 2 hrs on my shoulders. My hips hardly ever got red.

    Now, I have had this new bed one month and my sides and mainly my shoulders look scratched. Today we tied it down better and it seems to have eliminated the wrinkle problem. The nylon cover you are talking about also caused wrinkles but not scratch like marks. Of couse we only tried the nylon for 3 days.

    I live in bed because it is too painful to sit up. About three years. How did you find a clinitron, can you find any other air fluidizd beds. KCI has them too, but they are hard to get. How effective is the clinitron as a help in the fight against getting bed sores.

    I have a take down of my ileostomy in 28 days and I don't know if I will bleed again or not during bowels. Can you restate the part about the loss of the fluid (concept) on a clinltron.

    David

    david tippitt

  7. #7
    We stopped using the Microair 3500S a year ago due to the problems I described. If you can try to return your Flexicare and get a Triline (Wound Support Services) TxCair replacement LAL mattress instead, I suspect you might be happier. We no longer use Flexicare either, due to both the expense and problems with the cushions as you describe. I always recommend renting equipment such as this first to be sure it will work for you.

    I would not recommend using a home-care Clinitron for the problems you describe. Due to the warm air blowing over your skin all the time, you loose about 1-2 liters of water from your body daily just due to this, meaning you must drink more and be careful about constipation. In addition, catheters often do not drain well in a Clinitron, especially external catheters.

    You must have excellent insurance if they are willing to purchase these high costs items for you without requiring you to meet Medicare guidelines for their use.

    (KLD)

  8. #8
    Nurse,

    It is very strage. Hil-Rom's will not allow anyone to see their products any more. They have redesigned their web site and it stinks, Is the alternative mattress u mentioned by Hil-Rom. I don't recall seeing it in the listing.

    These wrinkles are not good for my situation. Can u link me with the bed you are mentioning.

    On my Micro Air 3500, I kept the mattress cover tighter, so maybe that is why it has not given me that poblem, just a problem with no control for pressure reduction.

    Right now, maybe a mattress with three badders like the 3500 BUT with independent settings would be better than what I have.

    Tricell is close but the bladders are not thar smooth. Questionable. Already made one bad mistake on the Eclipse. The name says a lot.

    Thanks for your concern.

    David

    p.s. considering the negatives of the clinitron, does it help preent skin break downs.

  9. #9
    Properly used and maintained, a Clinitron will usually prevent skin breakdown, but this is like killing a fly with a nuclear weapon.

    I also had recently seen the new Hill-Rom site, and I agree, it sucks!

    There are other bed manufacturers. Stryker, Pegasus, and KCI are amoung the largest competitors of Hill-Rom. I would suggest that you talk with a wound care specialist in your area about trying something different than what you have prior to purchase.

    Here is the link to Triline:

    http://www.woundsupport.com/index.html

    (KLD)

  10. #10
    I don't know, but does sheep skin help prevent bed sores. I read recently on a wound web site where this is prefered.

    david tippitt

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