Pressure ulcers or decubitus ulcers in patients can occur when the pressure on the skin and soft tissue, typically at a boney prominence, exceeds the capillary blood pressure and blood flow stops. After about two hours, tissue necrosis begins to set in. When this happens, a sore starts to develop. This can pose a serious danger to any surgical patients, but especially those undergoing longer procedures.

Among the best practice for preventing pressure sores is the utilization of cushioning gel or polymer products, which distribute pressure more like a liquid than a solid. Traditional padding such as foam and other materials that can be easily compressed can potentially bottom out, causing pressure at boney prominences.

Pressure ulcer prevention should be a top priority of every hospital and surgical center. Aside from being listed as a "Never Event" as specified by MediCare, and thus proving very costly to hospitals in the long run, pressure sores are very easily preventable, requiring little capital expenditure for pressure reduction products and minimal effort in bring the OR up to compliance levels. Here we look at some of the latest offerings to help hospitals prevent pressure injuries in surgical patients.

STERIS Corporation (Mentor, OH) is a global leader in medical and surgical equipment, including surgical tables and table accessories. They offer a broad range of pads and positioning products for use on their line of OR tables that can help reduce injury to patients caused pressure point during long procedures. Among the latest additions to their line of table accessories are the Foam Immersion Technology™ (FIT) table pads.

The Foam Immersion Technology (FIT) table pads from STERIS minimize interface pressure.

The unique features of Foam Immersion Technology pads maximize the skin-to-pad contact area to minimize interface pressures. The latex-free stretchable cover material moves relative to the patient's skin surface to reduce shear and features RF-welded seams for a completely fluid-proof barrier.

STERIS's patent-pending technology includes two layers of foam; each layer contains a patented conical cutout in critical areas to help maximize conformity. After the patient's body weight settles into the pad and the air valve is closed, the pad maintains the exact profile of that patient's anatomy, redistributing pressure evenly and supportively over the entire body surface. The FIT pads effectively "immerse" the patient in the pad, mimicking the weightless buoyancy of floating, thus providing the ultimate protection against pressure sores.

Action Products, Inc. (Hagerstown, MD) has been a provider of high-quality, clinically proven OR table pads and positioners for over 30 years. Action® pads and positioners provide high-performance shear and pressure management for Pediatric to Bariatric patient. Made of Akton® polymer, these reusable, durable products are designed to withstand the physical demands of even the obese population. Action products evenly distribute weight and heat, offer maximum patient support and provide consistent high-performance, all of which are critical for longer term procedures. Free of latex, silicone and plasticizers, they are also easy to clean and repair. Action products are available in a wide range of shapes and sizes.

In addition to their existing product line, Action Products recently introduced the Body Smart Solutions® line of positioning products, offering a more environmentally responsible option for patient positioning in the OR. Body Smart Solutions are premier viscoelastic polymer positioning products. They are domestically made of the company's Akton® polymer and are reusable, which significantly cuts down on waste caused by disposable positioning products. The reusable products and reduced waste can translate in significant cost savings to hospitals and other health care facilities.

Innovative Medical Products (IMP), Inc. (Plainville, CT) is a supplier of patient positioning devices for orthopedic surgical procedures. The products are designed to provide accuracy for the surgeon, save time for OR personnel and benefit the overall patient surgical experience.

IMP's TUFFease® Pressure Ulcer Prevention Gel Pad Products provide long-lasting tenderness to the patient. The pads offer a full ½-inch of specially formulated gel, enveloped in a significantly thicker, puncture-resistant covering that is latex free and contains no silicone or plasticizers. The reusable TUFFease pads come in both standard sizes and custom designs and can help prevent pressure wounds and ulcers during a variety of surgical procedures.

The Gelli-Roll from CSZ combines patient temperature management and tissue pressure reduction in a single, easy-to-use, reusable product.

Cincinnati Sub-Zero Products (Cincinnati, OH), a healthcare market leader and innovator since 1963, offers a full line of patient temperature management products for the OR, ICU, PACU, Cath Lab and other hospital areas. Their extensive product line includes patient warming systems, cold therapy system, hyper/hypothermia systems and a broad range of products and systems to meet any temperature management need. In addition, CSZ recently released a innovative patient warming blanket that also helps prevent pressure wounds in surgery patients.

The Gelli-Roll® combines patient temperature management and tissue pressure reduction in one simple-to-use, reusable product. It can be used before, during or after surgery to effectively provide patient warming or cooling as well as pressure reduction. A warming blanket is encapsulated within Akton® gel pads to maintain patient temperature throughout surgery using such CSZ's warmers as Norm-O-Temp®, Blanketrol® or Hemotherm®. The Gelli-Roll provides the benefit of tissue pressure reduction and aids in the reduction of tissue trauma and nerve damage while delivering a high degree of patient comfort.

Medline Industries, Inc. (Mundelein, IL) is a global provider of healthcare supplies and equipment to the long term care market. Medline is also a leader in several categories of products to the hospital marketplace. Their extensive product offerings address the most pressing concerns facing hospitals, including patient safety. To address the dangers of pressure ulcers in the healthcare setting, Medline now offers a line of foam mattresses.

Medline's TheraTech Pressure Redistribution Mattresses feature superior pressure redistribution, reduced shearing and a cool sleep surface.

Medline's TheraTech Pressure Redistribution Mattresses feature anatomically zoned foam mattresses and self-adjusting, non-powered convertible air and foam mattresses. Specifically designed to accommodate any facility's pressure ulcer prevention program, TheraTech mattresses feature outstanding pressure redistribution, reduced shearing effects and a cool sleep surface. Independent load bearing cells, built in air channels and anatomically designed zones make these mattresses ideal for any hospital. TheraTech mattresses can also be customized to meet individual requirements.

David Scott Company, (Framingham, MA) has been a supplier of high quality OR pads, positioners and accessories for over 35 years. With over 150 pressure reducing positioners, David Scott offers the innovative line of Blue Diamond gel pads and positioners, made from clinically proven Viscoelastic polymer. Under the Blue Diamond line the company offers viscoelastic polymer positioners, Light Cloud™ resposable head positioners, four levels of pressure reducing OR table pads and a variety of other OR accessories.

The newest offerings from David Scott are their innovative BeanBag Positioners. These Gel BeanBag Vacuum-Pac Positioners feature an integral soft layer of Blue Diamond Gel that conforms to the body and distributes the patient's weight uniformly, thus ensuring the maximum protection available to help prevent pressure points. Easy to connect to and disconnect from the wall suction line to utilize the vacuum feature, the vacuum valve system is replaceable if compromised. The positioners are available in a standard size as well as a 46-inch by 46-inch bariatric size, both with U-shaped shoulder cut-outs.

Allen Medical Systems (Acton, MA) focuses on improving patient outcomes and caregiver safety, while enhancing hospital efficiency through the development of technologically advanced surgical positioning accessories. Allen offers an extensive array of patient positioning systems and products for protecting the patient's skin during long procedures in general surgery, orthopedics, spinal surgery and many other surgical specialties.

Allen Medical's Astrus Elite OR Table Surface has a four-layer foam composite construction for optimal patient protection.

Allen Medical's table pads contain multiple foam layers for optimal pressure management. New to the company's line of pressure reduction products is the Astrus Elite™ OR Table Surface. The Astrus Elite has a four-layer foam composite construction that protects patients in four ways. A top layer of conforming foam molds to the patients' anatomy. The pressure displacement foam middle layer transfers pressure off the bony prominences. The closed cell foam bottom layer prevents bottoming out, while the Anti-Shear™ Cover protects the patient's skin. These table surfaces are available in a range of thicknesses and are available for use with most major manufacturers' tables.