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Interface pressure mapping pilot study to select surfaces that effectively redistribute pediatric occipital pressure
Samantha Higer1, Thomas James1
1Department of Mechanical Engineering, Tufts University, 200 College Avenue, Medford, MA, USA.
Insights
An air support surface is the best option for preventing pediatric occipital pressure ulcers, offering the lowest interface pressure and most uniform distribution. This finding aids clinical decisions for selecting appropriate reactive support surfaces for children.
Area of Science:
- Biomedical Engineering
- Pediatric Care
- Material Science
Background:
- Pediatric occipital pressure ulcers pose a clinical challenge.
- Lack of quantitative data hinders selection of effective support surfaces.
- Preventing pressure ulcers is crucial for infant well-being and reducing healthcare costs.
Purpose of the Study:
- To quantitatively evaluate interface pressure and distribution on various support surfaces for pediatric occipital loading.
- To inform clinical decisions regarding the selection of optimal reactive support surfaces.
- To provide data-driven insights for preventing pediatric occipital pressure ulcers.
Main Methods:
- Utilized a validated capacitive pressure mapping system (XSENSOR) for pediatric use.
- Assessed standard pediatric mattresses and four pressure-redistributing surfaces (gel, foam, air, fluidized).
- Conducted a pilot study on 22 healthy children under 6 years old, measuring occipital interface pressure and distribution.
Main Results:
- The pressure mapping system demonstrated high accuracy (0.5-9% error) for pediatric occipital loading.
- Air surfaces exhibited the lowest mean interface pressure (14.2 ± 1.41 mmHg) and peak pressure index.
- Air surfaces provided the most homogenous pressure distribution and largest contact area.
Conclusions:
- Air support surfaces are most effective in redistributing pressure for the pediatric occiput.
- Low interface pressure and homogenous distribution indicate superior envelopment of the occiput.
- Findings support the use of air surfaces to prevent pediatric occipital pressure ulcers.
Aim:
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.
Materials:
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).
Conclusion:
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.
