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Pressure Injury Preventive Mattresses in Paediatric Patients: A Scoping Review
Enes Şimşek1, Remziye Semerci Şahin1
1Koç University, School of Nursing, İstanbul, Turkey.
Insights
Air and fluidized mattresses significantly reduce pressure injuries in critically ill children. Advanced support surfaces, combined with risk assessment, offer effective prevention strategies for pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Biomedical engineering
- Nursing research
Background:
- Pressure injuries (PIs) pose a significant risk to critically ill children due to unique vulnerabilities.
- Effective prevention strategies are crucial for improving outcomes in pediatric intensive care units.
Purpose of the Study:
- To evaluate the effectiveness of pressure injury preventive mattresses in pediatric patients.
- To identify knowledge gaps and provide recommendations for clinical practice.
Main Methods:
- Systematic search of major databases (PubMed, Medline, Scopus, Web of Science, CINAHL) until December 2024.
- Included randomized controlled trials, cohort studies, quasi-experimental studies, and finite element modeling.
- Followed PRISMA-ScR guidelines for scoping reviews.
Main Results:
- Air mattresses showed superior pressure redistribution (up to 29.2% reduction in peak pressure).
- Fluidized positioners decreased PI incidence by 2.67 times within prevention bundles.
- Gel mattresses offered moderate effectiveness; foam mattresses were cost-effective but less efficient for high-risk patients. Foam dressings aided in preventing device-related PIs.
Conclusions:
- Air mattresses, fluidized positioners, and gel mattresses are effective in preventing PIs in pediatric patients.
- A multifaceted approach integrating advanced support surfaces and risk assessment is recommended.
- Future research should address long-term outcomes, cost-effectiveness, and standardized pediatric PI prevention protocols.
Abstract:
Pressure injuries are a significant healthcare concern in paediatric populations, particularly among critically ill children due to their unique anatomical and physiological vulnerabilities. This scoping review aimed to evaluate the effectiveness of pressure injury preventive mattresses in paediatric patients, identify knowledge gaps, and provide recommendations for clinical practice. A systematic search was conducted in PubMed, Medline (OVID), Scopus, Web of Science, and CINAHL databases for studies published until December 2024. The review followed the PRISMA-ScR guidelines, and the inclusion criteria encompassed randomized controlled trials, cohort studies, quasi-experimental studies, and finite element modelling focusing on PI preventive mattresses in paediatric patients aged 0-18 years. A total of 10 studies were included, involving various methodologies such as randomized controlled trials, cohort studies, and finite element modelling. Air mattresses demonstrated superior pressure redistribution, reducing peak pressure points by up to 29.2% compared to foam mattresses. Fluidized positioners effectively decreased PI incidence by 2.67 times when used in prevention bundles. Gel mattresses showed moderate effectiveness, while foam mattresses were cost-effective but less efficient in high-risk patients. Additionally, foam dressings were beneficial in preventing device-related PIs. The review highlights the efficacy of air mattresses, fluidized positioners, and gel mattresses in preventing PIs in paediatric patients. A multifaceted approach, integrating advanced support surfaces with risk assessment tools, can significantly reduce PI incidence. Future research should focus on long-term outcomes, cost-effectiveness, and standardized protocols for paediatric PI prevention.
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