Preventive principles

Preventing pressure ulcers is cost-effective

Almost one out of ten healthcare injuries consists of pressure ulcers, which cause both significant suffering for the affected individual and prolonged hospital stays. Calculations from the Swedish National Board of Health and Welfare show that pressure ulcers lead to an extended hospital stay of approximately 50,000 days per year in closed hospital care in Sweden. This results in a cost of approximately 450 million SEK (Swedish Krona) each year, equivalent to 0.6 percent of the total cost of closed somatic care.

It is important to highlight that a significant portion of pressure ulcers occurring within healthcare settings are considered avoidable and can be prevented through early risk assessment and targeted interventions⁽¹⁾.

Pressure reduction and pressure relief

Access to and use of pressure-relieving materials are primary preventive measures to reduce the risk of developing pressure injuries. The Swedish Association of Local Authorities and Regions (SKR) has identified access to pressure-relieving products, such as mattresses, heel-offloading devices, seat cushions, and positioning pillows, as one of the seven success factors for preventing pressure injuries. Pressure-relieving products are often, but not always, made of foam and/or air-filled cells. Individuals at increased risk of pressure injuries should be prescribed
pressure-reducing or pressure-relieving products ⁽²⁾.

There are two concepts that need to be clarified and form the basis of the principle of pressure reduction and pressure relief: contact surface and contact pressure

Contact surface

Pressure ulcer prevention mattresses work on the principle of distributing pressure over as large a surface area as possible, without the individual risking bottoming out. When the body’s weight is supported by a larger surface area, the pressure is also distributed over a larger area. This leads to low peak pressures, which promote good pressure distribution.

Contact pressure

Contact pressure is the pressure that occurs between the skin and the mattress. The contact pressure that arises depends on how much the individual weighs and the surface area of the mattress that is being loaded. A low contact pressure is desirable.

Before selecting the appropriate surface for the patient to lie on, it is necessary to assess the risk. Read more about it here:

Read more about risk assessment

References
⁽¹⁾ Socialstyrelsen, 2018. Attachment 2: Healthcare Costs for Avoidable Pressure Ulcers – An Example Calculation. Retrieved from Socialstyrelsen 2022.
⁽²⁾ Socialstyrelsen Pressure Ulcers – Success Factors for Prevention (2015) Pressure Ulcers (https://patientsakerhet.socialstyrelsen.se/risker-och-vardskador/vardskador/trycksar/kr.se) Retrieved 22-06-16.
⁽³⁾ Gefen, A., Brienza, D. M., Cuddigan, J., Haesler, E., & Kottner, J. (2022). Our Contemporary Understanding of the Aetiology of Pressure Ulcers/Pressure Injuries. International Wound Journal, 19(3), 692–704. https://doi.org/10.1111/iwj.13667.