For the first time the EPUAP/NPIAP/PPPIA guidelines have defined characteristics for a single layer high specification foam mattress.
The characteristics have been put together based on studies where the outcomes are in general suggesting a positive effect. The evidence suggests that homogeneous high specification foam mattresses are superior to standard foam mattresses.
Use a high specification reactive single layer foam mattress or overlay in preference to a foam mattress without high specification qualities for individuals at risk of developing pressure injuries.
(Strength of evidence=B1; strength of recommendation=↑ )1
Important to understand is the fact that the above recommendation is just valid for a single layer foam mattress. Most foam support surfaces however are not made of a single layer of foam.
Multi-layering of various grades or types of foam alters the design features of the mattress which might impact effectiveness.
Translating the evidence to more complex foam mattresses made from multiple layers and including multiple zones, may be possible by adequately describing foam characteristics as indicated in the table below.1
Characteristic | Explanation | High Spec |
Foam Type | Poly urethane foams vary in cell structure and density. High resilience foams (HR) has relatively uniform and dense cell structure that allows it to provide good support while loaded, and also maintains its shape while unloaded. | Type HR, High Resilience |
Density | Foam density is expressed in units of Lb/ft3 or Kg/m3. Density affects many foam characteristics including resistance to heat flow, durability, resilience, stiffness and strength, among others. | ≥ 35kg/m3 or 2.18 Lb/ft3 |
Hardness | Foam hardness characterizes the ability of the foam to “push back” and carry weight. It is expressed as an amount of force in Newton (N) required to indent a sample of the foam by a specific percentage of the original thickness using a small flat indenter. This measure is known as indentation force deflector (IFD). In Australia and Europe, hardness is characterized by 40% IFD. In the US stiffness is characterized at 25% IFD. The cover and bed linens used can affect IFD if they impede immersion and envelopment. | 40% IFD ≥ 130 N |
Characteristic | Explanation | High Spec |
Foam Type | Poly urethane foams vary in cell structure and density. High resilience foams (HR) has relatively uniform and dense cell structure that allows it to provide good support while loaded, and also maintains its shape while unloaded. | Type HR, High Resilience |
Density | Foam density is expressed in units of Lb/ft3 or Kg/m3. Density affects many foam characteristics including resistance to heat flow, durability, resilience, stiffness and strength, among others. | ≥ 35kg/m3 or 2.18 Lb/ft3 |
Hardness | Foam hardness characterizes the ability of the foam to “push back” and carry weight. It is expressed as an amount of force in Newton (N) required to indent a sample of the foam by a specific percentage of the original thickness using a small flat indenter. This measure is known as indentation force deflector (IFD). In Australia and Europe, hardness is characterized by 40% IFD. In the US stiffness is characterized at 25% IFD. The cover and bed linens used can affect IFD if they impede immersion and envelopment. | 40% IFD ≥ 130 N |
Invacare provides cost effective high specification foam solutions that can help prevent heel pressure injuries.
The Essential range offers a versatile range of entry level mattresses that offer a combination of comfort and pressure reduction.
Single layer high specification foam mattresses within the range are:
1.National Pressure Ulcer Advisory Panel, European Pressure Injury Advisory panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Emily Haesler (Ed.) EPUAP/NPIAP/PPPIA 2019
Essential Care
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1.National Pressure Ulcer Advisory Panel, European Pressure Injury Advisory panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Emily Haesler (Ed.) EPUAP/NPIAP/PPPIA 2019