assessment of support surfaces (static & mixed) for neonates

ASSESSMENT OF SUPPORT SURFACES (STATIC & MIXED)

FOR NEONATESM. M. Sánchez-Lorente1; P. García-Molina2-3; C. Vergara-Hernández2;

E. Sanchis-Sánchez2; J. Martos-Torres2; A. Álvarez-Ordiales4; & E. Balaguer-López2-3

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1. Conselleria de Sanitat, Valencia (SPA).

2. University of Valencia, Valencia (SPA).

3. Hospital Clínico Universitario, Valencia (SPA).

4. Hospital Universitari i Politècnic “La Fe”, Valencia (SPA).

Presenting author: Mr. Pablo García-Molina

Background

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Existence of several neonatal support surfaces

Lack of evaluation

Interface pressure & pressure redistribution Efficacy in the prevention or treatment of PU

however…

regarding…

Aim

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• To assess the interface pressure and pressure redistribution of five devices of constant low pressure (static and mixed support surfaces).

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Methods

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Study design• Laboratory study with repeated measures design.

Sample• Eight neonatal simulation dummies with different characteristics

regarding head circumference, weight and height.

Methods

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Support devicesVisc-T Visc-White Visc-Gray Visc-Blue Pol-3D

Structure Viscoelastic“T” units

ViscoelasticBlock

ViscoelasticBlock

ViscoelasticBlock

Polyester filaments

Layers 1 2 2 2 1

Density (Kg/m3) 50 50/50 50/50 40 NA

Hardness (Kpa) 1.6 1.01/5 1.01/3.6 2.5 NA

Compression factor 2 2/2 2/2 - NA

Methods

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Variables• Mean pressure (mmHg).• Maximum pressure (mmHg).• Mean pressure in head region (mmHg).• Area of contact (cm2).

Equipment• XSENSOR X3 PX100:40.40.002 device.

Procedure• See: E-poster no. 50006.

Methods

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Statistical analysis• Descriptive statistics.

• Due to a small sample size, a non-parametric test (Friedman test) was carried out to assess differences among groups. If a significant difference was found, post hoc comparisons among groups were performed using the Wilcoxon-Nemenyi-McDonald-Thompson test.

• The analysis was carried out by means of the R environment (The R Foundation for Statistical Computing).

• Data set and code employed for the analysis can be found at www.figshare.com (*).*http://dx.doi.org/10.6084/m9.figshare.977866

Results

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Visc-T Visc-White Visc-Gray Visc-Blue Pol-3D

Mean pres., x̅ (SD) 16.26 (2.77) 17.51 (3.32) 18.12 (3.32) 17.11 (3.07) 17.82 (2.58)

Max. pres., x̅ (SD) 24.58 (7.39) 26.79 (8.88) 28.15 (7.91) 25.49 (7.55) 27.53 (6.12)

Head pres., x̅ (SD) 17.25 (3.37) 18.58 (4.17) 19.53 (4.45) 17.95 (3.71) 18.7 (2.92)

Area, x̅ (SD) 19.29 (11.29) 22.11 (12.13) 22 (9.75) 23.52 (13.21) 29.23 (12.46)

Lowest values!

Highest values!

Results

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Friedman test χ2 Df P-value

Mean pres., x̅ (SD) 14,3 4 0,006

Max. pres., x̅ (SD) 11,2 4 0,02

Head pres., x̅ (SD) 8,7 4 0,07

Area, x̅ (SD) 18,51 4 < 0,001

Results

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Row-Column Visc-T Visc-White Visc-Gray Visc-Blue Pol-3D

Visc-T - - - - -

Visc-White 0,24 - - - -

Visc-Gray 0,005 0,61 - - -

Visc-Blue 0,71 0,93 0,17 - -

Pol-3D 0,056 0,97 0,93 0,61 -

Post hoc analysis: mean pressure (p-value)

Results

Results

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Row-Column Visc-T Visc-White Visc-Gray Visc-Blue Pol-3D

Visc-T - - - - -

Visc-White 0,32 - - - -

Visc-Gray 0,014 0,71 - - -

Visc-Blue 0,88 0,88 0,17 - -

Pol-3D 0,32 1 0,71 0,88 -

Post hoc analysis: maximum pressure (p-value)

Results

Results

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Row-Column Visc-T Visc-White Visc-Gray Visc-Blue Pol-3D

Visc-T - - - - -

Visc-White 0,71 - - - -

Visc-Gray 0,95 0,98 - - -

Visc-Blue 0,27 0,95 0,71 - -

Pol-3D < 0,001 0,053 0,01 0,27 -

Post hoc analysis: pressure area (p-value)

Results

Conclusion

The “T” device presents the best values of pressure relief.

The polyester fiber device presents the best values of pressure redistribution.

Adding an upper layer of polyester fiber to the “T” device could result in a better support surface.

Next step: studying the properties of the new support surface in healthy subjects under clinical conditions.