[1] Eucomed, The burden of wounds on EU healthcare systems, EWMA 2009. [2] EPUAP, Patient safety across Europe: the perspective of pressure ulcers, 2017. [3] European Commission, The costs of unsafe care and the cost effectiveness of patient safety programmes in healthcare systems in the EU Member, 2016. [4] OECD, The Economics of Patient Safety: Strengthening a value-based approach to reducing patient harm at national level, 2017. [5] NPUAP, EPUAP, PPPIA International Pressure Ulcer Guidelines, 2014. [6] McInnes, Jammali-Blasi, Bell-Syer, Dumville, Cullum, Support surfaces for pressure ulcer prevention, Cochrane database of systematic reviews, 2008.

While pressure ulcers are common adverse events in care facilities, affecting as many as 20% of all patients, in particular among the most vulnerable [1], they  are considered as a great burden in both the quality of life, by exerting unnecessary harm, and in the healthcare budget. [2]

The cost of prevention being 3.6 less than that of treatment, the prevention of pressure ulcers is a critical cost issue with one hospital week reduction resulting in potential savings of up to 9,000 €, 50% to 80% of them being facility acquired. [3]

Globally, the cost of injury due to pressure ulcers may amount to as much as 4% of a country’s annual health expenditures. [4]

Arexan provides support surfaces that meet the individual needs and help achieve a cost-effective and comprehensive pressure ulcer prevention on the basis of clinical factors, including immobility and inactivity, need for microclimate control and shear reduction, individual’s size and weight, risk for development of pressure ulcers. [5]

Across the full range of Arexan products, maximum interface pressure redistribution and reduction of shear, low pressure therapy and limited pressure amplitudes, optimum support surface design and careful selection of materials maintain the best possible tissue viability in order to increase pressure ulcer prevention. [6]

-> View products for pressure ulcer prevention :

[1] Eucomed, The burden of wounds on EU healthcare systems, EWMA 2009. [2] NPUAP, EPUAP, PPPIA International Pressure Ulcer Guidelines, 2014.

Pressure ulcer prevalence is 2-4 in 1,000 individuals and affects approximately 2 million people in Europe with 20% to 25% of beds are occupied by pressure ulcer patients. [1]

Average time to pressure ulcer healing is 224 days.

When a pressure ulcer fails to heal despite appropriate and comprehensive care, or when deep tissue injury is suspected, the selection of a support surface that has enhanced pressure redistribution, shear reduction, and microclimate control is one of several strategies to consider. [2]

Arexan portfolio provides a specifically tiered care environment meeting various treatment needs with respect to pressure, shear, microclimate, number, severity and location of existing pressure ulcers or off-loading and reperfusion of ischemic and injured tissue.

The unique air distribution system of the CliniPro™ air mattress allows zero pressure deflation of any air cells individually and specifically underneath high risk areas and/or existing pressure ulcers. [2]

-> View products for pressure ulcer treatment.

[1] NPUAP, EPUAP, PPPIA International Pressure Ulcer Guidelines, 2014. [2] Cadue, Karolewicz, Tardy, Barrault, Robert, Pourrat, Prevention of hell pressure sores with a foam body-support device, 2008. [3] Donnelly, Winder, Kernohan, Stevenson, An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture, 2011. [4] Romero, Cornejo, Galvez, Llanos, Tobar, Berasain, Arellano, Larrondo, Castro, Extended prone positioning ventilation in severe acute respiratory distress syndrome: a pilot feasibility study, 2009. [5] Huber et al., Popliteal vein compression under general anesthesia, 2009.

Repositioning and early mobilisation help prevent and treat pressure ulcers by reducing the duration and magnitude of pressure over vulnerable areas. In addition, early mobilisation and repositioning contribute to comfort, hygiene, dignity and functional ability. [1]

An important point of interest in clinical practice is the avoidance of high pressure under the heel posterior prominence and the Achilles tendon, even when a pressure redistribution surface is used. [2]

Selectively deflatable air cells of the CliniPro™ air mattress off-load pressure points underneath the heels (“floating heels” concept) [1, 3] and underneath at–risk areas while in the supine position as well as on the face and body while in the prone position.

The prone position therapy is applied to improve pulmonary gas exchange and to reduce the rate of ventilator-associated pneumonia in critically ill individuals. [4]

The max firm mode of CliniPro™ also helps patient transfer and repositioning while the seating mode increases air pressure within cells to facilitate seating.

The CliniForm™ viscoelastic foam mattress and the CliniPremium™ hybrid mattress have the capability to slightly flex the knee (5°) and thus to prevent popliteal vein compression and increased risk of deep vein thrombosis. [5] They both feature firm edges to assist in auto-centring and to improve stability during bed ingress or egress.

-> View products for early mobilisation and repositioning: CliniPro™CliniForm™ and CliniPremium™.

[1] Regan, Teasell, Keast, Aubut, Foulon, Mehta, Spinal cord injury rehabilitation evidence, 2010. [2] Rosenthal, Felton, Nastasi, Naliboff, Harker, Navach, Healing of advanced pressure ulcers by a generic total contact seat: 2 randomized comparisons with low air loss bed treatments, 2003. [3] NPUAP, EPUAP, PPPIA International Pressure Ulcer Guidelines, 2014.

While repositioning in a chair is important to reducing the hazards of immobility, facilitating eating and breathing, and promoting rehabilitation and overall health, the skin and soft tissues bear intense pressure and shear, particularly in the area of the coccyx, the sacrum and the ischia. [1]

Consequently, the risks and benefits of supported sitting are always weighed against physical and emotional health. [2]

Complex evaluation by a seating specialist is often required to prescribe appropriate positioning techniques and sitting time schedules. [3]

On the other hand, a safe sitting and repositioning approach implies multiple benefits: respiratory, digestive, urological, physiological and sociopsychological, to mention only a few.

For individuals sitting in a chair whose mobility is reduced, the CliniMove™ dynamic air seat cushion provides autonomy, adequate seated posture, effective pressure redistribution and stability to prevent forward sliding. [3]

Thus, the benefits of pressure redirection and off-loading are not outweighed by the potential for instability and shear.

-> View products for safe sitting and repositioning.

[1] Angelidis, Lidman, Sjöberg, Thorfinn, Pressure alone increases tissue temperature, 2009. [2] Wounds International, International Review, Pressure ulcer prevention: pressure, shear and microclimate in context, 2010. [3] NPUAP, EPUAP, PPPIA International Pressure Ulcer Guidelines, 2014.

Heat increases the metabolic rate, induces sweating and decreases the tolerance of the tissue for pressure. [1]

Any surface, depending on its nature and on its type of cover, that is in contact with the skin has the potential to affect the microclimate. [2]

Arexan provides specialised surfaces that permit air exchange and alter the skin microclimate by changing the rate of evaporation of moisture and the rate of heat dissipation from the skin. [3]

The use of breathable materials in Arexan products, combined with air circulation between cells and thermal dissipation, reduce the effects of heat accumulation and of skin maceration in the CliniPro™ air mattress or in the CliniMove™ dynamic air seat cushion, whereas the foam blocks and open-cell structure of the memory foam in the CliniPremium™ hybrid mattress or in the CliniForm™ viscoelastic foam mattress also assist in skin microclimate.

-> View products for skin maceration reduction : CliniPro™, CliniMove™, CliniPremium™ and CliniForm™.

[1] Dallam, Smyth, Jackson, Krinsky, O’Dell, Rooney, Badillo, Amella, Ferrara, Freeman, Pressure ulcer pain: assessment and quantification, 1995. [2] Szor, Bourguignon, Description of pressure ulcer pain at rest and at dressing change, 1999. [3] Bale, Dealey, Defloor, Hopkins, Worboys, The experience of living with a pressure ulcer, 2006. [4] Spilsbury, Nelson, Cullum, Iglesias, Nixon, Mason, Pressure ulcers and their treatment and effects on quality of life, 2007. [5] Alvarez, Meehan, Ennis, Thomas, Ferris, Kennedy, Rogers, Bradley, Baker, Fernandez-Obregon, Rodeheaver Chronic wounds: palliative management for the frail population, 2002. [6] Peterson, Schwab, McCutcheon, van Oostrom, Gravenstein, Caruso, Effects of elevating the head of bed in volunteers, 2008. [7] Rithalia, Pressure sores: which foam mattress and why? 1996. [8] NPUAP, EPUAP, PPPIA International Pressure Ulcer Guidelines, 2014.

Pressure ulcers are permanently painful, even at rest. [1, 2, 3, 4]

The management of pain involves repositioning, including for individuals receiving palliative care, and, in the case of chronic pressure ulcer, input from a range of healthcare professionals. [5]

Arexan places a lot of emphasis on the individual’s well-being, dignity and pain management.

The low pressure therapy supplied by the CliniPro™ air mattress enhances comfort by reducing interface pressure and by using low friction materials. When the profiling bed is articulated, its specific hinged design using bellows prevents the skin and the support surface from being excessively dragged and torn one across the other. Painful friction and shear are thereby reduced. [6]

The castellated memory foam construction and the underneath cuts in the CliniPremium™ hybrid mattress and in the CliniForm™ viscoelastic foam mattress also increase comfort and limit the pain resulting from shear and friction. [7]

The CliniMove™ dynamic air seat cushion helps increase comfort and prevent the implications of postural disorders, including painful pressure points. [8]

-> View products for pain relief : CliniPro™CliniMove™CliniPremium™ and CliniForm™.