Salisbury November ‘95 TM Mistral Standard Recommended for general ward usage. A quality mattre ss wit h pro Modular cut foam improves pressure reduction. v en p ress “Pressure redistribution over the bony prominences ure r elief of the body is achieved extremely well in the design . of some laminated and modular cut mattresses. The ‘hygrowave’ principle. Unique new way of When subjected to localised high pressure areas, ventilating mattress core: horizontal tunnels individual squares collapse, thereby increasing through the foam get rid of the moisture that support area and lowering interface pressure.” causes both premature foam fatigue and Wet Compression Set. This gives Mistral longer S. Rithalia, Nursing Times, Oct 20, Vol 89 No 42, 1993 active life. “Mistral Standard gave significantly better pressure relief than the Transfoam mattress on all three anatomical locations. Although Mistral gave lower mean pressures than the Softform, it was only on the trochanter that the Mistral was significantly better. The results shown here are interesting in that in the Medical Devices Agency report PSl it was shown that Transfoam gave the best pressure relief of any of the mattresses tested. The work undertaken in this trial is the first time since that report that the authors have made a comparison of a range of similar products. This has shown that although the Transfoam is significantly better than the Standard King's Fund mattress, it is not as good as the Softform and in particular the Mistral, which in this evaluation gave the best pressure reduction.” I.D. Swain, D. Norman - November 1995. TM Mistral Big M The new ‘M’ profile helps redistribute pressure away from bony prominences towards the flanks. The firm foam wedges running along the sides of the mattress increase the lateral area of contact between body and mattress. Mistral is ideal for general ward usage: it needs no extra overlay for pressure sore prevention, thereby it avoids the problems some overlays have with laundering. Mistral fits any King’s Fund bed. “Recent tests carried out by the Orthopaedic Mechanics Research at the University of Salford found some improvements with the Mistral compared with other replacement mattresses previously tested. Skin interface pressures at the trochanter were somewhat better with Mistral, whilst those at the sacrum were within the range of three other good mattresses.” Loose fitting waterproof/vapour permeable cover with printed 4 Way turning schedule. Loose fitting two-way stretch cover optimises pressure redistribution. Waterproof yet vapour permeable – to avoid heat build up. Code: BFM4 Medium resilience central foam. Corrugated tunnels disperse heat and perspiration sideways by hygrowave principle. Soft outer foam with chequer board cuts: squares collapse under high pressure ensuring neighbouring squares provide support. Mistral Standard damp Firm edges provide patient stability. Mistral Standard damp Lifespan “The foam density is the most appropriate indication of its quality. A high density foam is more expensive but it retains support properties for longer. Mistral Big M is the heaviest mattress in its category.” NHS 150 VAPERM TRANSFOAM STM5 Mistral Standard Mistral Big M Journal of Tissue Viability October ‘95 “In conclusion it is felt that the Mistral is at least as good at reducing interface pressure as any replacement mattress tested. It gave marked pressure reduction and did not suffer from the foam fatigue problems that a number of other cut rather than moulded foam mattresses did.” D. Norman, C. Dunford, I. Swain. Percentage Pressure Reductions 9.5 kgs 15.0 kgs 8.5 kgs 9.5 kgs 15.0 kgs 18.0 kgs (Compared with NHS contract mattress) Percentage Pressure Reductions (Compared with NHS contract mattress) (full details available on application) S Rithalia May 1994 Mistral Big M perspiration More uniform enveloping pressure with Mistral Big M reduces vertical shear in tissue. Firm Soft Firm Firm Medium Soft Firm photograph exaggerates degree of dip Body heat helps moisture in the centre of the foam to escape from Mistral’s sides. E xc e ll e tp re s Conner and Clack (1993) evaluated this shear force in several mattresses using CT scans. “The presence of vertical shear or shear forces decreases the amount of pressure required to occlude the capillaries and cause pressure ulcers. Therefore a support surface that decreases vertical shearing of tissue should reduce the occurrence of pressure ulcer formation.” (3) n Horizontal tunnels in Mistral allow moisture to escape from the side of the mattress. Avoids need for mesh King’s Fund bed base. 6” depth avoids excess pressure when semi recumbent. Firm orange side panels stop patient rolling out of bed. Uniform enveloping pressure has been found to significantly increase the duration of the applied pressure required to traumatise soft tissue in animals. (Hussain 1953) (1) Bennett and Lee (1988) attribute this delaying of tissue traumatisation to the reduction of vertical shearing within the tissue. (2) Code: BFM3 Mean Pressures BodyFoam Mistral is cleaned by wiping with soap and water. Zips allow inspection of foam. Mistral can be used either way up allowing 4 way monthly rotation for maximum life expectancy. sur e re li e f o n all Mistra products* l (1) Hussain T. Pathology Bacteriology, 66,347-363 (2) Bennett, L. & Lee, B.Y. Vertical shear existence in animal pressure threshold experiments. Decubitus 1, 18-24 (3) Conner, L.M. & Clack In vivo (C.T. scan) comparison of vertical shear in human tissue caused by various support surfaces. Decubitus Vol 6 No. 2 p20-28. mmHg ( Swain & Norman Nov 95) Salford 94 Evidence that the new ‘M’ profile reduces the risk of pressure sores: Salisbury 94 Hygrowave Principle: Pumping action as patient is moved, draws fresh air into foam tunnels. By keeping the foam dry one prevents ‘Wet Compression Set’ foam fatigue and lessens bacterial growth. Comparative Interface Pressures in Mattresses mmHg Key Mistral Big M STM 5 Mistral Standard Vaperm Softform Polyfloat Transfoam NHS Standard Salisbury 95 Waterproof /Vapour permeable covers normally cause a moisture build-up in core of mattress. This damp can lead to premature foam fatigue and inadequate pressure relief. But... Salisbury 94 Normal solid foam mattress generates unidirectional force causing shear as tissue cups around the bone. “Both the Mistral Standard and the New Mistral Big M are being clinically evaluated by the Department of Medical Physics and Biomedical Engineering at Odstock Hospital, Salisbury. The initial results of these tests show that both Mistral mattresses performed well and are encouraging (see below). The methods used are identical to those used in analysing a number of popular foam mattresses and published by the NHS' Medical Devices Directorate publication PSl in August 1993.” I.D. Swain, D. Norman, C. Dunford - June 1995 Salford ‘94 Four way monthly turning schedule gives long mattress life. Old NHS Specification Salisbury June ‘94 1. Modular cut foam Membrane tension on the upper surface of the foam is broken: cuts in the foam ensure independent pressure response to the weight directly above it rather than to the average weight in the area. 2. “It has been clearly shown that such cuts on their own will dramatically reduce pressures for heels, whereas the flatter areas of the body require deep form designing to reduce pressures.” Shaw B.H., BRADU Report, Roehampton. Why Bo Reducing Vertical Shear Recent studies by Conner & Clack (3) using computerised tomographic imaging have found that mattresses must not only avoid high peak skin pressures but also sudden contrasts in pressure between adjacent areas of tissue. Avoiding such ‘vertical shear’ is critical in preventing the capillary occlusion that causes pressure sores. BodyFoam achieves this: both the outer foam cubes and the inner crennellated foam naturally point their own supporting forces towards the source of pressure on the bone underneath. As a result, pressure is borne over a 30% wider surface area, giving lower peak pressures and more even and all-round support. dyF oam Modular cut foam ensures independent pressure redistribution. Similar idea to expensive pocketed spring domestic mattress. products 3. Water 4. Waterproof yet vapour permeable cover. Normal perspiration rate is approx. 240 gms per m2 of body surface, but in a fever this can rise to 1000gms over 24 hours. This upper surface blue fabric allows proper perspiration and prevents the skin becoming hot and clammy. Elasticity of fabric prevents ridges and hammocking effects of normal mattresses. It has a soft and supple feel with a low coefficient of friction to reduce skin shearing stress. Blood Designed to go on top of normal hospital or domestic mattress. An inexpensive but effective way of preventing pressure sores with low risk patients, gives good pressure redistribution. Suitable where laundry causes problems for other overlays. Can be rotated 2 ways for longer life. Less prone to static electricity build up. King’s Fund mattresses are now often covered with new vapour permeable yet waterproof covers: these allow perspiration to enter the foam but provide no easy escape for the moisture. Under such warm and moist conditions foam tends to lose its pressure redistributing capacity and makes pressure sores more likely. BodyFoam uses the latest bio-medical engineering principles and materials to both ventilate foam and provide more efficient pressure redistribution. Barrier Technology fabric allows ventilating air to blow both ways through yet repels water, blood, oil, alcohol etc. Recent studies have shown the prevalence of staph, aureus, Escerichia coli, klebsiella spp, Enterococci etc. in ventilated normal hospital mattresses. (S. Loomes, Nursing Times, 7/12/88) Conway found in a survey that a large number of mattresses interiors were damp; of these many had growths of pseudomonas. (N. Times 14/3/90) Oil are better by design Damp Damp Flatter outline Overlay Lack of lateral support causes stretch and tissue distortion under Ischium Adequate capillary flow Pressure concentrated near bony prominence. Normal foam with Wet Compression Set. Patient can feel hard base. Each cube points its supporting force towards the bone. Pressure is therefore borne over a 30% wider surface area, reducing pressure under bony prominences. Code: BFM21 Size: 73” x 34” x 3.75” The Government was over-hasty recently in demanding the introduction of fire resistant furniture foams before the technology was ready; this has contributed to an increased incidence of pressure sores. The new foams tended to early ‘Wet Compression Set’ and premature foam fatigue, especially when lain on as intensively as in hospitals. New materials used Blocked capillary flow BodyFoam Wet Compression Set A B Normal Foam Foam surface under hammock-like tension Ischaemia A B BodyFoam surface tension broken Modular Cushion: The BodyFoam Cushion is designed for those at risk of pressure sores whilst sitting. It has the excellent pressure redistribution characteristics of modular foam held within the Nonslip base with zip set inboard to reduce risk of contamination. Code: BFM26a/16ax Size: 18” x 16” x 4”Code: BFM27a/17ax Size: 18” x 16” x 2.5”(Low profile) Fire Retardance: All BodyFoam products comprise CMHR Foam conforming to NHS standard of BS 6807 ignition source crib 5. No CFC’s are used in the foam’s construction. BodyFoam products require minimal maintenance. *Guarantee details available on application. We reserve the right to change specification without notice. Patent application no. 941052.2 & 9326576.7. Mistral and BodyFoam are registered trademarks. Lateral support more perpendicular to the natural body shape reduces tissue distortion under ischium Trolley Big M Current opinion now realises what a large number of patients are waiting on transfer trolleys at A&E or X-Ray. The BodyFoam Trolley Pad gives excellent weight redistribution for preventing pressure sores. Ventilated chequer board cut foam. Tough enough to withstand the heavy demands of an A&E department. Suitable for X-Ray purposes. Can be rotated to prolong useable life. Outer cover can either be sponged or removed for laundering. Code: BFM5 Size 72” x 22” x 4” BodyFoam Overlay Vapour permeable cover is tear proof. Underneath is covered with non-slip fabric to prevent rucking. Inboard set zip underneath allows inspection with less risk of contamination. Code: BFM21/11 BodyFoam Cushion fits standard wheelchair. Fabric is waterproof, vapour permeable and robust. Zip opening allows foam to be trimmed for smaller chairs. BodyFoam Overlay with cover: Easily rolled up for use in the community. If hip area of normal foam has some Wet Compression Set, then it fails to properly redistribute pressure away from bony prominences. 39-41 North Road, Omnibus Industrial Estate, London N7 9DP Tel: 020 7609 8761 Fax: 020 7607 1062 Email: [email protected] www.firsttechnicare.co.uk Other products in the First Technicare range of pressure area care products: • BodyPillo • Aquavent • Flexicell • • Tri-Pos3 • BodyPillo Cushions and accessories • M means comfort
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