High-tech mattresses used by the NHS are no better than cheaper alternatives at protecting against pressure sores, according to a study.
The devices, built into one in ten hospital beds, are allocated to patients at risk of pressure sores – mostly the elderly.
Whether they work compared to cheaper special foam mattresses had not been studied in depth until now.
In the largest study of its kind, researchers found the mattresses only improved outcomes for two per cent of patients.
High-tech mattresses used by the NHS are barely any better than cheaper alternatives at stopping against pressure sores, according to a study. Pictured, a typical high-tech mattress
The mattresses cost up to £4,400 each, according to a report by the Royal College of Nursing.
The team said further experiments are needed to work out if the mattresses are cost-effective.
Pressure sores are a major complication for bedridden patients in hospital and a huge burden on the NHS.
When pressure builds on soft tissue it causes a disruption in the blood supply, killing or damaging the skin leading to painful ulcers.
The NHS spends £3.8million every day treating pressure sores, according to NHS Improvement, who described them as a ‘concerning and avoidable harm’ in 2018.
The UK Government’s health regulator, the National Institute of Health and Care Excellence (NICE) requested a scientific trial to investigate the benefits of the high-tech mattresses.
Known as an alternating-pressure (AP) mattress, they contain air pockets that inflate and deflate to constantly change pressure points on the skin.
That study was led by researchers at the University of Leeds, and involved more than 200 patients at risk of developing pressure sores in NHS hospitals.
HOW MUCH DO THE MATTRESSES COST?
A report by the Royal College of Nursing reprinted in 2005 gave a detailed evaluation of how pressure-relieving devices are used in hospitals.
They said pressure sores are as common as four in ten hospital patients.
Figures from 2000-2001 show AP mattresses are significantly more expensive, costing between £870 and £4,470.
A standard hospital mattress costs between £39 and £62, and a specialist foam mattress costs between £97 and £422.
The researchers said that while specialist foam matresses can reduce the incidence of pressure ulcers in people at risk, compared to standard hospital mattresses, the evidence for AP mattresses is unclear.
The RCON wrote in Clinical Practice Guidelines: ‘AP mattresses would have to reduce the risk of pressure ulcer development by 23.5 per cent to remain cost neutral.’
Very few economic evaluations have been published before the report or since.
Patients, with a median age of 81, were monitored for two months or until discharge, whichever came sooner. They were then assessed by a nurse for a final time 30 days after discharge.
According to the findings, published in the journal EClinicalMedicine, 6.9 per cent of patients on the AP mattresses developed a pressure sore that was grade two or worse on the scale of one to four.
This is compared with 8.9 per cent on the widely used specialist foam mattresses, made from materials designed to cradle the patient to reduce pressure on the skin and more expensive than standard mattresses.
This would mean only two per cent, or one in every 50 patients, allocated to an AP mattress instead of a specialist foam mattress would benefit.
The median length of time it took for the ulcers to develop for the patients on an AP mattress was 18 days compared to 12 days for those on the specialist foam mattress.
The paper also noted that the overall number of patients who developed pressure sores during the study was smaller than expected.
Study author Professor Jane Nixon, said: ‘There has not been any evaluation of the effectiveness of one type of mattress over another.
‘Some patients find the air mattress unsettling. They are kept awake by the noise of the pump, feel unsafe because the mattress is moving, or just find them uncomfortable.
‘Rehabilitating patients also complain that they can’t move around themselves or get in and out of bed – and that exacerbates already limited mobility.’
Although the beds are more expensive, the patients who slept in them had a slightly shorter stay in hospital, which reduced overall cost of care.
Therefore, it’s difficult to say what savings could be made on the NHS until research digs deeper.
The study found patients who benefitted most from the AP mattresses were those who were completely immobile, confused, had nutritional deficits and very red skin on a pressure area.
Professor Nixon said: ‘Staff should be free to exercise clinical discretion in provision of either mattress, informed by patient preference.’
A spokesperson for NICE said: ‘Devices, such as specialist foam mattresses and alternating-pressure mattresses, may prevent pressure sores and ulcers by reducing or redistributing pressure, friction or shearing forces.
‘However, the cost of pressure redistributing devices can vary significantly and there is limited evidence on whether more sophisticated devices – such as alternating-pressure devices – provide any additional benefit compared to more basic ones.
‘We welcome and will consider all new evidence when it comes to updating our guidelines.’