Forté Sovereign S4 Ventraflow 150kg High Care Medical Mattress

DUAL IMMERSION

Traditional medical mattresses such as multi-layered memory foam designs or profile designs can struggle to effectively provide Immersion together with Shear and Friction Mitigation without compromising on microclimate and ease of repositioning for offloading. This exposes vulnerable patients to greater risks of pressure injury incidence as a result of poor microclimate and difficulty in relation to repositioning leading to pain and suffering for the patient and considerable nursing cost and resource to manage. This is why dual immersion technology used on the Sovereign range was developed. This consists of an Airoform Immersion Foam interface and an engineered multi-zoned modulated 2nd layer of foam such as Ventraflow.

Both the Interface and modulated layers work together to create a dynamic region that absorbs harmful shear and friction forces, protecting vulnerable skin. Postural support of the mattress is increased, yet unparalleled immersion is created with the softness of the interface layer and deflection of the profiled region, particularly important for bony prominences.

VENTRAFLOW® FOAM TECHNOLOGY

With a marketing leading CNC machine, Forté has the in-house capacity to develop and produce engineered foams that can be used to offer unique features and functions within a mattress.

Each mattress within the Sovereign High Care range includes an engineered foam layer to provide deep immersion, tailored envelopment and enhanced micro-climate.

The engineered foam is often referred to as ‘castellated’ or ‘modulated’, whereby foam is cut into unique shapes – typically small cells in a grid-like pattern.

Forté engineered foams are zoned to provide optimal envelopment alongside stability where it is needed for critical body regions. i.e. larger cells in the sacrum, smaller cells in the Heel region, medium-sized cells for the scapular region.

The secondary immersion layer of the Sovereign S4 mattress has an engineered foam technology called Ventraflow. Distinctive to Ventraflow is the shape of each castellation – in almost a key-whole shape.

The Ventraflow design has several unique functions:

• creates lateral and longitudinal air channels throughout the mattress which facilitate free movement of air throughout the foam core, improving internal micro-climate conditions and reducing risk of ‘hot-spots’.
• enhances envelopment which provides the support surface with maximum surface area for the individual, providing optimal pressure redistribution.
• each cell has a 180° pivot point which increases lateral flexibility and lessens internal tension throughout the surface. Reducing tension also increases the longevity of the mattress.

MICRO-CLIMATE

Adverse Skin Micro-climate conditions (temperature, humidity and airflow next to the skin surface) can significantly compromise skin integrity and weaken the skin leaving it more vulnerable to its environment. The build-up of moisture and/or heat typically leads to sweating therefore overhydration of this skin. Overhydration and excessive moisture softens the skin and connective tissue which leads to maceration and the breaking down of the elasticity of the skin. This weakening of the skin greatly increases the susceptibility to damage by environmental factors. In addition to this, sweating and overhydration removes natural oils from the skin, which are needed to lubricate and protect the skin.

As such, micro-climate is a risk factor that must be managed to prevent pressure injury occurrence on an at-risk patient, and a support surface is an important tool in managing micro-climate.

Premium foams selected to be used in the Sovereign mattresses have a high ‘hot spot’ rating and prevent excessive build-up of heat. Engineered foams such as Ventraflow and Airform Breathe perforations allow air to flow freely throughout the mattress.

SLOPED HEEL REGION

The heels are one of the most susceptible sites for pressure injuries, due to factors such as heel anatomy, disease burden, comorbid conditions, and the aging process. Heel Pressure Injuries (HPI) has been found to be one of the most prevalent sites for pressure injuries to occur, with a study in Europe identifying that 38.5% of stage IV pressure injuries were found at the heels. Pressure upon the Calcaneus can be reduced and redistributed by elevating the lower leg and calf 2. There are three primary designs of heel elevation discussed in this article: the Heel Slope (Surface Modification), Heel elevator (external device) and the elevated Heel slope (Hybrid Model).

Though essential in the clinical setting, and particularly with those that are medically complex, elevating the heel and redistributing the pressure towards the calf is a difficult task. There are several implementation considerations such as ensuring the knee is at a slight flexion (5-10°) while the heel is elevated can help avoid vein compression and increased risk of deep vein thrombosis (DVT), adapting a plan of care to the individuals’ needs and avoiding causing harm to other ‘at-risk’ areas of the body (such as the Achilles tendon).

With patients on a traditional support surface with a completely horizontal fascia (no heel slope) and no additional aid from an external heel device, pressure injuries upon the heel region are more common than with heels that have elevated heels, with differences being from an 8% to 54.2% incidence on heel injury respectively.

Forté has conducted studies to illustrate the basic principles of heel offloading using a Tekscan Pressure Measurement System which utilises a thin and flexible sensor. We use this system to measure the pressure distribution of a human body on the surface of our mattresses with minimal interference.

The image demonstrates the pressure distribution of the NPIAP/RESNA 50th Percentile male mannequin (81.2kg, 1775mm tall) over a 6-hour period, shown in a variety of heel positions. The Support surface used is a Single Sovereign S3 High-Care Mattress.

Such a decrease in pressure, therefore, signifies the importance of heel offloading, and indirectly the importance of utilising a support surface modified with a heel slope as a means of offloading such pressure and reducing risk of an HPI. Furthermore, the heel slope was identified to encourage a slight bend in the knee of approximately 8-10°, in comparison to a flat surface which evidence has suggested reduces popliteal vein compression.