Article 2025 Jun 24

Guide to Choose the Best Pressure Relief Mattress

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Choosing the appropriate support surface is essential for preventing pressure injuries. Bedridden individuals who spend long hours in bed or have difficulty changing positions are at risk of developing pressure sores/injuries. The right pressure relief mattress plays a vital role in supporting recovery and enhancing overall well-being throughout the healing journey. 
What is a Pressure Relief Mattress ? 
A pressure relief mattress is a specialized support surface designed to help reduce the risk of pressure injuries (PIs) in individuals who spend extended periods in bed. These mattresses work by redistributing pressure, minimizing friction and shear, and managing the microclimate to protect vulnerable areas such as the sacrum, hips, and heels. 

Why is a Pressure Relief Mattress Important?

According to the 2025 EPUAP/NPIAP/PPPIA Clinical Practice Guideline, full-body support surfaces include specialized mattresses, overlays, and integrated systems that are designed to redistribute pressure, reduce friction and shear, and aid in microclimate management—all critical factors in pressure injury prevention. 

A pressure relief mattress is essential because individuals at risk of pressure injuries have varying clinical needs, preferences, and care goals. Therefore, providers of support surfaces should ensure access to a range of mattress types with different performance characteristics and design features to meet diverse patient needs. Choosing the right mattress not only enhances patient comfort and promotes wound healing but also reduces the burden on caregivers, ultimately improving overall care quality. 

What are the Benefits of Using a Pressure Relief Mattress? 
Pressure relief mattresses support bedridden, elderly, post-surgical, and immobile patients by redistributing pressure, improving circulation, and preventing bedsores. These mattresses reduce the risk of pressure injuries (PIs) by minimizing friction, shear forces, and excessive moisture buildup, all of which contribute to skin breakdown. 

  • Key Benefits of a Pressure Relief Mattress: 
- Prevents pressure sores/ injuries: Evenly distributes body weight to protect high-risk areas like the sacrum, hips, and heels. 
- Improves Circulation: Enhances oxygen flow to tissues, reducing the risk of pressure ulcers and aiding recovery. 
- Controls Microclimate: Breathable materials regulate heat and moisture, lowering infection risks. 

Who Needs Pressure Relief Mattress?
-Bedridden individuals who spend prolonged hours in bed. 
-Elderly patients with limited mobility, at risk of developing pressure sores. 
-Post-surgical patients who need a comfortable and supportive surface. 
-Individuals with mobility impairments who struggle to change positions independently. 

Types of Pressure Relieving Mattresses 
According to the 2025 EPUAP/NPIAP/PPPIA Clinical Practice Guideline, pressure relief mattress are categorized as active or reactive. 

Type Definition  Design features  
Active Support Surface  A powered support surface that can change its pressure redistribution properties independent of applied load.  Alternating pressure support surface 
Reactive Support Surface  A powered or non-powered support surface that changes its pressure redistribution properties only in response to an applied load.  Pressure redistribution foam, static air mattresses, low air loss support surfaces 
Active support surfaces  
These surfaces are designed for high-risk patients, particularly when manual repositioning is not feasible. Additionally, support surfaces can be classified based on their use, including integrated bed systems, mattresses, mattress overlays, and seat cushions. When selecting a support surface, it is essential to consider the patient’s risk factors, ease of use, and the impact on caregiving procedures.

Reactive Support Surfaces 
Common types of reactive support surfaces include: 
  1. Foam: Composed of foams with varying densities, but may degrade over time, leading to "bottoming out," where the patient sinks through to the base layer. 
  2. Air or Gel-Filled Compartments: Utilize air or gel-filled sections or bladders to redistribute pressure. 
  3. Low Air Loss Support Surfaces: Allow air to escape through small perforations, helping to manage skin moisture levels. 
  4. Air-Fluidized Support Surfaces: Contain sand-like particles that behave like a liquid through forced air circulation. 

How to Choose the Best Pressure Relief Mattress? 
Choosing the right pressure relief mattress is essential for individuals at risk of pressure injuries (PIs). According to the 2025 EPUAP/NPIAP/PPPIA Clinical Practice Guideline, support surfaces are categorized as reactive or active. Understanding patient needs and risk levels is crucial when selecting an appropriate mattress.

Key Considerations for Mattress Selection 

1.     Pressure Injury Risk Assessment
Evaluate the patient’s risk level for developing pressure injuries. Higher-risk individuals require advanced pressure redistribution surfaces to prevent complications.

2.     Choosing the Right Mattress Type
For patients at risk of pressure injuries, pressure redistribution foam mattresses (reactive) are typically the first choice. However, if pressure injuries persist or if the patient is at high risk (e.g., individuals in critical care), upgrading to alternating pressure air mattresses (active), reactive air mattresses, or air-fluidized beds should be considered. According to 2025 clinical guidelines, where available, alternating pressure air surfaces may offer greater clinical and cost-effectiveness for high-risk individuals, especially those who require less frequent repositioning, such as patients in palliative or end-of-life care, where comfort is the primary concern.

3.     Microclimate Management
Support surfaces should help regulate moisture and temperature to prevent skin breakdown. Low air loss technology is beneficial for maintaining skin integrity.

4.     Customized Fit & Standardized Testing
Choose a mattress that matches the patient’s weight, height, and body shape. Use performance-based test data to ensure effectiveness.

5.     Special Populations & Institutional Guidelines
Consider neonates, pediatric patients, and palliative care patients, who may require tailored support surfaces. Always follow institutional protocols and manufacturer guidelines for proper use and maintenance.

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