Use of a Low Air Loss/ Alternating Pressure Support Surface in the Management of Skin Flaps and Grafts

When pressure ulcers fail to respond to advanced methods of topical treatment and continue to decline with more severe tissue damage evident, often a plastic surgeon is consulted to consider the option of a skin flap or skin graft to accomplish wound closure.  Once the surgery has been completed an intensive and extended program of care ensues.  In the past the bed of choice for the recovery process, often lasting at least six or more weeks, was an air fluidized bed.  The use of this type of bed, while advantageous to the patient in the healing process, came with a list of disadvantages and inconveniences for both the patient and the nursing staff.  Patient comfort was compromised for the benefits derived from this type of bed.  The noise associated with the bed, the weight and bulk of the bed and the difficulty transferring the patient from the bed to any other surface were just a few of the problems associated with the air fluidized beds.  Modern advances in support surfaces have created solutions to the negative aspects of care that accompany the air fluidized beds.  Improved technology of low air loss support surfaces with additional alternation therapy have led to the use of a low air loss/alternation surface in the successful treatment of skin flaps and grafts.  Positive healing outcomes across various patient populations are comparable to those associated with the air fluidized bed but without the disadvantages and inconveniences associated with that type of bed.