Relieving The Pressure – a novel and cost effective option for pressure ulcer prevention
Pressure ulcer (PU) prevention in the care home setting can be challenging. Every setting where care is delivered, whether home, hospital or care home, faces challenges in delivering PU prevention(1). Defined as localised damage to the skin and underlying tissue caused by unrelieved pressure or a combination of pressure and sheer(2,3) PU’s incur a significant cost to the NHS 4,5,6varying from £1,214 (category 1) to £14,108 (category 4)3. Costs increase with ulcer severity (3,6) not to mention the impact on the individual such as pain, the need for additional nursing interventions, damage to a persons’ sense of self leading to depression, social isolation due to wound symptoms such as odour (1,6)as well as increased risk of infection.
The incidence of PU’s is the most common reporting category of serious incidents nationally (7,8). Therefore, the need to protect vulnerable areas of the skin from breakdown is a key focus for clinicians and care givers working in all areas of healthcare (7,8). Despite extensive prevention programmes, evidence suggests about 1,700 to 2,000 patients a month develop pressure ulcers(10,11,12).
Offloading devices such as the Heel Up®heel protection boot and All Up®cushions have proven to reduce the impact of pressure damage. The use of off-loading devices aligns with pressure ulcer prevention pathways(10) by providing a safe and supportive surface for preventing and treating pressure ulcers. The devices are ergonomically designed ensuring stability without hindering the patient’s movements and provide support to at risk areas of the body (7,8,10). For example, the All Up®head is designed to fit the shape of the head taking into consideration the natural curve of the spine in the recumbent position, while the Heel Up®short is shaped to fit the Achilles tendon whilst providing comfortable support for the foot.
The range is designed with patient comfort and concordance in mind and is made from a polyethylene and polypropylene non-woven material that is soft to the touch with a felt like feel. Unlike similar products, the material used is moisture and heat absorbent which means these offloading devices are skin friendly and manufactured in accordance with ISO 10993-1012 skin irritation and sensitisation standards therefore they can be used with confidence on delicate skin.
Single patient use ensures that optimum hygiene levels are maintained. The Heel Up®and All Up®cushions can be wiped clean with alcohol wipes, chlorhexidine or can be machine washed at 60°C, making them highly suitable to the care setting. Available in a range of sizes ensure you can fit the right product to the individual person.
The Heel Up®range is most suitable for bedbound patients however the short can be used by wheel chair users as well. The All Up®cushions come in a range of sizes and can be used interchangeably in differing seated and laying positions. They can be used to prevent pressure ulcer development but can also be used as part of the treatment pathway for existing pressure ulcers (Grad 1-4). They offer a cost-effective preventative method when comparing the cost of a Heel up medium at £13.95 compared with the estimated cost of treating a Grade 1 pressure ulcer at around £12143, to cite some examples.
The range is now available through NHS Supply Chain and can also be purchased directly from Algeos. Algeos is a leading global medical 
distribution company which designs and develops many products under its own brands and distributes world-leading product solutions within the physiotherapy, podiatry, orthotic and prosthetic markets. In the UK, Algeos offers the widest range of podiatry and physio products available for these markets and is the largest podiatry supplier to the NHS.
The family-owned business, based in Liverpool, dates back to 1881. The company also has offices in the Middle East and Australia and today has around 80 employees worldwide. Algeos sells into 60 countries and has over 45 distributors outside of the UK.
For further information and prices go to www.algeos.com or email info@algeos.com
Ellis M (2017) Pressure ulcer prevention in care home settings. Nursing Older People. 29, 3, 29-35.
European pressure Ulcer Advisory Panel (2009) Pressure Ulcer Prevention: A Quick Reference Guide. www.epuap.org
Dealey C, Posnett J, Walker (2012) A The cost of pressure ulcers in the United Kingdom. Journal of Wound Care. 21(6):261-266.
Guest J, Ayoub N, McIlwraith T, Uchegbu I, Gerrish A et al (2016) Health economic burden that different wound types impose on the UK’s National Health Service. International Wound Journal ISSN 1742-4801
Guest J, Fuller G, Vowden P, Vowden K (2018) Cohort study evaluating pressure ulcer management in clinical practice in the UK following initial presentation in the community: costs and outcomes. British Medical Journal
Beldon P (2006) Pressure ulcers: prevention and management. Wound Essentials.1: 68-81.
NICE (2015) Pressure Ulcers. www.nice.org.uk
Best practice statement: care of the older persons skin (2nd edition). Wounds UK. London. 2012. www.wounds-uk.com
Voegeli D (2008) The effect of washing and drying practices on skin barrier function. Journal of Wound Ostomy and Continence Nursing. 35(1): 84–90.
www.nhs.stopthepressure.co.uk/
www.safetythermometer.nhs.uk/
May R (2018) Pressure ulcers: revised definition and measurement – summary and measurement. www.improvement.nhs.uk
Levabo data on file
