Clinical Evidence

2020

1
 Contents
Introduction 3
Curocell® AREA 5
Curocell® Nova & Curocell® 2 6
Curocell® 4 7
Curocell® 4AD 8
Curocell® Encore 9
Testimonials 10

Care of Sweden develops and markets high-quality mattresses
for the health care sector. Our mattresses are used for pain
management, pressure ulcer prevention and as an aid in the
treatment of pressure ulcers. Our range offers alternating
pressure mattresses, foam mattresses and bedding accessories
such as pillows and cushions for pressure relief, positioning
and stabilization. All products meet health care sector require-
ments for hygiene, quality and safety.
We have focused on care beds for over 16 years and are now
one of the leading Scandinavian companies in this field. We
carry out extensive testing of our products, and our staff are
skilled and knowledgeable. We hold courses and lectures for
our customers on a variety of topics such as pressure relief,
positioning, nutrition etc.
Comfort and safety for the patient are top priority in the devel-
opment of our mattresses, but it is also important to include
features and capabilities that facilitate the work of staff. We
know that if a patient’s condition can be improved with the aid
of our products, and staff are happy with them, this will benefit
the entire care chain.
For many years we have operated structured environment and
quality management systems, and are certified to ISO 9001,
ISO 13485 and ISO 14001.

22 Copyright 2010 Care of Sweden AB


Introduction
Pressure ulcers – underlying factors
Pressure ulcers are a complication that causes great
suffering for those afflicted, but are also highly
problematic for the patient’s family and medical
staff. The care of patients with pressure ulcers con-
stitutes a strain on healthcare resources in the form
of increased costs (1-4) . The cost increases with the
category of pressure ulcer, since the healing time is
prolonged and the risk of complications increases
with the extent of the tissue damage (5-6) .
Pressure ulcers are a form of local injury to the skin
and underlying tissue that arise after a long period
of inadequate or blocked blood circulation. The
causes are primarily pressure, shear forces or a
combination of these factors (7-8) . Pressure against
tissue that exceeds the capillary pressure strangu-
lates the blood flow so that the flow of oxygen and
nutrients to the area is reduced or ceases altogether.
The link between pressure and pressure damage
depends on the intensity of the pressure and the
time over which the pressure remains (9-12) .
Pressure ulcers can occur on
any part of the body. At the
sacrum, hips and heels, the
skin lies close to bony promi-
nences and the pressure is
concentrated over a smaller
surface area. For people
who spend a large part of
their day sitting in a chair or
wheelchair, the risk of pres-
sure ulcers over the ischial
tuberosity is great (13-15) .
Image from Convatec
Prevention and cost reduction
Pressure ulcers can be prevented, and the costs of
prevention are much less than the costs of treat-
ment for pressure ulcers (4) . The primary goal is to
reduce or relieve pressure against the skin, which
allows the expansion of blood vessels, resulting in
increased blood flow to the area, so that oxygen can
be supplied and waste products transported away
more easily. This reactive hyperaemia is the body’s
own defence when an area of tissue has been sub-
ject to oxygen deprivation (8-11) .
Other factors affecting the condition
General health, mobility, age, the state of the skin,
incontinence, hypotension and malnutrition are
other factors that can increase the risk of pressure
ulcers developing (7, 16-18) .
Besides pressure and shear forces in combination
with time, factors such as moisture and temperature
are also significant in the development of pres-
Clinical Evidence 2010 - Care of Sweden
sure ulcers. A negative impact on the skin from
moisture can be caused by incontinence, sweating Categorisation of
and wound secretions, which in turn can cause
maceration of the skin. This affects the mechanical
pressure ulcers
functions of the skin and increases the probability of
chafing and blister formation. Moisture damage can
occur on areas of the skin with low pressure, but is
never seen over bony prominences other than in
combination with pressure damage (3, 10, 26) .
Performance
Pressure is described as the force over an area. Category 1*: Intact skin with
localised non-blanchable red-
Interface pressure (IP) is the pressure that occurs ness that does not subside after
between the user’s body and the support surface. pressure is relieved. Other signs
It is often used to describe the effectiveness of such as discolouration of the
skin, oedema, skin that is hotter
a product. IP is affected by factors such as body than normal or has an odd texture
position, temperature, and the shape and rigidity may also indicate pressure injury.
of both the tissue and the support surface. A high (Category 1 injuries can be dif-
ficult to identify in darker skinned
IP is indicative of a higher risk of impact on tissue,
individuals, which may put them
which can lead to capillary shutdown and disrup- at higher risk.)
tions to the lymphatic system. If this continues for a
sufficiently long period of time, tissue damage will
occur(11, 20-21) .
Measurements can be made
with the help of a thin pad
with a large number of
sensors on it. The sensors
measure the physical pres- Category 2*: Damage to the
epidermis and/or dermis. The
sure which is then elec- ulcer is superficial and may be vis-
tronically transferred to and ible as a blister on or an abrasion
presented on a computer of the skin.
screen. Xsensor is a system
for measuring and mapping
contact pressure between
any two surfaces. The lack of
elasticity in the pad impacts the results, because it
adds a hammock effect. Even the clothing of the test
subjects is a source of error, since seams, pockets
and other protuberances add pressure. Category 3*: Involves damage
to the full thickness of the skin
The maximum pressure (peak) and minimum and includes injury to, or necrosis
of, the subcutaneous tissue layer,
pressure are concepts used in the management of and may extend down to but not
primarily static products, the mechanical character- through the underlying fascia.
istics of which do not alter over time. A change in
the distribution of pressure can only be achieved by
the movement of the test subjects themselves. The
pressure is measured over particularly vulnerable
areas such as bony prominences. The average pres-
sure can also be mapped, which provides informa-
tion about the extent but not orientation (20-22) .
Category 4*: Deep tissue dam-
Pressure area index (PAI) is a means of calculating age, necrosis or damage to the
the area where the contact pressure is greater than muscle, bone or connective tissue
a selected threshold. 32 mmHg is the pressure that with wound cavitations (3, 7, 19) .
has been determined as the pressure at which capil- * European Pressure Ulcer Advisory
laries shut down in healthy adults (11, 20, 23–25) . Panel, Quick reference guide 2009.
Copyright 2010 Care of Sweden AB 33
 Clinical Evidence 2010 - Care of Sweden

Introduction (continued)
Pressure relief index (PRI) is used as a way of evaluating alternating
pressure products. This is the product’s capacity to maintain an IP
under the selected threshold value. Alternating pressure products use
the principle of alternating pressure, which means that the pressure is
regularly moved by filling and emptying cells on a cyclic basis to simu-
late spontaneous body movements. This creates periods when the
pressure is lower or non-existent and these periods are called cycle
times and can be preset.
You can measure the contact pressure that is under a certain thresh-
old level for each preset cycle time. These thresholds can be selected
on the basis of clinical relevance, for example, arteriole, capillary and
venous pressure at 30, 20 and 10 mmHg. Over a complete cycle,
it is then possible to calculate the percentage of time under these
threshold values, which gives an index for the tissue recovery period
and a way of evaluating the product’s efficacy and performance. The
pressure between the skin and the mattress should be kept as low as
possible for as long a time as possible (20-21, 23-25) .
The cycle time, along with how effective the fluctuations in pressure are,
play a decisive role in the basic effectiveness of an alternating pressure
system. The part of the cycle time when the body is completely free of
pressure in large part determines the effectiveness of the mattress.
To demonstrate this for our alternating pressure mattresses, we use a
method where we can measure the effectiveness of the fluctuations
in combination with the cycle time. The results are reported as the
mattress’s pressure relieving period and can be displayed in the form
of graphs and percentages of time under the set threshold values (30,
20 and 10 mmHg, respectively).
Summary
Care of Sweden works actively to verify the functionality of our prod-
ucts. This includes conducting comprehensive studies to verify the per-
formance of our products. This is done either by ourselves, at external
institutions or in collaboration with our clients. Ultimately, the desired
outcome is products that are safe to use and have good functionality.

References
1. Socialstyrelsen, 1997. Boken om trycksår. En kunskapssammanställning. Ädel 50, SOS-rapport, 1997:7. Socialstyrelsen, Stockholm.
2. Sveriges kommuner och Landsting, Förebygg trycksår i samband med vård, Nationell satsning för ÖKAD PATIENTSÄKERHET, 2008.
3. Handbok för hälso- och sjukvård, Sveriges kommuner och Landsting/Regioner, kapitel Trycksår, 2009-05-06.
4. Lyder CH, Shannon R, Empleo-Frazier O, McGeHee D, White C. A Comprehensive program to prevent pressure ulcers in long term care: exploring costs and outcomes. Ostomy Wound management 2002;
48(4):52-62.
5. Bennett G, Dealey C, Posnett J. The cost of pressure ulcers in the UK. Age and Ageing, 2004; 33:230-235.
6. Hopkins B, Hanlon M, Syke S, Rose T, & Cleary. A. Reducing nosocomial pressure ulcers in an acute care facility. Journal of Nursing Care Quality, 2000, 14(3), 2836.
7. EPUAP-NPUAP, Pressure Ulcer Prevention. Quick Reference Guide, 2009.
8. Lindholm C. Sår. 2:a uppl. / Lund: Studentlitteratur; 2003.
9. Jonsson A. Pressure Sore Etiology Highlighted with optical Measurements of the Blood Flow. Department of Computer Science and Electronics. Mälardalen University, No 63, 2006.
10. Regionalt vårdprogram, Trycksår Prevention och behandling. Stockholms läns landsting, 2010.
11. Parivash M, Gonzales I, Cureton V Y. The effect of body position and mattress type on interface pressure in quadriplegic adults: a pilot study. Dermatology Nursing/December 2004; 16(6)507-512.
12. Bader D.L. The recovery characteristics of soft tissues following repeated loading. Journal of Rehabilitation, Research and Development 1990; 27(2)141-150.
13. Lyndsey A. Pressure ulcer prevention in older people who sit for long periods. Nursing Older People, 2006; 18(4) 29-35.
14. Makhsous M, Rowles D.M, et al. Periodically Relieving ischial sitting load to decrease the risk of pressure ulcers. Arch Phys Med Rehabil, 2007; 88: 862-870.
15. Bar C.A. Evaluation of cushions using dynamic pressure measurement. Prosthetics and Orthotics International, 1991;15:232-240.
16. Ek A-C, Lindgren M. Boken om trycksår. Socialstyrelsen. SOS-rapport, 4:e tryckningen. 1997:7.
17. Lindgren M, Unosson M, Fredriksson M, Ek A-C. Immobility- a major factor for development of pressure ulcers among adult hospitalized patients: a prospective study. Scand J Caring Sci; 2004;18: 57-64.
18. Lindgren M. Pressure Sores Risk Assessment and Prevention, Linkoping University Medical Dissertations, No 784, 2003.
19. EPUAP. Pucklas klassifikation av trycksår, E-learning. Available from: www.pucklas.ugent.be/puclas/s/
20. Rithalia S. Assessment of patient support surfaces: principle, practice and limitations. Journal of Medical Engineering & Technology, 2005; 29(4)163-169.
21. Philips L. Interface pressure measurement: Appropriate interpretation of this simple laboratory technique used in the design and assessment of pressure ulcer management devices. Primary Intention, 2007;
15(3)106-113.
22. Cork R. Xsensor technology: a pressure imaging overview. Sensor Review, 2007; 27(1)24-28.
23. Rithalia S, Kenney L. The art and science of evaluating patient support surfaces. World Wide Wounds, 2001; sept, 1-11.
24. Landis EM. Micro-injection studies of capillary blood pressure in human skin. Heart, May 1993; 15:209-228.
25. Landis EM. The capillaries of the skin, a review. The journal of Investigative Dermatology, 1938, from the department of Medicine, University of Pennsylvania.
26. Fletcher J. Understanding the differences between moisture lesions and pressure ulcers, Nursing times. 2008; 104:50/51, 38-39.

44 Copyright 2010 Care of Sweden AB

 Clinical Evidence 2010 - Care of Sweden

CuroCell AREA ®

The CuroCell® AREA is a replacement mattress used in all types of health care environments. It is used preventatively and as an aid in treat-
ment of pressure ulcers up to and including category 3 (1) . Because of its unique construction combining foam and air, this mattress provides
high user comfort, as well as a solution for pressure care without the need for external pump or electricity.
CuroCell® AREA is delivered with a durable hygiene cover, which is easy to clean and has a very well documented hygienic standard (2) and is
manufactured with welded seems. The soft and elastic cover is vapour permeable (3) .

(1) European Pressure Ulcer Advisory Panel, Quick reference guide 2009.
(2) ISO 16603 “resistance of penetration by blood and body fluids”, ISO 16604 “resistance of penetration by blood-borne pathogens”, EN 14126, SS 876 00 19 “Health care textiles – Bacteria penetration – Wet”.
(3) SS-EN ISO 15496:2004, DIN 53.122.

Examination of the pressure relief capability and the shear force

(Berlin Cert, 02/09/09)

CuroCell® AREA gets highest rate, ”High Pressure Relief”, and is 33 % better compared to the reference mattress
(patient weight of 80 kg). Even at maximum load (230 kg) the average contact pressure is below 30 mmHg.

1. Pressure Area Index (PAI) Patient weight of 80 kg Patient weight of 230 kg

Below 30 mmHg 100 % 52 %
Below 20 mmHg 97 % 27 %
Below 10 mmHg 52 % 16 %

2. Examination of the shear forces

Maximum pulling force (Fmax) 187 N
Mean pulling force during slip-phase (Fquer) 183 N
Coefficient of sliding friction (µG) 0,75 ± 0,02
Horizontal stiffness ( H) 8,06 ± 0,36 N/mm

Comparative evaluation
(Care of Sweden, 30/04/09)

A check of the pressure relief capability, in comparison with products in the same area of use and from other leading manufacturers, CuroCell®
AREA receives significantly better results (1) . With a load of 80 kg CuroCell® AREA receives 7-30 % better RPI. At maximum load, the result is
even more significant. CuroCell® AREA shows 22-35 % better RPI (RPI = Relative Pressure Relief).
(1) The data is collected from a public database (MDS Hilfsmittel Informations System 30/09/08). Compared products are AtmosAir 4000, AtmosAir 9000 and Vicair Academy Mattress ARM415.

Example of pressure mapping (Xsensor). Male, 88 kg, 182 cm. mmhg

100
93
87
81
75
68
62
56
50
43
37
31
25
18
12
6
0
Describes the characteristics of the device, it cannot directly predict clinical outcome.

Copyright 2010 Care of Sweden AB 55

 Clinical Evidence 2010 - Care of Sweden

CuroCell Nova & CuroCell 2 ® ®

The CuroCell® Nova and CuroCell® 2 mattresses are suitable for many and are very easy to handle and operate. The CuroCell® Nova have a
built-in heel function. They are used preventatively and in the treatment of pressure ulcers up to and including category 2 (1) .
They are delivered with a durable, soft, elastic hygienic cover that is vapour permeable (2) , which is easy to clean and have a very well docu-
mented hygienic standard (3) .

(1) European Pressure Ulcer Advisory Panel, Quick reference guide 2009.
(2) SS-EN ISO 15496:2004, DIN 53.122.
(3) ISO 16603 “resistance of penetration by blood and body fluids”, ISO 16604 “resistance of penetration by blood-borne pathogens”, EN 14126, SS 876 00 19 “Health care textiles – Bacteria penetration – Wet”.

Evaluation of the effectiveness of the system

(Care of Sweden, 30/09/09)

Study aimed to describe the function and performance of alternating pressure mattresses feature. This was conducted with test subjects in a
weight range between 57 kg to 135 kg. Below are the pressure relief periods presented, ie percentage of a cycle period where the pressure is
below threshold values.

Pressure relief period

59 % below 30 mmHg
43 % below 20 mmHg
28 % below 10 mmHg

Performance example
The tables show a cycle period at different loads.

Male, 57 kg, 165 cm. Male, 88 kg, 182 cm. Male, 135 kg, 172 cm.
Pressure (mmHg)
Pressure (mmHg)
Pressure (mmHg)

Time (min) Time (min) Time (min)

Case Study
History Actions
Female, 65 years old, with angina pectoris, myocardial infarction and She was ordained an alternating pressure relief mattress, CuroCell Nova®,
dementia. Pressure ulcer, category 2 on both lower legs, R/T the use all other aids were removed. The patient received daily supplements of
of devices for heel protection. Point according to the Modified Norton nutrient drinks. After five weeks, the damage was completely healed.
scale is 14, BMI is 22. She has a normal diet but has eaten and drunk less
recently. Urinary incontinence, uses diapers.

28/08/07 5 weeks later

10
6 Copyright 2010 Care of Sweden AB
 Clinical Evidence 2010 - Care of Sweden

CuroCell 4 ®

The CuroCell® 4 is used in all types of health care environments and is a very functional and cost effective mattress replacement system. It is
used preventatively and in the treatment of pressure ulcers up to and including category 4 (1) .
For sensitive heels, a heel function is also available as an accessory.
The CuroCell® 4 is a very easy system to handle and manage and is delivered with a durable, soft, elastic hygienic cover that is vapour perme-
able (2) , which is easy to clean and has a very well documented hygienic standard (3) .

(1) European Pressure Ulcer Advisory Panel, Quick reference guide 2009.
(2) SS-EN ISO 15496:2004, DIN 53.122.
(3) ISO 16603 “resistance of penetration by blood and body fluids”, ISO 16604 “resistance of penetration by blood-borne pathogens”, EN 14126, SS 876 00 19 “Health care textiles – Bacteria penetration – Wet”.

Examination of the pressure relief capability and the shear force

(Berlin Cert, 02/09/09)

CuroCell® 4 gets highest rate, ”High Pressure Relief”, during testing of the product of accredited institutions
(29 % better compared to the reference mattress at weight of 80 kg).

Pressure Relief Index (PRI) (Load 80 kg) Pressure Area Index (PAI) (Load 80 kg)
100 % below 30 mmHg, 44 % below 20 mmHg, 15 % under 10 mmHg 100 % below 30 mmHg, 91 % below 20 mmHg, 47 % below 10 mmHg

Evaluation of the effectiveness of the system

(Care of Sweden, 30/09/09)

Study aimed to describe the function and performance of alternating pressure mattresses feature. This was conducted with test subjects in a
weight range between 57 kg to 135 kg. Below are the pressure relief periods presented, ie percentage of a cycle period where the pressure is
below threshold values.

Pressure relief period

75 % below 30 mmHg 66 % below 20 mmHg 45 % below 10 mmHg

Performance example
The tables show a cycle period at different loads.
Male, 57 kg, 165 cm. Male, 88 kg, 182 cm. Male, 135 kg, 172 cm.
Pressure (mmHg)
Pressure (mmHg)
Pressure (mmHg)

Time (min) Time (min) Time (min)

Case Study
History Action
Female, born 1943 with Multiple Sclerosis (MS). Point according to the She was ordained an alternating pressure relief mattress, CuroCell 4®.
Modified Norton scale is 19, BMI is 22. Pressure ulcer category 4 in the She also had a pressure relieving cushion in her wheelchair. Has home-
sacrum, R/T poor general condition after a respiratory infection. Incon- care assistance for position changes at nights.
tinent both of urine and faeces uses diapers. She is sitting up during the
day in a wheelchair, but rests about two hours each day.

07/09/07 4 weeks later 11 weeks later 18 weeks later

Copyright 2010 Care of Sweden AB 13

7
 Clinical Evidence 2010 - Care of Sweden

CuroCell 4AD ®

The CuroCell® 4AD is used in all types of health care environments and is a very functional and cost-effective mattress replacement system. It
is used preventatively and in the treatment of pressure ulcers up to and including category 4 (1) .
The CuroCell® 4AD has a built-in heel function for sensitive heels.
It’s a very easy system to handle and manage and is delivered with a durable, soft, elastic hygienic cover that is vapour permeable (2) , which is
easy to clean and has a very well documented hygienic standard (3) .

(1) European Pressure Ulcer Advisory Panel, Quick reference guide 2009.
(2) SS-EN ISO 15496:2004, DIN 53.122.
(3) ISO 16603 “resistance of penetration by blood and body fluids”, ISO 16604 “resistance of penetration by blood-borne pathogens”, EN 14126, SS 876 00 19 “Health care textiles – Bacteria penetration – Wet”.

Evaluation of the effectiveness of the system

(Care of Sweden, 30/09/09)

Study aimed to describe the function and performance of alternating pressure mattresses feature. This was conducted with test subjects in a
weight range between 57 kg to 135 kg. Below are the pressure relief periods presented, ie percentage of a cycle period where the pressure is
below threshold values.

Pressure relief period

89 % below 30 mmHg
52 % below 20 mmHg
29 % below 10 mmHg

Performance example
The tables show a cycle period at different loads.

Male, 57 kg, 165 cm. Male, 88 kg, 182 cm. Male, 135 kg, 172 cm.
Pressure (mmHg)
Pressure (mmHg)
Pressure (mmHg)

Time (min) Time (min) Time (min)

Case Study
History
Male, born 1927 with chronic bronchitis, hemolytic anemia, venous
insufficiency, pacemaker and colostomy. Since the summer of 2008,
pressure ulcers category 4 at his left heel and sacrum. Normal mixed
food, skinny. He needs help with everything - food, hygiene and clothes.
Incontinent both of urine and faeces, uses diapers. Mostly bedridden he
is only sitting during meals.
Action
The ulcer in sacrum has been treated with VAC Therapy (negative pres-
sure) several times, was discontinued 07/11/08. He was ordained an
alternating pressure relief mattress, CuroCell® 4 AD with heel slope. Reg-
ular position changes. He got a pressure relieving cushion for his chair.
He also had a urinary catheter because of the pressure ulcer in sacrum,
for total relief. Dressing changes three times a week, there has also been
constant contact with the department of infection and the department of
orthopedics. He has got a long term treatment of antibiotics and diuretic.
Daily nutritional drink supplement.

Sacrum Heel
10/11/08 10/06/09 29/10/08 06/05/09

14
8 Copyright 2010 Care of Sweden AB
 CuroCell Encore
¨

The Curocell encore is used in all types of healthcare environments and is a very functional and cost-effective mattresses overlay system. It is
used preventatively and in the treatment of pressure injury up to and including category 3.

Study aimed to describe the function and performance of variable low pressure mattresses feature. This was conducted with test subjects in a
weight range between 50kg to 145kg. below are the pressure relief periods presented, ie percentage of a cycle period where the pressure is
below threshold values.

PAI (pressure area index) PATIENT WEIGHT 50KG PATIENT WEIGHT 80KG PATIENT WEIGHT 145KG
Below 30mmHg 99.31% 95.65% 74.38%
Below 20mmHg 62.21% 53.81% 33.47%
Below 10mmHg 4.51% 6.11% 3.81%
Average pressure 18.1mmHg 19.7mmHg 24.0mmHg
Contact area 2534cm2 3279cm2 4713cm2

Performance example
The tables show a cycle period at different loads.
Male, 50 kg, 165 cm. Male, 80 kg, 182 cm. Male, 145 kg, 172 cm.
45 45 45

40 40 40

35 35 35

30 30 30

25 25 25

20 20 20

15 15 15
Pressure (mmHg)

Pressure (mmHg)
Pressure (mmHg)

10 10 10

5 5 5

0 0 0

-5 0 2 4 6 8 10 12 14 16 18 -5 0 2 4 6 8 10 12 14 16 18 -5 0 2 4 6 8 10 12 14 16 18
Time (min) Time (min) Time (min)

Case Study
History
Female born 1929 with quadriplegia and high-level diabetic, since the
summary of 2020 pressure injury category 3 at her sacrum. Normal
mixed food skinny in need of help with everything- food, hygiene, and
cloth. Mostly bed ridden she only sits during meals.
Action
She was ordained(09-11-2020) pressure relief mattress Curocell Encore.
Regular position changes, wound dressing changes 3 times a week, there
has also been consult contact with department of infection. Daily
nutritional drink supplement.

Pressure Injury formed on sacral area, during 2 weeks after they stared using CuroCell 4 weeks after in CuroCell Encore,
this period patient was on normal mattress, Encore, wound reduced and 60% recovered 100% recovered

9

Testimonials
CuroCell® Nova
At the beginning of 2007 we started to use CuroCell Nova as a
mattress for prevention to patients with impaired general condi-
tions and low weight. The mattress fits patients with low weight
and those who according to the Modified Norton scale have low
points. Mattress has worked well and we are very pleased. It is
easy to install, we got help with the first order and it meant that
we got good introduction and details how the product is used and
could instruct staff around the patient.
Yours sincerely
Katti Ghavami, Registered Occupational Therapist & Vaike Nils-
son, Registered Occupational Therapist - Väsby Rehab team,
Upplands Väsby, Sweden
CuroCell® 3 & 4
Care unit 17 Falu hospital is an orthopedic department with
emergency patients only. Our patients have difficulties to move,
need a lot of analgesic drugs and in addition are malnourished,
therefore we previously had problems with a large number of
pressure ulcers. Between 25-30 % of our earlier hip patients got
pressure ulcers from grade 1-3. We saw it as a problem that we
had contributed to increased suffering for the patient which led to
high cost for both county and municipality.
We began reviewing the mattresses we had in our beds, we
concluded that some of them where about 10 years old. We also
noted that we began to have increasingly ill patients in the ward.
We started our work for change by replacing all of our 10 cm
thick mattresses to thicker mattresses for prevention. Today we
have these as standard in all beds. We also use the Modified
Norton scale as an assessment to identify our risk patients and to
identify changes in our patients status. We involved all interested
in the importance of turning regime, pressure relieving material,
dietary guidelines and skin care.
Since we’ve started working more actively with the preventive
measures, we have in the current situation only 0.1 % pressure
ulcers among our patients. This has allowed us to reduce the num-
bers of treatment days and thus reduce the costs of unnecessary
operations on patients, who otherwise would have cost society
millions of Swedish crownes. Now after four years we see clear
results of our work and our goal is to have 0 % pressure ulcers.
We currently have a number of CuroCell 3 and CuroCell 4 linked
to our department (6 pieces) and a larger number in a store that is
accessible to all departments in the hospital. We are using Curo-
Cell 3 and CuroCell 4 to those patients who are waiting for sur-
gery, to multidisease and to those who are risk patients according
to the Modified Norton scale. If need, it is essential to provide an
alternating air mattress at early stage. Both patients and staff are
satisfied with CuroCell 3 and CuroCell 4. The staff wanted a mat-
tress that was easy to work with, easy to understand and where
the risk of making mistakes was small. We have tested a variety of
mattresses, and concluded that CC3 and CC4 fit our needs. The
10 Copyright 2010 Care of Sweden AB
Clinical Evidence 2010 - Care of Sweden
patients have found that the mattresses were comfortable to lie
on. Instead of moving patients to another clinic or municipality,
we have accept the little extra cost it takes to rent CuroCell 3 and
CuroCell 4. We can recommend CuroCell 3 and CuroCell 4 air
mattresses as an invest for health care.
With an action plan for prevention and treatment of pressure ul-
cers and using good products in both prone and sitting positions,
we can drastically reduce the number of pressure ulcers. The cost
this means is small compared to the high cost of pressure ulcers
involves the health care. Don’t forget the suffering of the patient.
In the end it is all our tax money whether it is county or municipal.
Peter Arvidsson, Responsible for wound care - Falu Hospital,
Sweden
CuroCell® Cirrus
I am a 63 year old woman who from many years, according to
many doctors, have a complex disease picture. I’ve got the diag-
nose Morbus Dercum (adipose tissue rheumatism) 20 years ago,
I also have major problems with my joints, osteoartritis changes
both in the neck, shoulders and ankles.
For eight years I’ve had full sickness benefit and I have assist-
ance services 4 hours per day. I can`t cope with the things of
everday life, using permobil which means that I am independent to
some extent.
I have high doses of analgetics, Nobligan Retard 200 mg x2,
Paracetamol 1000 mg x 4. Morfin 10 mg 3-4 times/day.
I’ve had major problems with sleeping, I always use sleeping
pills, have not been able to find a position in bed that have given
me relief at night, I have only been able to lie on my back because
of the pain in my hip which has been one of my biggest problems.
For about 3 months I’ve had the opportunity to try a new mat-
tress from Care of Sweden, the CuroCell Cirrus. From the begin-
ning I was very sceptical, I’ve never had the experince of being
offered something like this, I thought it might be a joke. But in my
situation there was no hesitation so I immediately said yes. Got the
mattress installed and demonstrated how it works, there has not
been any problems at all to handle the mattress or the pump.
Now 4 months later I have only praise, think that it completely
changed my daily life. For the first time for many years I can turn
around in bed, able to lie on my bad hips, I sleep better which
helps me in everyday life. If I have a bad day I comfort myself that
I always can rest awhile. I have also been able to reduce the intake
of Morfin, now only once per day.
My five children feel that I have become more alert. Myself
would not even spend one night with any of them anymore, I long
for my mattress.
I can warmly recommend this mattress to other people who
have similar problems as mine.
Thank you for the opportunity.
Lena Holst - Malmö, Sweden
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