Use of Immersion Therapy Mattress with Low Air Loss to Facilitate Healing of Post Myocutaneous
Historically, the use of support surfaces in the treatment of
myocutaneous flaps resulting from Stage IV pressure ulcers
on the torso has been limited in our hospital to air fluidized
therapy. The WOC nurses were asked to find an alternative
surface for post-myocutaneous patients. The professional staff
recognized multifactorial concerns with the use of the fluidized
therapy beds. These concerns included staff injuries with
patient transfers and patient safety.
Method and Results
In our search to find a different support system, we initially
trialed a mattress that provided immersion therapy.
Immersion therapy simulates a fluid environment and
immerses the patient into the surface. During this
evaluation, patients experienced adverse outcomes due to the
microclimate of the patient’s skin. Patients had problems with
moisture and skin breakdown.
In an attempt to manage the microclimate environment in
these post-myocutaneous patients, we trialed a new prototype
Immersion therapy mattress with low air loss. Our five case
studies consisted of post myocutaneous flap patients from
stage IV torso ulcers. The study was from Sept. 2013 to
Feb. 2014. All five patients were placed on the low air loss
Immersion therapy mattress directly after surgery along with
our hospital's total pressure ulcer management plan. As part
of our hospital's clinical pathway for post-myocutaneous flap
patients, all five patients were transferred to a critical access
hospital. The low air loss Immersion therapy mattress was
transferred with the patient. Upon discharge to home, all flap
incisions were approximated and closed. Hospitalization days
between both hospitals ranged from 4 - 7 ½ weeks.
Our experience with this newer therapy was quite positive for patient outcomes; and
feedback from our patients was favorable. As a result of this study, our hospital no
longer uses air fluidized therapy for post myocutaneous flaps. The response from
our multidisciplinary team has been supportive of this change.
About the Authors
Judy VanWyhe, RN, BSN, CWOCN
A 1989 graduate of Abbott Northwestern Enterostomal Therapy Nurse Education Program, Judy currently works in
an acute care setting and also contracts to home health, both at Mercy- Sioux City Iowa. She is a past
the Iowa Affiliate WOCN and currently serves as an active member.
Sue Willer, RN, BSN, CWOCN
A 1991 graduate of Abbott Northwestern Enterostomal Therapy Nurse Education Program, Sue is a WOC Nurse at
Mercy Medical Center, Sioux City, Iowa-an acute care hospital of 250 beds. Sue also contracts with Mercy
and is an active member of the Iowa Affiliate WOCN and as well as former Treasurer.