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Pressure Mapping & In-situ Slings

Pressure Mapping & In-situ Slings – Silvalea 2017

Silvalea has spent many years working with material suppliers to produce fabrics for in-situ slings which will minimise pressure ulcer development if possible and Silvalea has carried out studies and tested our fabrics using pressure mapping software and mats. These studies have been purely for an R&D perspective as Silvalea believe that a general statement and ‘fabric’ data supplied could be misleading. Providing a positive pressure mapping statement may be counterproductive as every individual should be assessed for risk regardless of positive fabric ‘evidence’.

There have been many clinical trials carried out to test fabric used for in-situ patient sling situations such as the study carried out by Jo Webb MSc.Dip COT PGCAP FHEA – University of Salford. The general suggested results have found that a spacer fabric if left in-situ is more likely to reduce the risk of pressure ulcer development than any other fabric. However, what is important to point out is that pressure ulcers remain a complex issue with numerous contributing factors; clothing (pockets, seams, thickness), weight, disability, body tone, seating condition, core stability, age, seating cushions, spinal curvature etc… The simple fact is that everyone is different, sits differently, favours one-side over another, for those clients who are at risk and vulnerable to pressure issues will need to be individually assessed rather than relying solely on evidence supplied by the manufacturer. Silvalea strongly advises risk assessment for every individual and that care plans should regularly be reviewed.

If, after a thorough risk assessment, it is thought appropriate to leave a sling in-situ it is essential that the style and fit of the sling are accurate. Regular monitoring and pressure management should also be practiced. If the end user is within an institution which has pressure mapping facilities such as a hospital, then pressure mapping can help pin point vulnerable pressure areas, once a full recreation of a sling routine and a full assessment has been carried out, creating a care plan tailored to that individual’s specific results.

Dealing with end-users who are specifically ‘at risk’ Silvalea consider that it is more important to eliminate any contributing risk factors, when recommending slings. Silvalea is very happy to work alongside healthcare professionals, assisting with a thorough risk assessment to establish an appropriate product. A product would be made in the most suitable fabric, to an appropriate design for the hoist transfer. In extreme cases, it is possible to manufacture a tailored product to mirror image the end-users contours, consequently reducing any excess bulk.

Once the end-user has been transferred in their sling, Silvalea recommend that the leg sections of the sling are removed. Even in difficult situations, this can be achieved using various techniques with sliding sheets. This is particularly necessary if there is a pressure care cushion present as nothing should hinder its properties. If this is not possible regular monitoring must be carried out. Research carried out over the last 5 years has shown the pressure relieving qualities of a compression cushion can be disrupted by a hoist sling left in place under the bottom which can increase compressive forces at the bony prominences. Silvalea teach and demonstrate various techniques for rearranging the sling once the lift has been carried out to avoid this.

Over the last 20 years, Silvalea can confirm that they have had no reports of an ‘In-situ’ sling, where it has been assessed, correctly sized and fitted, being attributable to any pressure issues.