The Effects of Different Lying Positions on Interface Pressure, Skin Temperature, and Tissue Blood Flow in Nursing Home Residents

Background: Although repositioning is considered an important intervention to prevent pressure ulcers, tissue response during loading in different lying positions has not been adequately explored. Aim: To compare the effects of different lying positions on interface pressure, skin temperature, and tissue blood flow in nursing home residents. Method: From May 2011 to August 2012, interface pressure, skin temperature, and blood flow at three tissue depths were measured for 1 hr over the sacrum in 30 degrees supine tilt and 0 degrees supine positions and over the trochanter major in 30 degrees lateral and 90 degrees lateral positions in 25 residents aged 65 years or older. Measurement of interface pressure was accomplished using a pneumatic pressure transmitter connected to a digital manometer, skin temperature using a temperature sensor, and blood flow using photoplethysmography and laser Doppler flowmetry. Results: Interface pressure was significantly higher in the 0 degrees supine and 90 degrees lateral positions than in 30 degrees supine tilt and 30 degrees lateral positions. The mean skin temperature increased from baseline in all positions. Blood flow was significantly higher in the 30 degrees supine tilt position compared to the other positions. A hyperemic response in the post pressure period was seen at almost all tissue depths and positions. Conclusion: The 30 degrees supine tilt position generated less interface pressure and allowed greater tissue perfusion, suggesting that this position is the most beneficial.