Treating the Whole Patient Not Just the Hole in the Patient

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Wound Specialists know that effective pressure injury care can be achieved only when the full range of a patient’s medical needs and quality of life issues are addressed. This philosophy is commonly summed up with the maxim: “Treat the whole patient, not just the hole in the patient.”

In most cases, a pressure injury (PI) is not the primary reason a patient is admitted to the hospital. Instead, it is an unfortunate consequence of poor health and immobility, which results in the severe breakdown of the skin. On one side of the equation are the patient’s internal factors that reduce the skin’s tolerance to pressure. These include diseases and chronic conditions that impede blood and oxygen flow to the tissues, reduce nerve sensation, or impair lymph function. Diabetes, cardiovascular disease, kidney failure, poor nutrition, and depressed immune system are all common PI risk factors. On the other side of the equation are the external forces that weaken the skin and diminish its capacity to withstand pressure. Moisture, shear, and friction all contribute to skin breakdown. Against this backdrop of internal and external factors, patients with limited ability to move on their own or change body positions may become especially vulnerable to PIs.

Addressing the many facets of PI prevention requires a collaborative effort by a multidisciplinary clinical team, beginning when a patient first enters the hospital. Upon admission, a thorough skin check should be conducted to assess skin integrity and potential problem areas should be noted. In addition, medical issues such as poor nutrition, dehydration, insufficient circulation, or lack of nerve sensation which put the patient at higher risk should be identified and communicated to the appropriate clinical specialists. Similar documentation should be done at the beginning of each nursing shift when a patient’s condition changes, and upon transfer to a different nursing unit, medical department, or discharge from the hospital.

In addition, the use of a multifunctional therapeutic support mattress can be beneficial in alleviating external risks to the patient’s skin integrity.  The most effective therapeutic surfaces redistribute the pressure load of the patient’s body mass over the greatest possible skin area. Targeted airflow to manage the skin’s microclimate combined with a surface material that allows the patient’s body to glide easily without undue tissue distortion are also key features.

However, many therapeutic support surfaces that are initially beneficial grow less successful in preventing PIs over time. This phenomenon occurs because the patient’s body becomes acclimated to anticipated pressure patterns. This adaptation process, known as allostasis, eventually slows healing.  Another obstacle clinicians sometimes encounter when trying to treat the whole patient is that traditional therapeutic support surfaces and pressure injury treatments may not be well suited to the needs of other members of the patient care team. More than 90 percent of people being treated for pressure injuries are also receiving care for other conditions such as pneumonia, nutritional disorders, diabetes, septicemia, UTIs, and musculoskeletal injuries. Therefore, it’s important that pressure injury prevention and treatment doesn’t benefit one care discipline while presenting challenges for others.

The power-active Airisana™ is an all-encompassing therapeutic support surface for the treatment of pressure injuries and more.  Its unique design incorporates multiple therapies for pressure control and microclimate management, which can replace up to 5 surface types in one easy-to-use surface. The smart control unit, innovative pressure therapy combination, and stabilized bedside construction makes it possible for clinicians from multiple disciplines to deliver a variety of bedside therapies. 

Click here to learn more about the wide range of Airsana™ Therapeutic Support Mattresses.

Pressure Injuries

Michelle Daniels
Michelle Daniels is the Managing Director, TPF & TSS Brands for Encompass Group. She can be reached at

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