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J Am Col Certif Wound Spec. 2010 Mar 21;2(1):4-8. doi: 10.1016/j.jcws.2010.02.002. eCollection 2010.

Use of alternatives to air-fluidized support surfaces in the care of complex wounds in postflap and postgraft patients.

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Medline Industries, Inc, St. Louis, MO.
Cytomedix Regenerative Biotherapies, Rockville, MD, USA.
Sycamore Wound Center, Sycamore hospital, Kettering Health System, Dayton, OH, USA ; Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
CHRISTUS Schumpert, Shreveport, LA, USA.
Corpus Christi Medical Center, Corpus Christi, TX, USA.
Shepherd Spinal Center, Atlanta, GA, USA.
Swedish Medical Center, Denver, CO, USA.
Avera McKennan Hospital, Sioux Falls, SD, USA.
Levindale Hebrew Geriatric Center and Hospital, Baltimore, MD, USA.
Skyline Medical Center, Nashville, TN, USA.
Rutland Regional Medical Center, Rutland, VT, USA.


Air-fluidized support surface therapy has many drawbacks, such as dehydration, in an already difficult recovery for those wound patients who have undergone flap and graft surgery. In addition, patient care and handling are also problematic. Patients complain of discomfort, and the instability of the surface interferes with patient stability in side lying and semi-Fowler's positions. Alternative support surfaces can be considered for postflap or postgraft patients. Such technologies as alternating pressure, low-air-loss, and therapeutic nonpowered, advanced, and lateral rotation surfaces are widely used for pressure management in high-risk patients and those with existing pressure ulcers. These surfaces must be used within a total pressure ulcer management program that includes frequent turning and repositioning, skin and ulcer care according to evidence-based protocols, patient and caregiver instruction, nutrition, and offloading and positioning. The proposed recommendations require more research on the relative effectiveness of less expensive and more user-friendly support surfaces such as low-air-loss and nonpowered advanced support surfaces and is necessary in order to conclusively recommend one type of surface over another. However, at this time the available clinical studies and opinions remain positive.


Air-fluidized therapy; Alternating pressure; Alternative support surfaces; Fasciocutaneous flap; High air loss; Low air loss; Myocutaneous flap; Postsurgical care; Pressure ulcer management; Split-thickness skin graft; Support surface; Therapeutic nonpowered advanced and lateral rotation

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