White Paper: Evidence-Based Pressure Injury Prevention
Explore what current clinical evidence reveals and examine how evidence-based mattress engineering and design can contribute to a safer care environment.
Suggestions for procurement documents
A smart checklist for procuring mattresses with a focus on pressure relief.
Would you board a flight with an airline that experiences a fatal crash every six weeks? Unlikely. Yet, within healthcare, a crisis of similar proportions silently unfolds daily. In Sweden alone, healthcare-associated infections (HAIs) claim approximately 1,500 lives annually—significantly outnumbering fatal traffic accidents[1]. Despite these stark figures, the primary patient contact surface is frequently overlooked: the medical mattress.
Below, we examine why conventional mattresses leak, define the clinical phenomenon of "strikethrough," and demonstrate how an uncompromised hygienic barrier can save lives.
While protocols for disrupting chains of infection heavily prioritize hand hygiene and the environmental disinfection of high-touch surfaces, patients frequently spend upwards of 20 hours a day in bed. This prolonged, continuous contact makes the medical mattress a critical risk zone in healthcare environments.
Research from the Columbia University School of Nursing reveals a stark reality: if a bed’s previous occupant harbored an infection, the risk of the subsequent patient contracting the same pathogen increases significantly, with studies indicating odds up to 5.83 times higher [2]. This demonstrates that conventional decontamination protocols and material selections frequently fail to "reset" the baseline infection risk during patient turnover.
A common misconception is that a medical mattress cover provides complete fluid impermeability simply because the textile itself is waterproof. However, a hygienic barrier is only as secure as its weakest point. In conventional mattresses, this critical vulnerability lies within the stitched seams.
When a cover is fabricated with stitched seams, the material is inherently perforated by thousands of needle punctures—a conventional medical mattress often contains more than 2,000 of these micro-perforations. Through a physical phenomenon known as capillary action (the wicking effect), contaminated fluids and pathogens—including blood, urine, and viral particles—can migrate along the sewing thread and penetrate directly into the underlying mattress core. This internal contamination can occur even when the external surface appears completely pristine and decontaminated [5].
In clinical environments, the phenomenon of "strikethrough" refers to a critical barrier failure where biological fluids either chemically degrade the internal coating of the cover through hydrolysis, or directly penetrate it via stitched seams.
The result is a literal Trojan Horse within the care environment. While the mattress exterior may appear perfectly intact and visually decontaminated, pathogens proliferate unchecked inside the foam core. Remarkably, a single gram of contaminated mattress foam can harbor up to 10 billion bacteria. When a subsequent patient occupies the bed, their body weight compresses the core, forcefully expelling these microorganisms into the patient room as an invisible, infectious aerosol—a clinical risk phenomenon known as the "bellows effect."
The U.S. Food and Drug Administration (FDA) has issued explicit safety alerts regarding this exact hazard, warning healthcare providers that biological fluids routinely penetrate cover seams and zippers without leaving any visible external evidence of internal contamination [3].
While the concept of "breathable" materials is widely promoted, it can introduce severe hygienic risks in clinical environments. When moisture vapor transfers through the cover but cannot efficiently escape, it condenses into liquid directly within the foam core.
When relative humidity exceeds 75%, mold spores germinate and proliferate rapidly. Exposure to mold within the clinical bed environment can trigger a wide spectrum of adverse health effects, ranging from asthma exacerbations and respiratory tract infections to cutaneous rashes and cognitive difficulties [4]. Consequently, a truly hygienic medical mattress must feature a completely impermeable barrier—not a "breathable" construction that permits moisture ingress into the core.
To effectively disrupt chains of infection and eliminate hidden reservoirs of contamination, minimizing critical risk zones within the care environment is paramount. Järven’s proprietary technology addresses this clinical imperative by completely eliminating stitched seams from the mattress design.
Evidence-based pest control
Gain deeper insight into life-saving technology. In this White Paper, we review clinical studies and provide you with a smart checklist to use when procuring pressure-relieving mattresses.
Suggestions for procurement documents
A smart checklist for procuring mattresses with a focus on pressure relief.