Additional layers of bedding can limit the pressure-dispersing capacities of therapeutic surfaces (such as therapeutic mattresses or cushions). As a result, extra sheets and pads can contribute to skin breakdown and impede the healing of existing pressure wounds.
Sources:
Institute for Healthcare Improvement. How-to guide: prevent pressure ulcers. Cambridge, MA: IHI; 2011.
Keast DH, et al. Best practice recommendations for the prevention and treatment of pressure ulcers: update 2006. Adv Skin Wound Care. 2007 Aug;20(18):447-60. PMID: 17762312.
Norton et al. Chapter 3: Best Practice Recommendation for the Prevention and management of pressure injuries. 2018 Jan 24 [cited 27 Aug 2019].
Registered Nurses’ Association of Ontario. Assessment and management of pressure injuries for the interprofessional team. 3rd ed. [Internet]. 2016 [cited 2016 Oct 18].
Williamson R, et al. The effect of multiple layers of linens on surface interface pressure: results of a laboratory study. Ostomy Wound Manage. 2013 Jun;59(6):38-48. PMID: 23749661.