When someone spends extended periods in bed — whether recovering from surgery, managing a chronic condition, or receiving aged care at home or in a facility — the surface they sleep on is far more than a comfort consideration. It becomes a frontline defence against one of the most common and preventable complications in long-term care: pressure injuries, also known as bed sores.
With a wide range of support surfaces now available — from simple foam overlays to sophisticated alternating air systems and hybrid full mattress replacement systems — choosing the right one can feel overwhelming. This guide walks through the main types and explains when each is most appropriate, so you can make an informed decision for yourself or the person in your care.
Why the Right Surface Matters: Understanding Bed Sores
Bed sores — clinically known as pressure injuries — develop when sustained pressure cuts off blood flow to soft tissue, most often over bony prominences like the heels, sacrum, hips, and shoulder blades. In high-risk individuals, tissue damage can begin within just a couple of hours of unrelieved pressure.
Pressure alone is not always the only factor. Shear forces from sliding or being repositioned, moisture from perspiration or incontinence, and reduced skin integrity from poor nutrition all contribute. A well-chosen support surface addresses several of these risk factors simultaneously — not just pressure.
The three main categories of support surface we discuss in this blog — foam, air (inflatable), and hybrid — each address these risks in different ways and are suited to different levels of clinical need.
Foam Mattresses and Overlays
Foam-based support surfaces are the most widely used and are appropriate for individuals with low to medium pressure injury risk. They work by distributing body weight more evenly across a larger surface area, reducing peak pressure at vulnerable points. Often they are a cost effective and simple solution for home use or clinical environments.
Standard foam mattresses are typically multi-layered, with varying foam densities to balance comfort and support. Higher-specification models incorporate a visco-grade memory foam layer that responds to body heat and weight, conforming closely to the body’s contours.
Convoluted (egg crate) foam overlays are placed on top of an existing standard mattress to improve comfort and air circulation. These are suitable for individuals with no significant pressure injury risk — they are primarily a cost-effective comfort aid rather than a clinical pressure care solution.
Premium foam mattresses with anti-microbial cores and vapour-permeable four-way stretch covers offer a step up in both hygiene and pressure redistribution. Safety and Mobility’s range includes single and king single options with two- or three-layer foam cores, suitable for both hospital-grade and home care bed frames. Take a look here at some of our premium foam mattresses. Safety and Mobility are proud to have supplied these throughout major aged care, public and private healthcare facilities and to individual users across Australia.
The key limitation of foam surfaces is that they are static — they reduce pressure, but they do not actively change the distribution of pressure over time. For individuals with higher risk profiles or existing wounds, an active air system will generally offer greater protection.
Inflatable Air Mattresses for Bed Sores: How They Work
An inflatable mattress for bed sores — more formally known as an alternating pressure mattress or sometimes used interchangeably with “alternating overlay” (the differences are discussed below) — is one of the most effective tools available for the prevention and management of pressure injuries in higher-risk individuals.
These systems work by using an electric pump to cyclically inflate and deflate rows of air cells within the mattress or overlay. As cells inflate and deflate in sequence, the pressure beneath the patient’s body shifts continuously — meaning no single area of skin is subjected to sustained compression. This mimics, in a limited way, the pressure relief that comes from natural movement.
There are two primary formats:
Alternating pressure overlays sit on top of an existing mattress. They are a practical and cost-effective choice for home care settings where replacing the mattress entirely may not be necessary or for busy wards where patients’ needs change and care teams need to quickly vary the set-up of patients’ beds. Safety and Mobility’s alternating overlays are TGA registered and supplied with either analogue or digital pumps, catering to low, medium, and high-risk clients. Our York, Kent and Eton alternating pressure overlays are supplied Australia-wide and well recognised in the industry for their quality, reliability and longevity.
Full mattress replacement systems replace the existing mattress entirely and are typically indicated for higher-risk individuals or those already managing existing pressure injuries. These offer greater immersion depth and are less susceptible to the ‘bottoming out’ issue that can affect inadequate overlays.
Safety and Mobility have designed and import the Otley range of full mattress replacement systems. This range uniquely features a 3-in-1 design that allows the mattress to be used as:
- a high-spec foam mattress
- a non-powered static air mattress
- a pump-powered dynamic air mattress
We discuss more about the Otley futher down in this blog post – this important pressure care aid deserves a paragraph of its own!
Some air mattress systems also incorporate a low air loss feature, which allows a continuous, gentle flow of air through the sleeping surface. This helps manage microclimate — the heat and moisture that build up between the patient’s skin and the mattress — which is a significant contributor to skin breakdown.
Browse Safety and Mobility’s full range of inflatable mattresses and air overlays for bed sores, including TGA-registered alternating systems with analogue and digital pump options.
ROHO Overlays: A Specialist Air System
Alongside alternating pressure systems, static air overlays such as those in the ROHO range offer a different approach. ROHO bed overlays use interconnected air cells that adjust dynamically to the patient’s position — promoting blood circulation and reducing shear forces during transfers and repositioning.
These are particularly well-suited to individuals who change position independently to some degree, or where a powered alternating system is not appropriate. The SAF overlay is another option, offering uniform pressure distribution for medium-risk clients.
Hybrid Mattresses: The Best of Both Worlds
Hybrid pressure mattresses combine foam and air technology in a single system, offering flexibility that neither material alone can provide. For many long-term care situations — particularly where a patient’s needs are likely to fluctuate — a hybrid system can be an excellent investment.
The Otley Integrated Hybrid Mattress, available through Safety and Mobility, is a full mattress replacement system that combines a high-quality foam core with an integrated air cell system. Uniquely, it can be used with or without a pump. Its Static Care Comfort Regulator means that even without power, the patient receives a degree of pressure redistribution simply through their own movement on the mattress.
With a safe working load of up to 250kg, the Otley is also well-suited to bariatric users — addressing both pressure care and size requirements in a single product.
Hybrid systems are particularly valuable in environments where power outages are possible, where carer capacity for repositioning varies, or where the patient’s condition — and therefore their pressure injury risk — is likely to change over time.
Choosing the Right Surface: A Practical Summary
When assessing which support surface is most appropriate it is crucial to consult with a clinical specialist – often an occupational therapist, wound care nurse or other appropriately qualified clinician. To guide some questions prior to purchase yo may consider the following:
- Risk level: Use a validated tool such as the Braden Scale. Low-risk individuals may be well served by a premium foam mattress; medium to high-risk individuals will generally benefit from an alternating air system or hybrid.
- Existing wounds: If a Grade 3 or Grade 4 pressure injury is already present, a reactive foam surface alone is unlikely to be sufficient. Seek clinical guidance and consider an active air or hybrid system.
- Body weight and size: Ensure the product’s safe working load matches the individual’s needs. Standard systems may not provide adequate protection for bariatric users — check specifications carefully.
- Home versus facility care: Alternating air systems require a reliable power supply and basic maintenance knowledge. Ensure the individual or their carer is comfortable operating and troubleshooting the pump. Facilities may require additional parts or extra components (such as spare pumps) to allow for easier sharing of equipment throughout wards.
- Noise and sleep quality: Alternating pressure pumps produce a low operational hum. This is manageable for most users but worth discussing with the individual before purchase.
- Overlay versus full replacement: If the existing mattress is in good condition and the individual is at low to medium risk, an overlay may be sufficient. Higher-risk individuals, or those with existing injuries, are generally better served by a full mattress replacement system.
- Other healthcare considerations: Always consider the overall health, including mental health of an individual before selecting a surface. It is important to seek clinical guidance to ensure all factors are known.
- Cost considerations: Some types of surface are more cost effective than others on an individual item basis, however when purchasing at scale – for example to use on a busy ward, it may be ultimately more cost effective to purchase hybrid systems such as the Otley that can perform as a 3-in-1 system for wider usage.
A Note on Covers and Maintenance
Even the most effective air or foam system will underperform with an inadequate cover. Look for mattress covers that offer two-way, or even four-way stretch (to allow the surface to contour without hammocking), waterproof and vapour-permeable properties, and easy removal for laundering or replacement.
Anti-microbial foam is an important feature for long-term use, protecting against bacteria, mould, and yeast growth. Many of Safety and Mobility’s mattresses incorporate anti-microbial foam cores as standard — a meaningful consideration for hygiene-conscious care environments.
Foam mattresses should also be inspected regularly for signs of compression or wear. Most high-specification foam products have a defined service life of five to seven years, after which their pressure-redistributing properties begin to decline regardless of visible condition.
Funding Options in Australia
Depending on the individual’s circumstances, pressure care equipment — including inflatable mattresses and overlays — may be partially or fully funded through:
- Home Care Packages (HCP) for eligible aged care recipients
- The NDIS, under the Assistive Technology budget for eligible participants
- The Department of Veterans’ Affairs (DVA) for eligible veterans
- Some private health insurance extras policies — check with your insurer
An occupational therapist, wound care nurse, or general practitioner can provide a formal clinical assessment and assist with funding applications where required. Safety and Mobility is a registered NDIS provider, making the procurement process straightforward for eligible clients.
Find the Right Solution with Safety and Mobility
Whether you are caring for a loved one at home, managing residents in an aged care facility, or supporting a patient through post-surgical recovery, choosing the right support surface is one of the most impactful decisions you can make for their skin health and comfort.
From affordable foam overlays and ROHO systems through to TGA-registered alternating air mattresses and the versatile Otley Hybrid, Safety and Mobility offers a comprehensive range to suit every level of need and every care environment.
Explore the full range of inflatable mattresses and overlays for bed sores at www.safetyandmobility.com.au, or call our team to speak with a product specialist about your specific needs.