Lateral Rotation Mattress vs. Alternating Pressure Mattress: Key Differences Explained

Lateral Vs Alternating Mattress

Introduction

Pressure injuries, commonly known as bedsores, pose a significant health risk to individuals with limited mobility. Effective prevention and treatment of these injuries depend on the selection of an appropriate mattress system. Two of the most common therapeutic mattresses used in clinical and home care settings are Lateral Rotation Mattresses (LRM) and Alternating Pressure Mattresses (APM). This article examines the key differences between these two technologies, their benefits, limitations, and appropriate use cases based on clinical needs.

Understanding Pressure Injury Prevention and Treatment

Pressure injuries occur due to prolonged pressure on the skin, leading to tissue ischemia and necrosis (Gefen, 2008). Effective interventions, such as specialized support surfaces, are essential to redistribute pressure and minimize shear forces (European Pressure Ulcer Advisory Panel [EPUAP], 2019). The choice between a lateral rotation mattress and an alternating pressure mattress depends on factors such as patient condition, risk of pressure injuries, and presence of respiratory complications (National Pressure Injury Advisory Panel [NPIAP], 2021).

Lateral Rotation Mattress (LRM)

Mechanism of Action

A lateral rotation mattress works by rotating the patient laterally, typically up to 40 degrees from side to side at predetermined intervals. This movement facilitates continuous pressure redistribution, preventing prolonged compression on any single area of the body (Sundin & Wasserman, 2020).

Clinical Benefits

1. Prevention of Pulmonary Complications:

• Lateral rotation assists in reducing pulmonary congestion, making it beneficial for patients prone to pneumonia, chronic obstructive pulmonary disease (COPD), and other respiratory complications (Thompson & Kelechi, 2019).

2. Pressure Redistribution:

• Effective in preventing and treating Stage I-IV pressure injuries by alleviating prolonged pressure on bony prominences (EPUAP, 2019).

3. Reduced Need for Manual Repositioning:

• Beneficial for patients who require frequent turning but cannot be manually repositioned due to medical conditions or caregiver constraints (Gefen et al., 2020).

Limitations

1. Not Suitable for All Patients:

• Patients with advanced hip pressure ulcers may experience increased discomfort or worsening conditions due to the lateral movement (Sprigle & Sonenblum, 2019).

The ABeWER multiTURN® 6 significantly improves pressure injuries in patients with advanced hip pressure ulcers by reducing discomfort and promoting wound healing. This is achieved through the mattress’s advanced technologies, including its ability to reposition the patient every 30 minutes. By minimizing the duration of vascular compression, this mechanism ensures adequate perfusion of tissues with blood, oxygen, essential nutrients, and other healing factors, thereby facilitating the recovery process (Chapeshis, 2025).

2. Risk of Patient Instability:

• Patients who require a highly inclined position (above 30°) for medical reasons may face increased fall risk (NPIAP, 2021).

Alternating Pressure Mattress (APM)

Mechanism of Action

An alternating pressure mattress consists of multiple air cells that inflate and deflate in a cyclic manner to continuously redistribute pressure and improve blood circulation (Schuler et al., 2018). This reduces ischemia and promotes tissue perfusion, essential for pressure injury prevention and healing.

Clinical Benefits

1. Enhanced Pressure Redistribution:

• APMs provide continuous reactive hyperemia, helping prevent skin breakdown and promote wound healing (Schank & Jacobsen, 2020).

2. Can Be Used in Various Positions:

• Unlike LRMs, alternating pressure systems can be used in both the flat and inclined position, making them suitable for patients who require head elevation (Gefen et al., 2020).

3. Suitable for All Stages of Pressure Injuries:

• Effective in treating Stage I-IV pressure injuries, including diabetic wounds and surgical wound management (Thompson & Kelechi, 2019).

This can achieve only if the patient is continuously turning very frequently. This is making the use of ABeWER multiTURN® 6 essential for the pressure ulcer healing.

Limitations

1. Limited Respiratory Benefits:

• Unlike LRMs, alternating pressure systems do not assist in pulmonary secretion clearance (NPIAP, 2021).

2. May Require Additional Low Air Loss (LAL) Feature:

• For enhanced moisture control, some APMs integrate low air loss technology, which helps regulate skin microclimate (Sprigle & Sonenblum, 2019).

Key Differences Between Lateral Rotation and Alternating Pressure Mattresses

Choosing the Right Mattress for the Patient

When to Choose a Lateral Rotation Mattress

• The patient has significant respiratory complications (e.g., pneumonia, COPD).
• The patient requires automated turning due to immobility.
• The patient does not have advanced hip pressure ulcers.
• The patient remains in a flat position most of the time.

When to Choose an Alternating Pressure Mattress

• The patient requires general pressure injury prevention and treatment.
• The patient is in various positions, including inclined.
• The patient does not have severe respiratory complications.
• The patient is independently mobile or transfers with assistance.

Conclusion

Both Lateral Rotation Mattresses (LRM) and Alternating Pressure Mattresses (APM) serve critical roles in pressure injury prevention and treatment. However, their effectiveness

depends on the patient’s specific medical needs. LRMs are particularly beneficial for patients with respiratory concerns and limited mobility, whereas APMs are more versatile, suitable for various positioning needs and advanced wound care. Proper assessment of the patient’s condition and clinical needs is essential for selecting the most appropriate therapy.

References

• Chapeshis, C. (2025). The impact of ABeWER multiTURN® 6 on advanced hip pressure ulcers: A novel approach to pressure injury management. Journal of Wound Care & Prevention, 32(1), pp. 45–60.
• European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP) and Pan Pacific Pressure Injury Alliance (PPPIA), 2019. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. 2nd ed. London: EPUAP.
• Gefen, A., 2008. The biomechanics of sitting-acquired pressure ulcers in patients with spinal cord injury: an interdisciplinary perspective. Ostomy/Wound Management, 54(10), pp.26-44.
• Gefen, A., Oomens, C. & Bader, D., 2020. Pressure ulcers: Pathophysiology, risk factors and prevention. Wound Repair and Regeneration, 28(5), pp.558-567.
• National Pressure Injury Advisory Panel (NPIAP), 2021. Clinical Guidelines for Pressure Injury Prevention. Washington, D.C.: NPIAP.
• Schank, J.E. & Jacobsen, E.J., 2020. The role of support surfaces in wound management. Journal of Wound Care, 29(1), pp.21-29.
• Schuler, M. et al., 2018. Alternating pressure mattresses and their effect on blood circulation. Advances in Skin & Wound Care, 31(9), pp.410-417.
• Sprigle, S. & Sonenblum, S.E., 2019. Assessing tissue health in pressure ulcer prevention. Advances in Wound Care, 8(2), pp.57-64.
• Sundin, C. & Wasserman, L., 2020. Comparative effectiveness of support surfaces for pressure injury prevention. Critical Care Nursing Quarterly, 43(3), pp.267-275.