Thanks to the expertise of KOHLAS in mastering medical applications of viscoelastic foams and gels, the company offers a full range of bedsore prevention devices, specially designed to prevent and help treat pressure ulcers.

Safe, all VISCO'KARE aproducts are formulated using only EC compliant components in accordance with Health Directive 93/42/EEC.

The pressure ulcer is a tissue necrosis due to a decrease of blood flow following an ischemic process (reduction of the arterial blood supply). If the origin of pressure ulcers is multifactorial, tissue compression associated with a loss of mobility and undernutrition plays a predominant role in its appearance.

Severity of pressure ulcer can take many forms that are classified in 4 stages:

• Stage 1
  Reversible dermo-epidermal lesion characterised by a persistent erythema upon finger pressure that rapidly disappears after removal of the pressure on the affected area.
  
  
• Stage 2
  Epidermal necrosis with blister or de-epidermisation. Epidermal layer is interrupted with a loss of both epidermis and dermis. Necrosis can take different forms: blister, abrasion or superficial ulceration.
  
• Stage 3
  Dermo-epidermal necrosis that involve the entire thickness of the skin. The lesion is characterized by intense peripheral redness, an abundant and often foul-smelling outflow. At the initial stage, necrosis is a dry black plate, and, in later stages presents a fibrin yellow plate or shallow ulcer. Stage 3 pressure ulcer is prone to secondary infections or infections that can lead to the onset of fever.
  
• Stage 4
  Necrosis is cutaneous and subcutaneous, reaching deep tissues: fascia, muscle, even the bone.
  
  

If the treatment of pressure ulcers can involve surgery, it is mostly medical and preventive. It is therefore essential to adapt bedsore prevetion devices to patient's morphology and condition, condition that can be evaluated according to different scales:

• The Braden scale
  Simple and clear, the Braden scale takes into account factors.
  
  

  	Sensitivity	Moisture	Activity	Mobility	Nutrition	Friction / Shear
  1	Completely limited	Constantly moist	Bedfast	Completely immobile	Very poor	Problème permanent
  2	Very limited	Very moist	Chairfast	Very limited	Probably inadequate	Potential problem
  3	Slightly limited	Occcasionally moist	Walks occcasionally	Slightly limited	Adequate	No apparent problem
  4	No impairement	Rarely moist	Walks frequently	No limitation	Excellent	-

  
  

  Score

  ≥ 18 : Risque bas

  13 à 17 : Risque modéré

  8 à 12 : Risque élevé

  ≤ 7 : Risque très élevé

  
  
• The Norton scale
  The simplest and oldest scale, the Norton scale does not take into account nutrition and was initially developped for patients aged of 65 or more.
  
  

  	Physical condition	Mental condition	Activity	Mobility	Incontinent
  1	Very bad	Stupor	Bed bound	Immobile	Doubly
  2	Poor	Confused	Chair bound	Very limited	Usually/Urine
  3	Fair	Apathetic	Walk with help	Slightly impaired	Occasionally
  4	Good	Alert	Ambulant	Full	Not

  
  

  Score

  ≤ 16 : Low risk

  > 16 : High risk

  
  
• The Waterlow scale
  More complex, the Waterlow scale is rather intended for multidisciplinary practice and surgery.