C-CORE: Technological innovation for pressure ulcer prevention with a focus on sustainability
DOI:
https://doi.org/10.12957/reuerj.2025.87436Keywords:
Products Technology, Technology Assessment, Biomedical, Device Approval, Diffusion of Innovation, Pressure UlcerAbstract
Objective: to analyze the scientific and sustainable advances offered by the C-CORE technology for pressure ulcer prevention. Content: pressure ulcers are a Public health problem with clinical, social and economic repercussions. Pressure redistribution and microclimate control are essential prevention measures. In the last few years, a number of innovations have been incorporated to the clinical practice. Developed from a tridimensional mesh made of polyethylene filaments, mattresses with C-CORE technology provide continuous ventilation, mechanical resilience and load redistribution. Health management requirements demand cost-effective, environmentally responsible and clinically safe solutions. Polyurethane foam faces technical challenges and high costs, whereas the C-CORE technology presents sustainable attributes, such as recyclability and greater durability, contributing to circular economy and to waste reduction. Final considerations: this is a support surface with the innovating C-CORE technology, representing an alternative for pressure ulcer prevention and contributing to sustainability.
References
1. Labeau SO, Afonso E, Benbenishty J, Blackwood B, Boulanger C, Brett SJ, et al. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study. Intensive Care Med. 2021 [cited 2025 Sep 10]; 47(2):160-9. DOI: https://doi.org/10.1007/s00134-020-06234-9.
2. Alshahrani B, Middleton R, Rolls K, Sim J. Pressure injury prevalence in critical care settings: an observational pre-post intervention study. Nurs Open. 2024 [cited 2025 Sep 10]; 11(2):e2110. DOI: https://doi.org/10.1002/nop2.2110
3. Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020 [cited 2025 Sep 15]; 105:103546. DOI: https://doi.org/10.1016/j.ijnurstu.2020.103546.
4. Chung ML, Widdel M, Kirchhoff J, Sellin J, Jelali M, Geiser F, et al. Risk factors for pressure injuries in adult patients: a narrative synthesis. Int J Environ Res Public Health. 2022 [cited 2025 Sep 10]; 19(2):761. DOI: https://doi.org/10.3390/ijerph19020761.
5. Martins SLLA, Cabral MAL, Fernandes FCGM, Policarpo HSPA, Fonseca JF, Leal NTB, et al. Improvement in the quality of pressure injury prevention in an intensive care unit. Texto Contexto Enferm. 2024 [cited 2025 Sep 10]; 33:e20230396. DOI: https://doi.org/10.1590/1980-265X-TCE-2023-0396en.
6. Ministério da Saúde (Br). Nota Técnica GVIMS/GGTES Nº 05/2023: Práticas de segurança do paciente em Serviços de Saúde: Prevenção de Lesão por Pressão. Brasília (DF): Agência Nacional de Vigilância Sanitária; 2023 [cited 2025 Sep 29]. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/ notas-tecnicas/notas-tecnicas-vigentes/nota-tecnica-gvims-ggtes-anvisa-no-05-2023-praticasde-seguranca-do-paciente-em-servicos-de-saude-prevencao-de-lesao-por-pressao.
7. Lovegrove J, Fulbrook P, Miles S, Steele M. Effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings: a systematic review and meta-analysis of randomised controlled trials. Aust Crit Care. 2021 [cited 2025 Jun 29]; 35(2):186-203. DOI: https://doi.org/10.1016/j.aucc.2021.04.007
8. Lovegrove J, Fulbrook P, Miles S. International consensus on pressure injury preventative interventions by risk level for critically ill patients: a modified Delphi study. Int Wound J. 2020 [cited 15 Jun 2025]; 17(5):1112-27. DOI: https://doi.org/10.1111/iwj.13461.
9. European Pressure Ulcer Advisory Panel, National Pressure Injuri Advisory Panel and Pan Pacific Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. The International Guideline. Emily Haesler (ed). EPUAP/NPIAP/PPPIA: 2019 [cited 2025 Sep 11]. Available from: https://static1.squarespace.com/static/6479484083027f25a6246fcb/t/6553d3440e18d57a550c4e7e/1699992399539/CPG2019edition-digital-Nov2023version.pdf.
10. Walker RM, Gillespie BM, McInnes E, Moore Z, Eskes AM, Patton D, et al. Prevention and treatment of pressure injuries: a meta-synthesis of Cochrane Reviews. J Tissue Viability. 2020 [cited 2025 Sep 11]; 29(4):227-43. DOI: https://doi.org/10.1016/j.jtv.2020.05.004.
11. Fang JJ, Shen LM. Compression Property of TPEE-3D Fibrous material and its application in mattress structural layer. Polymers (Basel). 2023 [cited 2025 Jun 11]; 15(18):3681. DOI: https://doi.org/10.3390/polym15183681.
12. Qiu Y, Wua D, Xiea W, Wang Z, Peng S. Thermoplastic polyester elastomer composites containing two types of filler particles with different dimensions: structure design and mechanical property control. Composite Structures. 2018 [cited 2025 Jun 11]; 197:21-7. DOI: https://doi.org/10.1016/j.compstruct.2018.05.035.
13. National Pressure Injury Advisory Panel, Support surface standards. Terms and definitions related to support surfaces. Schaumburg (IL): National Pressure Injury Advisory Panel; 2019 [cited 2025 Sep 29]. Available from: https://cdn.ymaws.com/npiap.com/resource/resmgr/s3i/10-23_Terms_and_Defs_2019_We.pdf.
14. Zeevi T, Levy A, Brauner N, Gefen A. Effects of ambient conditions on the risk of pressure injuries in bedridden patients-multi-physics modelling of microclimate. Int Wound J. 2018 [cited 2025 Jun 29]; 15(3):402-16. DOI: https://doi.org/10.1111/iwj.12877.
15. Nixon J, Smith IL, Brown S, McGinnis E, Vargas-Palacios A, Nelson EA, et al. Pressure Relieving Support Surfaces for Pressure Ulcer Prevention (PRESSURE 2): clinical and health economic results of a randomised controlled trial. EClinicalMedicine. 2019 [cited 2025 Jun 10]; 14:42-52. DOI: https://doi.org/10.1016/j.eclinm.2019.07.018.
16. Shi C, Dumville JC, Cullum N, Rhodes S, Jammali-Blasi A, McInnes E. Alternating pressure (active) air surfaces for preventing pressure ulcers. Cochrane Database Syst Rev. 2021 [cited 2025 Jun 10]; 5(5):CD013620. DOI: https://doi.org/10.1002/14651858.CD013620.pub2.
17. Marvaki A, Kourlaba G, Kadda O, Vasilopoulos G, Rovina N, Koutsoukou A, et al. Comparative study between two support surfaces for pressure ulcer prevention and healing in ICU patients. Cureus. 2020 [cited 2025 Jun 15]; 12(6):e8785. DOI: https://doi.org/10.7759/cureus.8785.
18. Molero A, Calabrò M, Vignes M, Gouget B, Gruson D. Sustainability in healthcare: perspectives and reflections regarding laboratory medicine. Ann Lab Med. 2021 [cited 2025 Jun 15]; 41(2):139-44. DOI: https://doi.org/10.3343/alm.2021.41.2.139.
19. Barner L, Herbst J, O’Shea M, Speight R, Mansfield K, Zhanying Z. Mattress recycling scoping study. Brisbane, Queensland: Centre for a Waste-Free World, Queensland University of Technology. 2021 [cited 2025 Sep 29] Available from: https://eprints.qut.edu.au/213747/1/Wanless_Mattress_Recycling_Scoping_Study_FINAL.pdf.
20. Banik J, Chakraborty D, Rizwan M, Shaik AH, Chandan MR. Review on disposal, recycling and management of waste polyurethane foams: a way ahead. Waste Manag Res. 2023 [cited 2025 Jun 10]; 41(6):1063-80. DOI: https://doi.org/10.1177/0734242X221146.
21. Miah MR, Mahmud S, Khan AN, Jalil MA, Wang J, Zhu J. Recent advances in sustainable thermoplastic polyester Elastomers: synthesis, properties and applications. Polymer. 2025 [cited 2025 Sep 29]; 336:128878. DOI: https://doi.org/10.1016/j.polymer.2025.128878.
22. Mansfield S, Obraczka K, Roy S. Pressure injury prevention: a survey. IEEE Rev Biomed Eng. 2020 [cited 2025 Jun 15]; 13:352-68. DOI: https://doi.org/10.1109/rbme.2019.2927200.
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Perla Oliveira Soares de Souza, Josimare Aparecida Otoni Spira, Eline Lima Borges

This work is licensed under a Creative Commons Attribution 4.0 International License.
When publishing in Revista Enfermagem UERJ, the authors declare that the work is their exclusive authorship and therefore assume full responsibility for its content.
Authors retain copyright to their article and agree to license their work using a Creative Commons Attribution International Public License (CC BY), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode.en), which allows material created by the author to be distributed, copied and displayed by third parties. The original work must be cited and present a link to the article available on the website of the journal in which it was published.
The Copyright of the articles published in Revista Enfermagem UERJ belongs to their respective author(s), with the rights of first publication assigned to Revista Enfermagem UERJ, with the work simultaneously licensed under a Creative Commons License CC BY, which allows sharing of work with recognition of authorship and initial publication in this journal.
The authors grant Revista Enfermagem UERJ the right of first publication, to identify themselves as the original publisher of the work and grant the magazine a license of non-exclusive rights to use the work in the following ways:
- Sell and/or distribute the work in printed copies and/or electronic format;
- Distribute parts and/or the work as a whole with the aim of promoting the magazine through the internet and other digital and printed media;
- Record and playback work in any format, including digital media.
In line with the journal's policies, each published article will be assigned a Creative Commons Attribution (CC BY) license.



