Letter of Justification
Updated August 29, 2026
Letter of Justification
OpalAir Turn — Letter of Justification
Clinical justification template for procurement of the Evergreen OpalAir Turn powered surface.
Last updated August 29, 2026
The Evergreen OpalAir Turn Surface is designed to prevent and manage skin injuries through use of advanced lateral rotation technology combined with alternating pressure and low air loss. The rotation feature not only provides additional pressure distribution but also facilitates caregiving activities. With a high airflow rate, this system is an ideal for use with bariatric clients to assist in moisture reduction, pressure redistribution and positioning.
‘Auto Detect’ reduces the need for complex set up and maintenance making the surface suitable for use in all patient care environments.
Product Feature: Lateral Rotation Therapy
Description
- Increased air flow to the lateral aspects (right and left alternatively) of the surface facilitates repositioning and offloading
- Single (right or left) or full turn cycle options based on client and caregiving needs
Clinical Application
- Lateral rotation allows positioning for greater pressure redistribution and offloading of high risk areas (greater trochanter, sacrum, scapula).
- Promotion of circulation (blood, interstitial fluid) in clients with limited or no active movement and compromised tissues.
- Reduced shearing during offloading as body position is maintained on the surface.
- Pain management (and associated quality of restorative sleep) through regular position changes and reduced peak pressures.
- Reduced stress on health care providers and caregivers as lateral surface motion facilitates repositioning allowing for caregiving and nursing activities (including sling application, bed linen changes, hygiene, medical equipment use)
Clinical Justification Statements
- Reduced pressure on high risk areas and wound sites promotes blood flow and oxygenation of compromised tissues to facilitate healing.
- Enhanced pressure redistribution for clients with limited movement and skin breakdown due to the damaging long term impact of tissue deformation.
- Promotion of wound healing, cardiac and pulmonary function through continuous lateral and alternating surface movement.
- Reduced risk of caregiver injury as client repositioning is assisted by the surface movement reducing strain on caregivers during nursing/caregiving activities.
Product Feature: Alternating Pressure Therapy
Description
- Cyclical inflation/deflation of cells to provide continuous pressure redistribution
- 1 in 3 air cells slowly deflate for greater surface contact and comfort
- Smooth cell design to reduce friction and shearing as cells inflate and deflate in a smooth motion
Clinical Application
- Enhanced pressure redistribution reduces sustained pressure on any one area of the body.
- Offloading decreases risk of pressure injury development over high-risk bony areas (sacrum, coccyx, greater trochanters, scapulas, etc.)
- Reduced potential for shear and friction due to gentle 1 in 3 alternating cell air pressure and smooth cell design.
- Immersion and gentle cell movement promotes relaxation and reduces agitation and movement related to discomfort. Shear and friction (leading to tearing of the skin) is thereby reduced.
Clinical Justification Statements
- Constant pressure redistribution reduces peak pressure points on high-risk bony areas reducing pressure injury development or worsening of existing sores.
- Alternating air flow promotes blood flow to high-risk tissues to ensure greater oxygenation and healing.
- Stability of the surface while still allowing cell inflation/deflation promotes skeletal alignment & positioning and allows for undisturbed sleep to promote tissue regeneration.
- Increased body surface contact and slow pattern of inflation reduces a client’s sensation of movement & discomfort leading to quality of sleep promoting healing.
Product Feature: True Low Air Loss
Description
- High air flow rate up to 1275 liters/minute) to promote a cool, dry healing environment
Clinical Application
- Metabolic rate is stabilized by maintenance of a constant temperature through cooling of the skin.
- Decreased humidity due to constant air flow reduces skin maceration & reduced tensile strength of the skin.
- High air flow rate provides greater humidity control for clients with significant moisture issues (sweating, incontinence, wound drainage)
Clinical Justification Statements
- Continuous high air flow controls microclimate (temperature and humidity) suitable to promote wound healing.
- Promotion of skin strength and integrity through reduced moisture buildup.
- Reduced risk of new pressure injury development through this controlled environment.
Product Feature: ‘Auto Detect’
Description
- Inflation is automatically calibrated based on the load (body weight & surface area)
- Reduces set up & maintenance challenges
- Product is ready to use upon delivery
Clinical Application
- Surface is automatically set to optimize pressure so the client is protected immediately after being transferred into bed.
- No need for constant monitoring and adjustments by trained healthcare staff.
- Protection of skin during caregiving activities.
Clinical Justification Statements
- Client’s skin is protected immediately after delivery of the product with no risk of developing skin breakdown while waiting for staff to determine and adjust air pressure.
- Automatic calibration of the surface reduces costs related to set up and ongoing monitoring by trained healthcare staff.
Product Feature: ‘Auto Fowler’
Description
- Automatic air inflation when head of the bed is raised to reduce risk of bottoming out
Clinical Application
- Reduced risk of bottoming out when client is in an upright/sitting position where additional pressure is put on the sacrum, coccyx and ischial tuberosities.
- Additional skin protection of the pelvic area for clients spending prolonged periods in this upright/sitting Fowler position.
Clinical Justification Statements
- Skin and bony areas of the pelvis have greater protection from contact with the hard bed deck surface when in an upright/sitting position.
- Decreased risk of worsening skin issues and development of pressure injuries due to pressure on bony and high-risk areas of the pelvis.
Product Feature: 8” Surface Depth
Description
- Designed for use with most homecare and hospital beds and side rails
Clinical Application
- Suitable for immersion and increased body surface contact reducing peak pressure areas
- Protection from entrapment risk
Clinical Justification Statements
- Surface depth suitable to allow full body surface contact and immersion to reduce pressure points on high-risk areas leading to skin breakdown.
- Protection from entrapment risk
Product Feature: Bariatric Mode
Description
- Enhanced pump output to support greater weight and prevent bottoming out of air cells
- Lateral movement of surface to facilitate position change of clients with minimal movement to size and function
Clinical Application
- High air flow maintains microclimate to reduce moisture and humidity caused by excessive sweating leading to moisture buildup in skin folds and skin maceration (reducing tensile strength).
- Air flow rate designed to support greater body weight/mass reduces risk of bottoming out leading to constant pressure on high risk areas and compromised skin.
- Pain management through more frequent position change and reduced peak pressures.
Clinical Justification Statements
- Air pressure suitable to support increased weight and reduce risk of bottoming out and contact with solid bed surfaces contributing to skin injuries.
- Increased air flow to reduce moisture and humidity associated with increased sweating and buildup of moisture in skin folds compromising skin integrity.
- Lateral rotation provides enhanced pressure redistribution and reduced shearing to promote tissue healing and reduce skin damage from caregiver handling.
- Promotion of pulmonary and cardiac function through lateral movement.
Product Feature: ‘StaticPillow’ - motionless head section
Description
- Air cells in the head section of the surface are motionless to promote head and neck positioning and reduce potential disturbance to the client.
Clinical Application
- To promote rest and healing, the head area is motionless to reduce sleep disturbances.
- Greater stability promotes head positioning, breathing, and swallowing.
- Stable head position reduces perceptual feedback for clients with vestibular challenges or those agitated by surface movement.
- Stability (and related sense of comfort) increase patient compliance and acceptance of surface use.
Clinical Justification Statements
- Stability at the head section allows for optimal head positioning to promote breathing and swallowing.
- Reduced movement of the head reduces vestibular cues and promotes greater quality of sleep and promotion of healing.
- Increased client compliance results from the sensation of stability and security.
Product Feature: 'HeelOffload'
Description
- Slimmer, lower-profile air cells at the heel section allow the lightweight, bony heel and ankle areas to immerse deeper into the surface.
Clinical Application
- Increased immersion and targeted pressure redistribution at the heels and ankles, reducing peak pressure on these high-risk bony prominences.
Clinical Justification Statements
- Reduction of peak pressure under the heel and ankle areas to reduce the risk of heel pressure injuries in at-risk clients.
Product Feature: ‘EasyCover’ for infection control
Description
- Cover is easily removed for cleaning/disinfecting without removing the entire surface
- Zippers are easily manipulated and covered with a protective flap
- Mattress surface can be laundered to ensure no cross contamination of the surface between multiple patient use
Clinical Application
- Covers are quickly and easily removed to ensure minimal disturbance and patient handling requirements.
- Ensuring additional cover availability reduces the need for clients to be transferred off the surface while cover is laundered.
- Full surface laundering reduces risk of contamination in multiple patient use situations (rental, facility equipment pools etc.).
Clinical Justification Statements
- Easy cleaning/disinfecting of covers and mattress surface ensures infection protection.
- Ease of cover removal reduces patient handling/transfer requirements and additional risk of skin damage.
Product Feature: Constant Low Pressure (CLP) Therapy/Static Therapy
Description
- Lower air cells remain inflated to reduce bottoming out
- Lower air cells retain air during power outages
Clinical Application
- Increased protection of skin and bony prominences (sacrum, coccyx and ischial tuberosities, greater trochanters) due to maintained air pressure, for those clients who cannot tolerate alternating cell movement or air loss functions due to pain and agitation or additional medical equipment.
- Skin protection during caregiving activities
- CLP mode is beneficial for palliative clients to maintain skin protection while reducing painful movement.
Clinical Justification Statements
- Skin and bony prominences are protected from contact with hard surfaces reducing risk of worsening skin issues and development of new pressure injuries.
- Client can be turned or change position (side lying, sitting, foot elevation etc.) in bed without risk of increased pressure on bony and high-risk areas.
- Maintained skin protection and wound management for clients with multisystem or palliative conditions where movement is disruptive and painful.
Product Feature: Pulsate Therapy
Description
- Inflation/deflation of cells simultaneously to create a pulsating motion to promote the movement of fluids through the body
Clinical Application
- Pulse action mimics body movement to promote circulation of blood and interstitial fluid throughout the body.
- Promotion of blood flow to ensure oxygen delivery to compromised tissues and development of wound healing.
- Reduced risk of edema leading to stretching of compromised skin.
Clinical Justification Statements
- Pulsation therapy promotes fluid movement throughout the body where clients have limited active movement and/or are in bed for long periods.
- Improved blood flow and oxygenation of tissues promotes wound healing.
- Promotion of cardiac and pulmonary function to encourage wound healing and decrease risk of further pressure injury development.
- Optimal skin protection for clients with multisystem or palliative conditions.
Product Feature: Low Noise Pump
Description
- Quiet pump decreases irritation and promotes a desirable sleep environment
Clinical Application
- Reduced sound from the pump promotes better quality sleep, reduced agitation and associated movement potentially damaging to tissues.
Clinical Justification Statements
- Quiet sleep environment promotes sleep and restoration of tissues. Decreased agitation and associated movement reduces risk of tissue damage due to shear and friction.
The examples of statements provided are suggestions based on general product applications. Specific clinical justifications should be based upon individual client physical and functional assessments.