In the quiet hours of an intensive care unit, nurses have long relied on a stopwatch. Every two hours, a bedridden patient has to be turned. The ritual, taught in nursing schools for decades, is the oldest defense against one of medicine’s most stubborn complications: the pressure injury.
That ritual is now changing. Hospitals in Europe, the Middle East, and parts of Asia are shifting toward automated systems that take the timing out of human hands, and a new category of mattress sits at the center of the change.
The category has a clunky acronym, MLTM, which stands for multifunction lateral turning mattress. Unlike older alternating-pressure mattresses, which inflate and deflate cells in turn to shift load, an MLTM physically turns the patient from side to side, combines that motion with pressure redistribution, controls the microclimate against the skin, and reduces the shear forces that tear fragile tissue during every manual reposition.
The category was created by ABeWER, a Cypriot medical device manufacturer whose flagship system, the multiTURN® 6, is now rolling out through distributor networks in Malta, Saudi Arabia, Romania, and several European markets. The company describes the product as the first MLTM of its kind, and presented the system at ROMMEDICA 2025 in Bucharest last year.
For clinicians, the appeal is not novelty. It is math. Pressure injuries, still commonly called bedsores or decubitus ulcers, affect between 5% and 15% of patients in long-term care and up to 40% of critically ill patients, according to figures compiled by the European Pressure Ulcer Advisory Panel. In high-income health systems, each hospital-acquired pressure injury is estimated to add thousands, and in severe cases tens of thousands, of euros to a single patient’s stay, once debridement, antibiotics, reconstruction, and extended admission are counted. In lower-resource systems, the cost is measured in mortality.
A case study published by ABeWER in 2025 tracked a cohort of patients with Stage 4 pressure injuries, the deepest and most dangerous form, where muscle, tendon, or bone becomes exposed. All patients in the cohort showed either full healing or clinical improvement on the multiTURN® 6 system, with zero cases of deterioration during the study window. Independent reviews remain more cautious about any single mattress class, but the direction of the evidence is consistent: modern moist dressings paired with dynamic support surfaces outperform traditional gauze and static foam in advanced pressure injuries.
That is where the industry conversation is now heading. Across 2024 and 2025, wound-care specialists have argued that dressings, however advanced, cannot eliminate the mechanical forces that create an ulcer in the first place. A silicone foam dressing can reduce friction. It cannot reduce the hours of continuous pressure on a sacrum or a heel. That gap, often called the biomechanical gap, is what products like the multiTURN® 6 are designed to close.
The clinical community is not unanimous. Older lateral rotation beds, available since the 1990s, drew mixed reviews at the time, with concerns about patient tolerance and staff training. Newer MLTM designs use gentler, adjustable turning cycles, integrated moisture control, and software that records position changes automatically for compliance audits. That last feature has become a selling point in systems where inspectors increasingly ask for digital evidence of repositioning rather than paper logs.
Hospital procurement teams are also responding to a workforce argument. Nursing shortages across Europe and North America have made manual two-hourly turns harder to guarantee on understaffed night shifts, a concern that has surfaced in staffing reviews of both acute and long-term care. Automated turning systems change the calculation by removing the requirement from the duty roster.
ABeWER’s own expansion follows the same logic. The company recently announced new distribution partnerships in Saudi Arabia and Malta, following its Romanian launch last year, with both acute hospitals and long-term care chains as target accounts. More information on the multiTURN® 6 system and the broader research program is available on the manufacturer’s website, ABeWER.
Not every health system will move at the same pace. Capital equipment cycles in hospitals are long, and smaller facilities may continue to rely on alternating-pressure mattresses for less critical patients. But the trend line is clear. The 2026 update to the international NPIAP/EPUAP/PPPIA pressure injury guideline, currently in final drafting, is expected to strengthen recommendations for dynamic support surfaces in Stage 3 and Stage 4 wounds, and for prophylactic use in high-risk ICU patients.
Whether that shift is remembered as a quiet revolution or a slow correction, nurses are likely to notice one thing first. The stopwatch is finally going back in the drawer.
