Vacuum-Compressed Underpads in Canadian LTC: SAP Loading, Rewet and Freight Density
A 120-bed home in Ontario rebuilt its supply room last year to fit a new medication refrigerator. The incontinence stock that used to occupy two shelving units now had to fit on one, and the business office was asked a question nobody enjoyed: could the home switch to the compressed case and keep the same number of pads in the building?
The answer turned out to be yes, and the more useful part of the exercise was what it forced the team to define. If a compressed case saves space, what exactly is being compressed, and what does that mean for the product the resident actually lies on?
What does a five-layer underpad actually do under a resident?
An underpad is a fluid management system made of layers that each have one job, and the performance of the whole depends on how well they hand fluid to each other.
| Layer | Job | What goes wrong when it is thin |
|---|---|---|
| :-- | :-- | :-- |
| Surface layer | Lets fluid pass through and keeps the surface feeling dry | Fluid pools on the surface, skin stays wet |
| Acquisition and distribution layer | Spreads a local gush across the core instead of letting it sit in one spot | A wet patch under pressure, wicking sideways to the linen |
| SAP core | Locks fluid into a gel so it cannot be released by pressure | Rewet rises; the pad holds fluid but gives it back |
| Barrier wrap | Keeps the swollen core from shedding particles | Gel escapes; the pad looks intact but the bed is soiled |
| Waterproof backsheet | Stops strike-through to the mattress | Linen and mattress contamination, more laundry |
The 60 x 90 cm five-layer underpad with a SAP core is built to that sequence, with a soft non-woven surface, an acquisition layer, the SAP core, a barrier wrap and a blue polyethylene backsheet. The layer that is easiest to cheapen without the product looking different is the acquisition layer, and it is the layer that decides whether a gush is spread or pooled, which is why it is the first thing to ask about when two quotes differ sharply.
How is absorbency tested, and why does rewet decide how a pad feels?
Capacity figures describe how much a core can take up. Rewet figures describe how much of it comes back. For a resident lying on a wet pad for two hours, the second number is the one that matters, because the skin reacts to moisture at the surface, not to the litres stored in the core.
A rewet test loads the pad, applies a defined pressure for a defined time, and weighs what transfers to an absorbent sheet placed on the surface. The pressure matters: a pad that performs well under a light load can release fluid when a heavier resident shifts position. That is why a rewet result quoted without its pressure and volume is not comparable, and why a specification should carry all three.
What does compression do to the core, and to your supply room?
Vacuum compression removes air from the pack. It does not remove polymer, and it does not change the formulation of the core, but it does flatten the loft of the fluff component that helps a pad spread fluid quickly. In a well-built product the loft recovers when the pack is opened and the pad is handled, which is why the practical test is a floor trial rather than a laboratory debate.
The logistics effect is easier to measure. Compressed packaging reduces storage volume substantially, and storage volume is what a care home in a Canadian city actually lacks: supply rooms double as clean linen storage, deliveries arrive on a dock shared with dietary, and every extra pallet position is a pallet position the home does not have. Fewer pallets also means fewer deliveries for the same number of pads, which is where the freight line moves.
How should a home compare cost per pad with cost per change?
Cost per pad is the easy number and the less useful one. Cost per change includes the pad, the gloves, the washcloth, the linen change if the pad failed, the staff minutes and the laundry load. A pad that costs a few cents more but holds a heavy overnight load without rewetting can be the less expensive product, because it removes a linen change and a skin-care episode from the shift.
Run the comparison on a single unit for a month. Count changes, count linen replacements that were caused by a pad failure, and multiply by your own loaded labour rate. Most homes discover that the difference between a budget pad and a specified pad is smaller than the cost of one avoidable linen change per resident per week.
What does Ontario's long-term care legislation expect from continence supplies?
The Fixing Long-Term Care Act, 2021 frames the home's obligation around a plan of care for each resident, which is why continence products belong in a documented plan rather than in a generic stock list. The practical implication for procurement is that the product has to be describable: a home that can name the pad, its absorbency class and the rationale for the choice is in a defensible position when a plan is reviewed or a family asks why a product was changed.
This is also where documentation standards pay off. A manufacturer working to ISO 13485 has a quality system behind its specification, and a home that asks for the specification, the rewet figure and the lot certificate is asking for the same discipline from its supplier that an inspector asks from the home.
Which secondary quality points are worth checking?
Three small ones come up repeatedly in Canadian homes. Colour fastness matters because a blue backsheet that bleeds onto a white sheet is a laundry problem, and the ISO 105 series is the method family behind that claim. Antibacterial or odour-control statements should be backed by a method such as ISO 20743, which is written for textile products and describes how the activity was measured. Skin contact claims sit under the ISO 10993 series, with irritation and sensitization testing under Parts 23 and 10 respectively.
None of these is a substitute for the structure and the rewet figure, but each is a place where a marketing sentence can outrun the evidence. A supplier who can name the method behind a claim is a supplier whose other numbers are worth trusting.
What should a home put in the specification?
| Field | Why it belongs in the tender |
|---|---|
| :-- | :-- |
| Dimensions in centimetres and inches | Avoids a size mismatch between a Canadian spec and an imported carton |
| Layer count and construction | Defines the product, not just the absorbency class |
| SAP loading in grams per square metre | The only figure that lets two cores be compared |
| Rewet value with test pressure and volume | Predicts skin dryness under a resident |
| Backsheet type and colour | Determines strike-through control and laundry risk |
| Pack count and compression | Drives storage and pallet arithmetic |
| Sampling standard | Tells you how the supplier judges a lot |
For lighter tasks, a smaller format keeps cost aligned with need: the 30 x 36 inch heavy-absorbency underpad covers chairs and treatment surfaces where a full-size pad is more product than the task requires. Homes running a sustainability line for non-infectious waste can add the PLA-backed underpad for the same format, kept on its own cart and its own waste route. The rest of the range, including briefs and bed protection, sits in the incontinence care collection.
A pad is one of the few products in a home that touches a resident for hours at a time. Specifying it properly is not paperwork; it is the difference between a dry resident and a laundry load, and the arithmetic of that difference is available on any unit that keeps a change log.
References
- ISO 10993-1:2018 — Biological evaluation of medical devices, Part 1 (checked 27 October 2026)
- ISO 10993-5:2009 — Biological evaluation of medical devices, Part 5: tests for in vitro cytotoxicity (checked 27 October 2026)
- ISO 10993-10:2021 — Biological evaluation of medical devices, Part 10: tests for skin sensitization (checked 27 October 2026)
- ISO 10993-23:2021 — Biological evaluation of medical devices, Part 23: tests for irritation (checked 27 October 2026)
- ISO 13485:2016 — Medical devices: quality management systems (checked 27 October 2026)
- ISO 14971:2019 — Application of risk management to medical devices (checked 27 October 2026)
- ISO 2859-1:1999 — Sampling procedures for inspection by attributes, Part 1 (checked 27 October 2026)
- ISO 9001:2015 — Quality management systems: requirements (checked 27 October 2026)
- ISO 31000:2018 — Risk management: guidelines (checked 27 October 2026)
- ISO 45001:2018 — Occupational health and safety management systems (checked 27 October 2026)
- ISO 14001:2015 — Environmental management systems (checked 27 October 2026)
- ISO 20743:2021 — Textiles: determination of antibacterial activity of textile products (checked 27 October 2026)
- ISO 105-E04:2013 — Textiles: tests for colour fastness, Part E04: colour fastness to perspiration (checked 27 October 2026)
- ISO 105-A02:1993 — Textiles: tests for colour fastness, Part A02: grey scale for assessing change in colour (checked 27 October 2026)
- ISO 15223-1:2021 — Medical devices: symbols used with information supplied by the manufacturer (checked 27 October 2026)
- Fixing Long-Term Care Act, 2021 — Ontario e-Laws (checked 27 October 2026)
Printable companion: the continence supply and storage SOP template carries the fields an auditor asks for: pack size, storage location, par level and the date the lot was opened.
Run your monthly pad count through the clinic supply planner before you compare cases, then put the pallet quantity on the bulk quote form so freight is priced against the volume you actually move.
Buying for a facility? Open a wholesale and institutional account for case pricing, purchase-order billing and a named account contact.
Related Reading
- Underpad par levels for Ontario long-term care homes: a reorder formula
- Disposable underpads and patient safety: what Canadian clinics must explain
- Qualifying a new disposable underpad supplier in Canada: samples, specs and a floor trial
Frequently Asked Questions
Does vacuum compression reduce how much a pad absorbs?
Not in the way the question usually implies. Compression removes air from the pack so the case occupies less volume in transit and in the supply room; it does not remove super absorbent polymer from the core. What compression can affect is loft, the fluffed thickness that helps a pad spread fluid quickly across the core instead of letting it pool in one spot. A well-built pad recovers most of that loft when the pack is opened, and the way to verify it for your own home is a floor trial: open a pack, let it sit for the shift, then compare how a wetted pad behaves against an uncompressed product.
What does a rewet figure mean on a product sheet?
Rewet measures how much liquid comes back out of a pad and onto the surface when pressure is applied after the pad has absorbed a load. It is the number that predicts whether a resident feels dry, because a pad that holds fluid but releases it under body weight produces the same skin exposure as a thinner pad that never absorbed properly. Ask for the test pressure and the load volume alongside the result, since a rewet value quoted without its conditions cannot be compared with another supplier's figure.
Is a 60 x 90 cm pad always better than a 30 x 36 inch pad?
They are close to the same size, and the choice is about the task rather than the dimensions. A full-size pad under a bed-bound resident covers the turning and repositioning zone; a smaller pad is more economical for a chair, a treatment surface or a lighter support need. Homes that buy one size for the whole building usually end up using a large pad where a smaller one would do, which is a quiet cost that never appears in the budget as a line item.
How does compression change freight and storage for a care home?
It changes the volume, and volume is what freight and storage are priced on. A case that occupies roughly 70 percent less space than an uncompressed equivalent takes fewer pallet positions, which matters in homes where the supply room is also the clean linen room. The saving is real but it belongs to the logistics line rather than the clinical line, so it should be argued on pallet count and deliveries per month, not on absorbency.
What should a tender ask for beyond a price per pad?
Dimensions, layer count, SAP loading stated in grams per square metre, backsheet type, rewet figure with its test conditions, pack count and pack compression. Add the sampling standard the manufacturer works to, and ask for a lot-level certificate rather than a general product brochure. A price per pad buys a number; a specification buys a product you can hold a supplier to when the third delivery feels thinner than the first.
Should a home switch to a compostable underpad?
Only where the waste route supports it and the task is appropriate. A PLA-backed underpad in a home with an industrial composting contract can divert a meaningful share of non-infectious waste, which is why some Ontario homes run them on lighter care tasks. It should not be used where a heavier absorbency is clinically required, and it must not enter a biomedical waste stream. Keep the two products on separate carts with separate labels.
How should compressed cases be stored before use?
On a pallet or shelf off the floor, in a dry room, away from exterior walls that sweat in a Canadian winter, and away from the room where disinfectant concentrates are decanted. Compressed packs are rigid and stack well, which tempts a home to build a tall column; keep the stack height reasonable so the lower packs are not permanently deformed. Rotate by lot, and write the date the case was opened on the pack, not just on the case.
How many pads a month does a 100-resident home actually use?
The arithmetic is per resident, per shift, and the honest answer comes from your own change log rather than from a benchmark. A resident on two-hourly checks with a light support need may use three to five pads a day; a palliative resident may use eight or more, plus extra during repositioning. Take the home's actual change count for a month, add a 15 percent buffer for admissions and heavy weeks, and compare that figure against the case you are being quoted.
Last updated: October 2026. CliniEco Medical is a licensed medical device establishment (MDEL #35334).
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