A cushioning surface for cooling tissue that reaches a predefined level of immersion into the cushioning surface, comprising: a segmented fluid cushion comprising a plurality of cells interconnected to allow fluid to flow from each cell to at least one of the other plurality of cells; and wherein one or more of the plurality of cells contains a heat exchange material. The cushioning surface may further comprise a cooling element associated with and for removing heat from the one or more cells containing a heat exchange material.