This article reports the findings of a small evaluation audit which compares the Dyna-Form Mercury Advance Mattress to that of the Softform Premier Active Mattress (a foam mattress with dynamic underlay). A small group of patients with similar co-morbidities who were an emergency admission were recruited to an evaluation audit. Their median age and Waterlow score indicated that these patients were at high risk of pressure ulcer development. All patients were given the same nursing care on the two mattresses and all were moved, handled and repositioned 2-4 hourly. Of the patients nursed on the Dyna-Form Mercury Advance mattress, three did not develop pressure ulcers. The two who already had pressure ulcers when they were recruited appeared to have healed within four days. Of the patients nursed on the Softform Premier Active mattress, three patients did not develop ulcers and two did. Although the sample size was small, the comprehensive assessment gave interesting results, particularly on the Dyna-Form Mercury Advance. A larger study may be of benefit to demonstrate efficacy of these products further.
The NHS is driven by quality targets that permeate all specialties and care settings, and by the need for safety, efficiency and patient-centred care. Efficient care pathways need to be safe and indicated, and should offer measurable advantages and patient benefits as well as giving a treatment end point. Complex wounds require very careful management from the multidisciplinary team and present clinicians with intricate challenges to promote cost-effective wound healing. Wound bed preparation and debridement need to be as effective and as non-traumatic as possible. Larval therapy removes devitalised tissue effectively with minimal tissue trauma, and early intervention results in cost-effective wound care in the patient's own surroundings and can prevent admission to hospital for surgical debridement. This article discusses the history of, and evidence for, larval therapy, its cost effectiveness and the different presentations of larval therapy and their various benefits.
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