A clinical trial of a bead bed system for the prevention of pressure sores in elderly orthopaedic patients

Goldstone, Leonard A.; Norris, Michael S.; O’Reilly, Michael; White, John

doi:10.1111/j.1365-2648.1982.tb00274.x

Cited by 49 publications

(10 citation statements)

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“…In some prospective, randomized trials, use of pressure-reducing devices led to a lower incidence and severity of pressure ulcers than with a standard hospital mattress among orthopedic patients, 30,31 surgical and oncology patients, 32 intensive care patients, 33,34 and acute hospital patients. 35 Not all trials, however, showed a difference in preventing pressure ulcers in acute care [36][37][38] or in long-term care.…”

Section: Turning Every 2 Hours May Not Be Enoughmentioning

confidence: 99%

Prevention and treatment of pressure ulcers: what works? what doesn't?

Thomas¹

2001

Cleveland Clinic Journal of Medicine

116

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Although no gold standard for preventing or treating pressure ulcers has been established, data from clinical trials indicate specific efforts are worthwhile. Preventive strategies include recognizing risk, decreasing the effects of pressure, assessing nutritional status, avoiding excessive bed rest, and preserving the integrity of the skin. Treatment principles include assessing the severity of the wound; reducing pressure, friction, and shear forces; optimizing wound care; removing necrotic debris; managing bacterial contamination; and correcting nutritional deficits. s KEY POINTS Pressure ulcers are often blamed on poor nursing care in long-term care facilities, but the incidence is actually higher in acute care hospitals. The most important reversible host factor contributing to wound healing is nutritional status. Several studies suggest that dietary protein, in particular, is important in healing pressure ulcers. Surgical closure of pressure ulcers results in more rapid resolution of the wound. The chief problems are frequent recurrence and inability of frail patients to tolerate the procedure. Any therapy that dehydrates the wound, such as dry gauze, heat lamps, air exposure, or liquid antacids, is detrimental to chronic wound healing The most common complications are increased mortality, osteomyelitis, and sepsis.

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Section: Turning Every 2 Hours May Not Be Enoughmentioning

confidence: 99%

Prevention and treatment of pressure ulcers: what works? what doesn't?

Thomas¹

2001

Cleveland Clinic Journal of Medicine

116

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“…A variety of materials are used for support surfaces, such as air-filled supports, water-filled supports, contoured or textured foam supports, and alternative foam mattresses or overlays [2]. As the surface materials differ significantly from each other, previous studies have not reached a definite conclusion on the effect of support surfaces on preventing pressure injury development [2,24,[26][27][28][29][30][31][32]. Furthermore, these studies have a high heterogeneity in study design, sample size, settings, and comparative standard hospital mattresses, which may also partially explain the heterogeneity in results.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, foam mattresses or overlays, especially those with pressure redistributing characteristics, have become an increasingly popular method of attempting to reduce the development of pressure injuries without compromising patients' comfort [2,25]. However, the findings on the association between foam supports and the occurrence of pressure injuries are inconsistent, with some showing a decrease in the incidence of pressure injuries [26][27][28][29], some concluding no significant effect [30][31][32], and some presenting a slight increase in the development of pressure injuries [33] depending on various characteristics of the support surfaces, study design, settings, etc.…”

Section: Introductionmentioning

confidence: 99%

Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study

et al. 2020

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Background and purpose Pressure injuries remain a significant health care issue in various settings. The purpose of this study was to examine the relationship between a pressure redistributing foam mattress (PRFM) and the development of pressure injuries. Methods This study employed an observational prospective cohort study design. We enrolled 254 participants from the intensive care unit who were at risk of developing pressure injuries. Participants were exposed to either a nonpressure redistributing foam mattress (NPRFM), which was the standard mattress used at the study site, or a PRFM made of viscoelastic, temperature-sensitive, polyurethane memory foam. The patients’ assignment to either a PRFM or NPRFM was performed upon their admission, before the study eligibility screening. The relationship between the PRFM and the development of pressure injuries was studied using a logistic regression model. Results The overall incidence of pressure injuries was 5.9% (15/254) in our study, with 1.6% (2/127) for participants who used a PRFM and 10.2% (13/127) for those using a NPRFM. After adjusting for potential confounding variables, use of a PRFM was associated with an 88% reduced risk of pressure injury development (OR = 0.12, 95% CI: 0.03, 0.56, P = 0.007). The use of a PRFM also contributed to a postponed occurrence of pressure injuries by 4.2 days on average in comparison with that of a NPRFM (P = 0.041). Conclusions A PRFM is associated with a significantly reduced incidence and postponed occurrence of pressure injuries. It is recommended to use a PRFM for patients at risk of developing pressure injuries.

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“…Incorrect randomisation method (randomisation based on participants' hospital numbers) Gebhardt 1996 Incorrect randomisation method Geelkerken 1994 Commentary Goldstone 1982 Incorrect randomisation method The study authors describe a random component in the sequence generation process, such as referring to a random number table, using a computer random number generator, coin tossing, shuffling cards or envelopes, throwing dice, drawing of lots.…”

Section: Low Riskmentioning

confidence: 99%

Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers

Shi

Dumville

Cullum

et al. 2021

Cochrane Database of Systematic Reviews

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Background Pressure ulcers (also known as injuries, pressure sores, decubitus ulcers and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Reactive surfaces that are not made of foam or air cells can be used for preventing pressure ulcers. Objectives To assess the effects of non‐foam and non‐air‐filled reactive beds, mattresses or overlays compared with any other support surface on the incidence of pressure ulcers in any population in any setting. Search methods In November 2019, we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In‐Process & Other Non‐Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta‐analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Selection criteria We included randomised controlled trials that allocated participants of any age to non‐foam or non‐air‐filled reactive beds, overlays or mattresses. Comparators were any beds, overlays or mattresses used. Data collection and analysis At least two review authors independently assessed studies using predetermined inclusion criteria. We carried out data extraction, 'Risk of bias' assessment using the Cochrane 'Risk of bias' tool, and the certainty of the evidence assessment according to Grading of Recommendations, Assessment, Development and Evaluations methodology. If a non‐foam or non‐air‐filled surface was compared with surfaces that were not clearly specified, then the included study was recorded and described but not considered further in any data analyses. Main results We included 20 studies (4653 participants) in this review. Most studies were small (median study sample size: 198 participants). The average participant age ranged from 37.2 to 85.4 years (median: 72.5 years). Participants were recruited from a wide range of care settings but were mainly from acute care settings. Almost all studies were conducted in Europe and America. Of the 20 studies, 11 (2826 participants) included surfaces that were not well described and therefore could not be fully classified. We synthesised data for the following 12 comparisons: (1) reactive water surfaces versus alternating pressure (active) air surfaces (three studies with 414 participants), (2) reactive water surfaces versus foam surfaces (one study with 117 participants), (3) reactive water surfaces versus reactive air surfaces (one study with 37 participants), (4) reactive water surfaces versus reactive fibre surfaces (one study with 87 participants), (5) reactive fibre surfaces ve...

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A clinical trial of a bead bed system for the prevention of pressure sores in elderly orthopaedic patients

Cited by 49 publications

References 0 publications

Prevention and treatment of pressure ulcers: what works? what doesn't?

Prevention and treatment of pressure ulcers: what works? what doesn't?

Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study

Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers

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