Pressure-relieving supports in an ICU

Abstract

Intensive care wards have a high incidence of pressure sores. This trial, in an eight-bed unit, aimed to compare the cost-effectiveness of constant-low-pressure and alternating-pressure support systems for preventing pressure sores. Patients without sores with a Norton risk score of <13 were allocated to either alternating- or constant-low-pressure supports according to their hospital number. The cheapest supports were used initially, and changed for more sophisticated types if the patient's pressure areas deteriorated. None of the 23 patients using low-cost alternating-pressure supports developed open sores and only one had to be transferred to a more sophisticated mattress because of persistent erythema. Eleven out of 20 patients on constant-low-pressure mattresses or overlays developed either persistent erythema (three) or sores (eight). Ten were transferred to more expensive support systems. The mean cost of supports per patient in the alternating-pressure group was £44.50 and in the constant-low-pressure group £86.20.

Evaluation of prevalence and incidence of pressure ulcers and their relationship with mattresses used in a general hospital intensive care unit

“…Gray and Smith [3] compared standard hospital mattress (Transfoam) with a new foam mattress (Transfoamwave); due to the very low observed incidence of PU, however, it was not possible to determine a difference in the clinical performance of the mattresses. Gebhardt et al [2] compared the costeffecctiveness of constant-low-pressure and alternatingpressure support systems for preventing PU. The least expensive supports were used initially, and these were changed for more sophisticated types if the patient's pressure areas deteriorated.…”

A systematic review of economic evaluations assessing interventions aimed at preventing or treating pressure ulcers

“…The studies were conducted in a variety of settings: three studies (Gebhardt et al, 1996;Inman et al, 1993Inman et al, , 1999 were conducted in Intensive Care Units (ICUs); one in spinal injury centre (Catz et al, 2005); one in an orthopaedic unit (Price et al, 1999); one in the operating theatre (Pham et al, 2011b); one in long term care (Pham et al, 2011a); and, one included vascular, orthopaedic and medical elderly units (Iglesias et al, 2006). There were also differing definitions of pressure damage with some studies including grade 1 pressure damage (i.e.…”

“…There were also differing definitions of pressure damage with some studies including grade 1 pressure damage (i.e. intact skin with non-blanching erythema) (Catz et al, 2005;Gebhardt et al, 1996;Price et al, 1999;Pham et al, 2011a,b), others grade 2 and above (Iglesias et al, 2006), and in the remaining studies it was unclear (Inman et al, 1993(Inman et al, , 1999. High specification foam mattresses were evaluated against low air loss mattresses (Catz et al, 2005) and against a package of care including skin cleaning and nutrition (Pham et al, 2011a).…”

“…The alternating pressure mattresses had a lower mean cost of £283.6 per patient linked to a longer time to developing a pressure ulcer and a reduced length of stay for the alternating mattresses. Gebhardt et al (1996) compared low airloss with alternating pressure mattresses. They found that 4% (1/23) in the alternating-pressure group developed a grade 1 or above pressure ulcer compared with 55% (11/20) in the low-pressure group (p < 0.001, 95% CI: 27-74).…”

Recursos materiales para la prevención y el tratamiento de las úlceras por presión: análisis de la situación en Andalucía

“…Los tipos de apósitos que llevan más tiempo comercializados están presentes en mayor número de centros. evaluar la dotación de medios materiales preventivos y de tratamiento en los centros sanitarios son muy escasos, tanto en nuestro país (8-10) como en países de nuestro entorno (4,11,12), lo cual hace difícil contrastar con datos objetivos la percepción de baja disponibilidad expresada por las enfermeras clínicas, cuya importancia ha sido puesta de manifiesto por diversos autores, tanto en hospitales (9,10,13,14) como en la atención de salud comunitaria (15,16), donde han demostrado la mejora en los indicadores epidemiológicos de UPP relacionada con el aumento de la disponibilidad de superficies especiales de manejo de la presión (SEMP).…”