The cost of prevention and treatment of pressure ulcers: A systematic review

Demarré, Liesbet; Lancker, Aurélie Van; Hecke, Ann Van; Verhaeghe, Sofie; Grypdonck, Maria; Lemey, Juul; Annemans, Lieven; Beeckman, Dimitri

doi:10.1016/j.ijnurstu.2015.06.006

Cited by 336 publications

(271 citation statements)

References 44 publications

(18 reference statements)

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“…This amount does not include the savings in legal fees to defend against claims of HAPUs. However, according to a recent systematic review by Demarre and colleagues, 64 the cost of pressure ulcer prevention lowers the overall mean cost per patient by more than $1200 to $1500 per patient day. Organizational estimates demonstrate that a savings of more than $1 million has been amortized in the past 2 years, after dressing purchase.…”

Section: Discussionmentioning

confidence: 99%

“…This cost savings estimate related to prevention is also consistent with other cost analysis studies of pressure ulcers. [63][64][65][66] Our robust prevention program, now including the dressing, has yielded a substantial cost savings and has contributed to our sustained pressure ulcer incidence of zero to 0.2 (all stages of HAPUs) in the past 2 years since completion of this trial.…”

Section: Discussionmentioning

confidence: 99%

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Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit

Kalowes

Messina

2016

American Journal of Critical Care

104

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Background In critically ill patients, prevention of pressure ulcers is a challenge because of the high risk for multiple comorbid conditions, immobility, hemodynamic instability, and increased use of medical devices. Objectives To compare the difference in incidence rates of hospital-acquired pressure ulcers (HAPUs) in critically ill patients between those treated with usual preventive care and a 5-layered soft silicone foam dressing versus a control group receiving usual care. Secondary goals were to examine risk factors for HAPUs in critically ill patients and to explicate cost savings related to prevention of pressure ulcers. Methods A prospective, randomized controlled trial in the intensive care units at a 569-bed, level II trauma hospital. All 366 participants received standard pressure ulcer prevention; 184 were randomized to have a 5-layered soft silicone foam dressing applied to the sacrum (intervention group) and 182 to receive usual care (control group). Results The incidence rate of HAPUs was significantly less in patients treated with the foam dressing than in the control group (0.7% vs 5.9%, P = .01). Time to injury survival analysis (Cox proportional hazard models) revealed the intervention group had 88% reduced risk of HAPU development (hazard ratio, 0.12 [95% CI, 0.02-0.98], P = .048). Conclusion Use of a soft silicone foam dressing combined with preventive care yielded a statistically and clinically significant benefit in reducing the incidence rate and severity of HAPUs in intensive care patients. This novel, cost-effective method can reduce HAPU incidence in critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit

Kalowes

Messina

2016

American Journal of Critical Care

104

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“…The total cost in United Kingdom is between 1.4 and 2.1 billion annually, 4 which is confirmed by a recent systematic review. 30 Unfortunately, despite the intensive research in this particular area, there are few RCTs in the literature yet. The evidence-based analysis of Medical Advisory Secretariat of Ontario Ministry of Health and LongTerm Care published in 2009 concluded that "the role of NPWT in chronic pressure ulcers remains unclear".…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, in various acute or chronic wounds, others reported better QoL. 30,39 In fact, a true cost analysis was not performed. Wanner, 28 wrote only that NPWT was "cheaper than the traditional dressings".…”

Section: Discussionmentioning

confidence: 99%

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

Cirocchi¹,

G²,

Mutafchiyski³

et al. 2017

NPWTJ

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REVIEWAbstract-: Pressure ulcers are a highly prevalent source of morbidity with an equally high incidence of up to 38.0% amongst different categories of healthcare institutions. Therefore, the management and therapeutic approach toward these often hospital-or facility-acquired problems remain critical aspects of long-term care. Negative pressure wound therapy (NPWT) has proven effective in addressing the barriers to pressure ulcer healing including increasing blood flow to previously ischemic wound areas by generating subatmospheric pressure which vacuums in circulation. The objective of this study was to compare negative pressure wound therapy (NPWT) versus surgical wounds healing by secondary intention (SWHSI). A systematic literature search was conducted using the PubMed and Scopus search engine up until the 20 Th January 2017 including the terms: "negative pressure wound therapy" and "pressure ulcers". In this systematic review, six randomized controlled trials were included. NPWT is deemed appropriate and effective method and widely used by clinicians to promote the healing of wounds and ulcers of different etiology. The heterogeneity found in individual trials regarding the inclusion criteria, therapeutic procedures, the criteria and methods of outcome evaluation, however, did not allow for a data evaluation with statistically valid conclusions. It is reasonable to assume that a subset of patients with pressure ulcers can be effectively treated with NPWT, with optimal results and good cost-benefit ratio, also with respect to the quality of life.

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“…Среди них во всем мире пролежни являются одной из наиболее сложных медицинских и социальных проблем. Сложность заключается в недостаточной эффективности многих традиционных методов консервативного и хирургического лечения, отсутствии ранних прогностических критериев в развитии пролежней [4][5][6].…”

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Clinical and Immunological Aspects of Bedsores Development

Borisov¹,

Kasparov²,

Matsenko³

2017

СПНО (MPSE)

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Проведен анализ литературных данных по развитию пролежней. Определено понятие пролежней как местной, локализованной травмы кожи и/или мягких тканей, развивающееся в результате сдавления в сочетании с ишемией. С переходом от термина «pressureulcer» (дословно язва давления) к термину «pressureinjury» (дословно травма давления). Описан исторический экскурс данной проблемы. Представлена распространенность заболевания. В свете современных представлений охарактеризованы этиологические факторы развития пролежней. Несмотря на то, что пролежни представлены как мультифакторное заболевание, одну из основных причин их развития определили как нарушение в иммунитете, в связи с большим набором функций выполняемых иммунной системой, в том числе контроль целостности анатомических барьеров кожи, регуляции процесса воспаления, формирования иммунного ответа, контроля пролиферации и дифференцировки клеток. Что послужило основанием рассматривать больных с пролежнями как пациентов с иммунопатологией. Ключевые слова: пролежни, иммунитет, клинико-иммунологическая диагностика. CLINICAL AND IMMUNOLOGICAL ASPECTS OF BEDSORES DEVELOPMENTBorisov S.A., Kasparov E.V., Matsenko M.V. Research Institute of Medical Problems of the North FRC KSC SB RAS, Krasnoyarsk, e-mail: org@impn.ruWe carried out the analysis for the data on decubitus development from scientific literature. We had taken into account this lesion as local focalized injury of skin and/or soft tissues, which appears as a result of compression associated with ischemia with the transition from the term «pressure ulcer» to the term «pressure injury» (дословно травма давления). We also offer historical insights into the problem and the description of the prevalence of the disease. The etiological factors of decubitus development had been characterized in terms of their modern presentation. Despite decubitus is a multi-factor disease, one of the main reasons of its development is related to immunity disturbances. It is caused by the wide range of functions, common for immune system, including the control over the continuity of skin anatomic barriers, the inflammation process regulation, the formation of immune response, the control of proliferation and differentiation of cells. The aforementioned have resulted in considering the patients with decubitus as the patients with immune pathology.

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The cost of prevention and treatment of pressure ulcers: A systematic review

Cited by 336 publications

References 44 publications

Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit

Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

Clinical and Immunological Aspects of Bedsores Development

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