Martin van Leen1, Steven Hovius2, Ruud Halfens3, Jacques Neyens4, Jos Schols3. 1. Avoord Zorg en Wonen, Etten-Leur, The Netherlands; email:martin_van_leen@zonnet.nl. 2. Department of Plastic Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands. 3. Department of Health Services Research, Maastricht University, Maastricht, The Netherlands. 4. Department of Health Services Research, Maastricht University, Maastricht, The Netherlands; and De Riethorst Stromenland, Geertruidenberg, Netherlands.
Abstract
OBJECTIVE: Evidence of the best mattress for preventing pressure ulcers is not conclusive. In a single center, prospective, crossover trial on pressure ulcer incidence in nursing home residents, a static air overlay mattress, without a pump, on top of a visco-elastic foam mattress was compared with a visco-elastic foam mattress alone. METHODS: The study was performed using a randomized crossover design. Forty-one patients with a score of 19 or lower on the Braden scale, but with no pressure ulcer at the start, were divided into 2 groups; 21 patients received a visco-elastic foam mattress (control group) and 20 patients a static air overlay on top of a visco-elastic foam mattress (intervention group) for a period of 6 months. In the second (crossover) period of 6 months, 19 patients participated in each group. Patients were checked weekly and, only when signs of development of a pressure ulcer were present was treatment altered to reposition patients according to the nursing home pressure ulcer protocol. No statistically significant differences were noted between the 2 groups with regard to age, gender, or Braden scale score. RESULTS: Of 41 patients, 3 died and were unable to participate in the crossover period, 8 patients (22.2%) developed a category 2 or higher pressure ulcer on a visco-elastic foam mattress (control group) and 2 (5.2%) on a static air mattress (intervention group)(P = 0.087). There was a difference regarding pressure ulcer incidence between patients with a very low Braden score between 6 and 12, and patients with a mean score between 13-19. Out of 8 patients, in the 2(25%) who developed a pressure ulcer on a foam mattress, the ulcers showed no signs of healing. In the static air group all pressure ulcers healed by normal treatment according to a standardized pressure ulcer treatment protocol. CONCLUSIONS: In this small study, static air overlay mattresses provided a better prevention than visco-elastic foam mattresses alone (5.2% vs 22.2%). The Braden scores of the patients in both groups did not change during the 6-month test. The decision to use repositioning only when there were signs of a pressure ulcer is acceptable when a static air overlay is in position. The 22.2% incidence of pressure ulcers in the foam group, however, may stress the need to continue repositioning when using this type of mattress. .
RCT Entities:
OBJECTIVE: Evidence of the best mattress for preventing pressure ulcers is not conclusive. In a single center, prospective, crossover trial on pressure ulcer incidence in nursing home residents, a static air overlay mattress, without a pump, on top of a visco-elastic foam mattress was compared with a visco-elastic foam mattress alone. METHODS: The study was performed using a randomized crossover design. Forty-one patients with a score of 19 or lower on the Braden scale, but with no pressure ulcer at the start, were divided into 2 groups; 21 patients received a visco-elastic foam mattress (control group) and 20 patients a static air overlay on top of a visco-elastic foam mattress (intervention group) for a period of 6 months. In the second (crossover) period of 6 months, 19 patients participated in each group. Patients were checked weekly and, only when signs of development of a pressure ulcer were present was treatment altered to reposition patients according to the nursing home pressure ulcer protocol. No statistically significant differences were noted between the 2 groups with regard to age, gender, or Braden scale score. RESULTS: Of 41 patients, 3 died and were unable to participate in the crossover period, 8 patients (22.2%) developed a category 2 or higher pressure ulcer on a visco-elastic foam mattress (control group) and 2 (5.2%) on a static air mattress (intervention group)(P = 0.087). There was a difference regarding pressure ulcer incidence between patients with a very low Braden score between 6 and 12, and patients with a mean score between 13-19. Out of 8 patients, in the 2(25%) who developed a pressure ulcer on a foam mattress, the ulcers showed no signs of healing. In the static air group all pressure ulcers healed by normal treatment according to a standardized pressure ulcer treatment protocol. CONCLUSIONS: In this small study, static air overlay mattresses provided a better prevention than visco-elastic foam mattresses alone (5.2% vs 22.2%). The Braden scores of the patients in both groups did not change during the 6-month test. The decision to use repositioning only when there were signs of a pressure ulcer is acceptable when a static air overlay is in position. The 22.2% incidence of pressure ulcers in the foam group, however, may stress the need to continue repositioning when using this type of mattress. .
Authors: Brecht Serraes; Martin van Leen; Jos Schols; Ann Van Hecke; Sofie Verhaeghe; Dimitri Beeckman Journal: Int Wound J Date: 2018-03-05 Impact factor: 3.315
Authors: Chunhu Shi; Jo C Dumville; Nicky Cullum; Sarah Rhodes; Asmara Jammali-Blasi; Victoria Ramsden; Elizabeth McInnes Journal: Cochrane Database Syst Rev Date: 2021-05-10