Dimitri Beeckman1, Brecht Serraes2, Charlotte Anrys3, Hanne Van Tiggelen4, Ann Van Hecke5, Sofie Verhaeghe6. 1. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland; School of Health Sciences, Örebro University, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Southern Denmark; School of Nursing and Midwifery, Monash University, Australia. Electronic address: Dimitri.Beeckman@UGent.be. 2. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Nursing department (General Hospital) AZ Nikolaas, Hospitaalstraat 1, B-9100 Sint-Niklaas, Belgium. Electronic address: Brecht.Serraes@UGent.be. 3. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium. Electronic address: Charlotte.Anrys@UGent.be. 4. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium. Electronic address: Hanne.VanTiggelen@UGent.be. 5. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium. Electronic address: Ann.VanHecke@UGent.be. 6. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium. Electronic address: Sofie.Verhaeghe@UGent.be.
Abstract
BACKGROUND: Pressure ulcers are a global issue and substantial concern for healthcare systems. Various types of support surfaces that prevent pressure ulcer are available. Data about the effectiveness and cost of static air support surfaces and alternating air pressure mattresses is lacking. OBJECTIVES: To compare the effectiveness and cost of static air support surfaces versus alternating air pressure support surfaces in a nursing home population at high risk for pressure ulcers. DESIGN: Prospective, multicentre, randomised controlled clinical, non-inferiority trial. SETTING: Twenty-six nursing homes in Flanders, Belgium. PARTICIPANTS: A consecutive sample of 308 participants was selected based on the following eligibility criteria: high risk for pressure ulcer and/or with category 1 pressure ulcer, being bedbound and/or chair bound, aged > 65 years, and use of an alternating air pressure mattress. METHODS: The participants were allocated to the intervention group (n = 154) using static air support surfaces and the control group (n = 154) using alternating air pressure support surfaces. The main outcome measures were cumulative incidence and incidence density of the participants developing a new category II-IV pressure ulcer within a 14-day observation period, time to develop a new pressure ulcer, and purchase costs of the support surfaces. RESULTS: The intention-to-treat analysis revealed a significantly lower incidence of category II-IV pressure ulcer in the intervention group (n = 8/154, 5.2%) than in the control group (n = 18/154, 11.7%) (p = 0.04). The median time to develop a pressure ulcer was significantly longer in the intervention group (10.5 days, interquartile range [IQR]: 1-14) than in the control group (5.4 days, [IQR]: 1-12; p = 0.05). The probability to remain pressureulcer free differed significantly between the two study groups (log-rank X² = 4.051, df = 1, p = 0.04). The overall cost of the mattress was lower in the intervention group than in the control group. CONCLUSIONS: A static air mattress was significantly more effective than an alternating air pressure mattress in preventing pressure ulcer in a high-risk nursing home population. Considering multiple lifespans and purchase costs, static air mattresses were more cost-effective than alternating air pressure mattresses.
RCT Entities:
BACKGROUND: Pressure ulcers are a global issue and substantial concern for healthcare systems. Various types of support surfaces that prevent pressure ulcer are available. Data about the effectiveness and cost of static air support surfaces and alternating air pressure mattresses is lacking. OBJECTIVES: To compare the effectiveness and cost of static air support surfaces versus alternating air pressure support surfaces in a nursing home population at high risk for pressure ulcers. DESIGN: Prospective, multicentre, randomised controlled clinical, non-inferiority trial. SETTING: Twenty-six nursing homes in Flanders, Belgium. PARTICIPANTS: A consecutive sample of 308 participants was selected based on the following eligibility criteria: high risk for pressure ulcer and/or with category 1 pressure ulcer, being bedbound and/or chair bound, aged > 65 years, and use of an alternating air pressure mattress. METHODS: The participants were allocated to the intervention group (n = 154) using static air support surfaces and the control group (n = 154) using alternating air pressure support surfaces. The main outcome measures were cumulative incidence and incidence density of the participants developing a new category II-IV pressure ulcer within a 14-day observation period, time to develop a new pressure ulcer, and purchase costs of the support surfaces. RESULTS: The intention-to-treat analysis revealed a significantly lower incidence of category II-IV pressure ulcer in the intervention group (n = 8/154, 5.2%) than in the control group (n = 18/154, 11.7%) (p = 0.04). The median time to develop a pressure ulcer was significantly longer in the intervention group (10.5 days, interquartile range [IQR]: 1-14) than in the control group (5.4 days, [IQR]: 1-12; p = 0.05). The probability to remain pressure ulcer free differed significantly between the two study groups (log-rank X² = 4.051, df = 1, p = 0.04). The overall cost of the mattress was lower in the intervention group than in the control group. CONCLUSIONS: A static air mattress was significantly more effective than an alternating air pressure mattress in preventing pressure ulcer in a high-risk nursing home population. Considering multiple lifespans and purchase costs, static air mattresses were more cost-effective than alternating air pressure mattresses.
Authors: Brecht Serraes; Ann Van Hecke; Hanne Van Tiggelen; Charlotte Anrys; Sofie Verhaeghe; Dimitri Beeckman Journal: Int Wound J Date: 2020-06-30 Impact factor: 3.315
Authors: Charlotte Anrys; Hanne Van Tiggelen; Sofie Verhaeghe; Ann Van Hecke; Dimitri Beeckman Journal: Int Wound J Date: 2018-11-09 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