Methods for Pressure Ulcer Prevention Jeremy Doody Biomedical Engineering /6/15
What is an Ulcer? Also known as pressure sores or bed sores Occurs on bony area of body (ex: hip) Damage to skin and tissue Elderly/bedridden people are more succeptable 4 stages of Ulcers
Solutions Detect and treat as early as possible Dressings (bandages) Topical Agents Turning to elleviate pressure spots Cleanliness
Comparing Topical Agents with Placebo Houwing study 4 week study split patients into 3 groups Intervention group- 29 patients given DMSO-cream every 6 hours Placebo group- 32 patients given a “fake cream” every 6 hours Control group- 18 patients given no cream All groups changed their lying position by 30 degrees every 6 hours
Results of Study 62.1% got ulcers in the intervention group 31.3% got ulcers in the placebo group 38.9% got ulcers in the control group Effectiveness based on risk ratio (RR) There was no statistically significant difference in pressure ulcer incidence between the intervention and the control group (RR 1.60, 95% CI 0.84 to 3.04). There was no statistically significant difference in pressure ulcer incidence between the placebo and control group (RR=0.80, 95% CI 0.37 to 1.74). There was a statistically significant difference in pressure ulcer incidence between the intervention and the placebo group (RR = 1.99, 95% CI 1.10 to 3.57).
Dressing vs. No Dressing Kalowes study This study followed up participants while in the intensive care unit average length of stay was 6.5 days (range was 0 to 120 days) Intervention group- 169 patients had a dressing applied to the skin covering the tailbone area Control group- 166 patients had no dressing applied.
Results of Study Intervention group- 0.4% got ulcers Control group- 4% got ulcers Effectiveness based on risk ratio (RR)
Conclusion Topical agents actually increased ulcers in Houwing study Topical agents vs. placebo was inconclusive Dressings decreased ulcer occurance in Kalowes study Dressings were effective in general Studies were inconsistent with each other (ex: follow up times)
The future Trials should be bigger to show more meaningful results More variables should be kept constant Better technology could create more effective topical agents, dressings, or a combo of both.