1. Methods for Pressure Ulcer Prevention Jeremy Doody Biomedical Engineering 2018 10/6/15

2. 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

3. Solutions  Detect and treat as early as possible  Dressings (bandages)  Topical Agents  Turning to elleviate pressure spots  Cleanliness

4. 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

5. 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).

6. 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.

7. Results of Study  Intervention group- 0.4% got ulcers  Control group- 4% got ulcers  Effectiveness based on risk ratio (RR)

8. 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)

9. 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.