Methods for Pressure Ulcer Prevention

1
Methods for PressureUlcer 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 (RR0.80, 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).

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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.