Investigating the efficacy of a nonpowered pressure-reducing therapeutic mattress: a retrospective multi-site study

To ascertain the ability of combining data to examine the effectiveness of a lateral support surface, data from independent studies were analyzed. Patients placed on the surface (N = 75) were elderly (mean age 70.2 years), had multiple comorbities, and an average Braden score of 12.66. Of these patients, 8.4% had a history of preexisting pressure ulcers and their average albumin was 3.56. Seventeen patients without wounds and believed to be "at risk" (average Braden score = 10.75) were treated prophylactically for an average of 63.3 days. Records of 45 wounds (32 subjects) were sufficiently complete to be included in the wound healing rate analysis. No ulcers occurred in the preventive group. No impact was associated with combining the data across the setting. A slight impact was anticipated when combining the data by setting and wound stage. Wounds on 28 of the subjects healed or were reduced in size, three remained unchanged, and one worsened. Overall, wound size reduced by an average of 68.85% over 84.69 days on the mattress, or 25.5% per week (n = 45, P = 0.0004). Stage I pressure ulcers reduced 46% per week (n = 6, P = 0.022), Stage II ulcers at 33% per week (n = 22, P = 0.05), Stage III ulcers at 6.97% per week (n = 13, P = 0.004), and Stage IV at 3.24% per week (n = 4, P = 0.058). The results of this retrospective review indicate that data from various sites can be combined and that the support surface may be an effective intervention modality. However, wound healing is a complex process, and support surfaces are only one of many interventions needed to facilitate healing. Future research using valid wound-healing instruments is needed.