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Research comparing three heel ulcer-prevention devices.

Darlene M Gilcreast1, Joseph B Warren, Linda H Yoder

  • 1University of Texas Health Science Center at San Antonio, USA. gilcreast@uthscsa.edu

Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society
|May 4, 2005
PubMed
Summary

The bunny boot effectively prevented heel ulcers in high-risk patients, similar to advanced devices. However, adding pillows to the bunny boot confounded results, impacting cost-effectiveness analysis for pressure ulcer prevention.

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Area of Science:

  • Medical Devices
  • Wound Prevention
  • Patient Care

Background:

  • Heel ulcers are a common complication in moderate- to high-risk inpatients.
  • Effective pressure-reduction devices are crucial for preventing heel ulcers.

Purpose of the Study:

  • To compare the effectiveness of three distinct pressure-reduction devices in preventing heel ulcers.
  • To evaluate the cost-effectiveness of these devices in a clinical setting.

Main Methods:

  • A prospective, quasi-experimental study involving 338 adult inpatients at two medical centers.
  • Patients were randomly assigned to three groups using the High-Cushion Kodel Heel Protector (bunny boot), Egg Crate Heel Lift Positioner (egg crate), or EHOB Foot Waffle Air Cushion (foot waffle).
  • Data collected included demographics, Braden Scale scores, comorbidities, skin assessments, length of stay, and device costs, analyzed using Chi-square, ANOVA, and regression.

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Main Results:

  • Out of 240 subjects with complete data, 12 heel ulcers developed (5% incidence).
  • The overall incidence was 3.9% for the bunny boot, 4.6% for the egg crate, and 6.6% for the foot waffle, with no significant difference among groups.
  • The bunny boot with added pillows demonstrated the highest cost-effectiveness.

Conclusions:

  • The bunny boot was found to be as effective as higher-technology devices in preventing heel ulcers.
  • The study's findings on cost-effectiveness were potentially confounded by the addition of pillows to the bunny boot.
  • Further research may be needed to isolate the effect of the device itself.