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Pressure relieving support surfaces: a randomised evaluation
J Nixon1, E A Nelson, G Cranny
1Clinical Trial Research Unit, University of Leeds, UK.
Health Technology Assessment (Winchester, England)
|June 6, 2006
Summary
Alternating pressure mattress replacements and overlays show no significant difference in preventing new pressure ulcers. However, mattress replacements are more cost-effective, reducing overall healthcare expenses and delaying ulcer development.
Area of Science:
- Medical Devices
- Wound Care
- Health Economics
Background:
- Pressure ulcers pose a significant challenge in healthcare settings, impacting patient well-being and increasing costs.
- Alternating pressure surfaces are commonly used to prevent and manage pressure ulcers.
- Comparative effectiveness and cost-effectiveness of different alternating pressure surfaces require rigorous investigation.
Purpose of the Study:
- To compare alternating pressure overlays and replacement mattresses regarding new pressure ulcer development, healing, patient acceptability, and cost-effectiveness.
- To assess the impact of pressure ulcers on patients' overall well-being.
Main Methods:
- A multicenter, randomized, controlled trial involving 1972 patients aged 55 years and older.
- Patients were randomized to alternating pressure overlays or replacement mattresses.
- Qualitative study and focus groups explored patient well-being and clinical experiences.
Main Results:
- No statistically significant difference in new pressure ulcer development (10.7% overlay vs. 10.3% replacement).
- Alternating pressure mattress replacements were associated with lower overall costs and delayed ulceration.
- Higher patient dissatisfaction and difficulties with movement reported with overlays.
Conclusions:
- Alternating pressure mattress replacements are recommended for procurement due to cost-effectiveness, with no increased risk of pressure ulcer development.
- Patient preferences for overlays can be accommodated if replacements are unavailable or if patients request them.
- Further research should compare mattress replacements with high-specification foam mattresses and investigate costs in higher-risk groups.
