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Wound Progression and Healing in Patients With Deep Tissue Pressure Injuries When Placed on Air-Fluidized Therapy
Mark McIntosh1,2,3,4, Haley Cervantes1,2,3,4, Lynn Oakes1,2,3,4
1Mark McIntosh, MD, MPH, Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, Florida.
Purpose:
The purpose of this study was to examine the effect of placement on an air-fluidized therapy (AFT) bed or a low-air-loss (LAL) surface bed on wound healing and progression in patients with deep tissue pressure injuries (DTPIs).
Design:
Retrospective, comparative descriptive study.
Subjects And Setting:
The electronic medical records of 18 patients diagnosed with DTPI involving the sacral, coccygeal, and ischial locations were reviewed. The sample comprised 10 men and 8 women with a mean age of 62.6 (SD 15.9) years. The study setting was an academic, level 1 trauma health center located in the Southeastern United States.
Methods:
Medical records were identified by a query from the Hospital-Acquired Pressure Injury (HAPI) Debrief Tool, a secure clinical database completed by nursing wound care specialists. The size of the initial, worst, and final DTPI was operationalized as the surface area in cm2. Changes in the surface area from initial measure to worst measure, from worst measure to final measure, and from initial to final measure were compared between patients in the air-fluidized therapy (AFT) and LAL groups using Wilcoxon rank-sum tests.
Results:
Ten patients were placed on the AFT bed and compared with 8 patients placed on an LAL surface bed. The median and interquartile [Q1, Q3] initial wound size was similar for both bed-type groups: 11.9 [IQR 6.0, 19.5] cm2 for the AFT group and 4.7 [IQR 3.3, 22.5] cm2 for the LAL group, respectively (P = .2636). The median and interquartile change in wound size from initial to worst was 0.0 [IQR 0.0, 0.0] cm2 for the AFT group compared to 6.8 [IQR 1.8, 61.5] cm2 for the LAL group (P = .0050), while the change from initial to final was -7.4 [IQR -16.5, - 3.7] cm2 for the AFT group compared to 5.1 [IQR 1.8, 25.8] cm2 for the LAL group (P = .0178). These findings indicate less wound progression and better healing for the AFT group.
Conclusion:
Placing a patient diagnosed with a DTPI on an AFT bed rather than an LAL bed may prevent wound progression and promote more effective wound healing.
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