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Adults in any patient


care setting

(14 RCTs)

12 RCTs assessed two types of overlays in a mixed, neurology, ICU and Cardiology population* (from 1985 to 2005) 4 studies were done from 2000 and forward. One study (Gilcreast et al. 2005) reported on other devices not included in this HTIS report.

Any prevention program, devices, mattress or overlay that may alter the incidence of heel ulcers

2 studies were already included in the Reddy report (Russell and L i c h t e n s t e i n e t a l . 2 0 0 0 1 5 ; a n d G u n n i n g b e r g e t a l . 2 0 0 One study (Gray and Smith, 200018) found no difference in comparing foam mattresses to standard hospital mattresses in a surgical orthopedic ward and medical ward population. Another study (Sanada et al., 200314) found no difference in heel ulcer occurrence rates in a mixed population comparing air overlays to standard hospital mattresses 0 1 7 )

* N i c o s i a e t a l . 6 i d e n t i f i e d o n e o t h e r R C T ( V y h i l i d a l 1 9 9 7 ) a s a L T C p o p u l a t i o n h o w e v e r t h i s s a m e R C T w a s s t a t e d t o b e a c u t e c a r e o r s k i l l e d n u r s i n g f a c i l i t y i n t h e R e d d y e t a l . 3 a n d C u l l u m e t a l . 7 s y s t e m a t i c r e v i e w s . T h e r e w a s a l s o a d i s c r e p a n c y i n t h e c o m p a r a t o r i n t e r v e n t i o n . I t w a s r e p o r t e d a s a s t a n d a r d h o s p i t a l m a t t r e s s b y N i c o s i a e t a l . 6 a n d a s a f o a m o v e r l a y i n t h e o t h e r t w o r e p o r t s . 3 , 7

Randomized controlled trials

Two additional RCTs were retrieved that were not included in the systematic reviews.19,20 In a prospective randomized controlled 7-month clinical trial, Berthe et al.19 compared the Kliniplot® mattress with the standard hospital mattress in the prevention of PUs (N=1729). Two groups were monitored for the prevention of pressure sores. The patients were evaluated on a daily basis from their admission until the eventual occurrence of a bed-sore. Forty-two of the 1729 patients (2.4%) who entered the study developed at least one pressure sore. Twenty-one of the 657 patients (3.2%) nursed on the Kliniplot® mattress, and 21 of the 1072 patients (1.9%) on the standard mattress developed bed-sores (p = 0.154). The median time for the occurrence of pressure sores was 31 days (range 6-87) with the Kliniplot® mattress and 18 days (range 2 to 38) with the standard mattress (p < 0.001). The risk categories for developing bed-sores using the modified EK's scale were no different at the baseline between both groups (p = 0.764). The severity of the pressure sores was no different between both groups (p = 0.918). The authors concluded that the occurrence of PUs is not reduced but is delayed when patients are nursed on Kliniplot® pressure-decreasing mattresses. 19

Russell et al.20 conducted a randomized trial to compare patient outcomes with the RIK mattress (KCI) and the Nimbus 3 mattress (Huntleigh Healthcare). Patients (N=158) were assessed for their risk to develop pressure ulcers during the trial. There were no statistically significant differences. They authors concluded that for a significant proportion of patients, a static (RIK) mattress can be as effective as an active (Nimbus 3) mattress for management of pressure ulcers

Specialty Mattresses for Prevention of PUs in Acute and Critical Care


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