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Methods for Pressure Ulcer Prevention. Jeremy Doody Biomedical Engineering 2018 10/6/15. What is an Ulcer?. Also known as pressure sores or bed sores Occurs on bony area of body (ex: hip) Damage to skin and tissue Elderly/bedridden people are more succeptable 4 stages of Ulcers.
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Methods for PressureUlcer Prevention Jeremy Doody Biomedical Engineering 2018 10/6/15
What is an Ulcer? • Also known as pressure sores or bed sores • Occurs on bony area of body (ex: hip) • Damage to skin and tissue • Elderly/bedridden people are more succeptable • 4 stages of Ulcers
Solutions • Detect and treat as early as possible • Dressings (bandages) • Topical Agents • Turning to elleviate pressure spots • Cleanliness
Comparing Topical Agents with Placebo • Houwing study • 4 week study split patients into 3 groups • Intervention group- 29 patients given DMSO-cream every 6 hours • Placebo group- 32 patients given a “fake cream” every 6 hours • Control group- 18 patients given no cream • All groups changed their lying position by 30 degrees every 6 hours
Results of Study • 62.1% got ulcers in the intervention group • 31.3% got ulcers in the placebo group • 38.9% got ulcers in the control group • Effectiveness based on risk ratio (RR) • There was no statistically significant difference in pressure ulcer incidence between the intervention and the control group (RR 1.60, 95% CI 0.84 to 3.04). • There was no statistically significant difference in pressure ulcer incidence between the placebo and control group (RR=0.80, 95% CI 0.37 to 1.74). • There was a statistically significant difference in pressure ulcer incidence between the intervention and the placebo group (RR = 1.99, 95% CI 1.10 to 3.57).
Dressing vs. No Dressing • Kalowes study • This study followed up participants while in the intensive care unit • average length of stay was 6.5 days (range was 0 to 120 days) • Intervention group- 169 patients had a dressing applied to the skin covering the tailbone area • Control group- 166 patients had no dressing applied.
Results of Study • Intervention group- 0.4% got ulcers • Control group- 4% got ulcers • Effectiveness based on risk ratio (RR)
Conclusion • Topical agents actually increased ulcers in Houwing study • Topical agents vs. placebo was inconclusive • Dressings decreased ulcer occurance in Kalowes study • Dressings were effective in general • Studies were inconsistent with each other (ex: follow up times)
The future • Trials should be bigger to show more meaningful results • More variables should be kept constant • Better technology could create more effective topical agents, dressings, or a combo of both.