Titles

• Blumel JE, Tirado K, Schiele C, Schonffeldt G, Sarra S. [Prediction of the pressure ulcer development in elderly women using the Braden scale]. Rev Med Chil. 2004;132(5):595–600. [PubMed: 15279146]
• Cadue JF, Karolewicz S, Tardy C, Barrault C, Robert R, Pourrat O. [Prevention of heel pressure sores with a foam body-support device. A randomized controlled trial in a medical intensive care unit]. Presse Med. 2008;37(1 Pt 1):30–6. [PubMed: 18037257]
• Feuchtinger J. [Preventing decubitus ulcer in heart surgery interventions: visco-elastic foam layer on the operating room table--a study]. Pflege Z. 2006;59(8):498–501. [PubMed: 16955593]
• Gallart E, Fuentelsaz C, Vivas G, Garnacho I, Font L, Aran R. Experimental study to test the effectiveness of hyperoxygenated fatty acids in the prevention of pressure sores in hospitalized patients [Spanish] Enferm Clin. 2001;11(5):179–83.
• Matsui Y, Miyake S, Kawasaki T, Konya C, Sugama J, Sanada H. Randomized controlled trial of a two layer type air cell mattress in the prevention of pressure ulcers. Japan J Pressure Ulcers. 2001;3(3):331–7.
• Torra i Bou JE, Rueda Lopez J, Camanes G, Herrero Narvaez E, Blanco Blanco J, Martinez-Esparza EH, et al. [Heel pressure ulcers. Comparative study between heel protective bandage and hydrocellular dressing with special form for the heel]. Rev Enferm. 2002;25(5):50–6. [PubMed: 14508939]
• Segovia Gomez T, Verdu Soriano J, Nolasco Bonmati A, Rueda Lopez J. The effectiveness of a hyperoxygenated fatty acid compound in preventing pressure ulcers. EWMA Journal. 2005;5(2):27–31. [PubMed: 15779642]

Abstracts (When Available)

Blumel JE, Tirado K, et al. [Prediction of the pressure ulcer development in elderly women using the Braden scale]. Rev Med Chil. 2004;132(5):595–600. [PubMed: 15279146]

BACKGROUND: Pressure ulcers are a common complication among elderly patients confined to bed for long periods. The Braden scale is a commonly used risk assessment tool. AIM: To evaluate the use of Braden scale. PATIENTS AND METHODS: Seventy women aged 61 to 96 years, admitted to the Internal Medicine Service of Barros Luco-Trudeau Hospital, were studied. Their risk was evaluated using the Braden scale. The presence of pressure ulcer was diagnosed according to the National Pressure Ulcer Advisory Panel on admission, two weeks later and at discharge. RESULTS: On admission, mean Braden scale score was 16.6+/-2.8 and 34 women had a score of 16 or less, that is considered of risk. Twenty five women (20 with a score of 16 or less) developed pressure ulcers, mostly superficial. The odds ratio of a score of 16 or less for the development of ulcers was 4.2 (95% CI 1.8–11.7, p <0.001). The sensitivity and specificity of such score were 80 and 69% respectively. CONCLUSIONS: The Braden scale predicts the risk of developing pressure ulcers with a good sensitivity and specificity in female elderly patients.

Cadue JF, Karolewicz S, et al. [Prevention of heel pressure sores with a foam body-support device. A randomized controlled trial in a medical intensive care unit]. Presse Med. 2008;37(1 Pt 1):30–36. [PubMed: 18037257]

BACKGROUND: To assess in a prospective controlled study the efficacy and safety of a specific foam body-support device designed as to prevent heel pressure ulcers. METHODS: A randomization table was used to allocate 70 patients into 2 groups. The control group was treated with our standard pressure sore prevention protocol (half-seated position, water-mattress and preventive massages 6 times a day); the experimental group was treated with the same standard protocol as well as with the foam body-support device being evaluated. Patients were included if their Waterlow score was >10, indicating a high risk of developing pressure ulcers and if they had no skin lesion on the heels. Foam devices, covered with jersey, were constructed for the legs and allowed the heels to be free of any contact with the bed; another foam block was arranged perpendicularly to the first, in contact with the soles, to prevent ankles from assuming an equinus position (to prevent a dropfoot condition). The principal criterion for efficacy was the number of irreversible skin lesions on the heel (that is, beyond the stage of blanching hyperemia, reversible after finger pressure); these lesions were assessed every day until the end of the study (up to 30 days). FINDINGS: The number of irreversible heel pressure ulcers was lower in the experimental (3 patients, 8.6%) than in the control group (19 patients, 55.4%) (p<0.0001). Mean time without any pressure ulcer was higher in the experimental group (5.6 days, compared with 2.8 days, p=0.01). The groups did not differ in the number of pressure sores on the sacrum and leg. CONCLUSION: An anatomical foam body-support is effective in preventing heel pressure ulcers in patients on a medical intensive care unit and is well tolerated.

Gallart E, Fuentelsaz C, et al. Experimental study to test the effectiveness of hyperoxygenated fatty acids in the prevention of pressure sores in hospitalized patients. Enferm Clin. 2001;11(5):179–183. [Spanish]

Aim: To identify whether there are differences in the incidence of pressure sores in patients receiving preventive and those not undergoing this therapy. Design: A randomized, experimental study including a control and experimental group of patients. Study site: Hospital General Vall d’Hebron, Barcelona (Spain) from December 1999 to May 2000. Subjects: After calculation of the sample size required, 192 patients admitted to hospital without pressure sores and with mobility and altered activities (according to the EMINA risk scale) were included in the study. The sampling technique used was accidental including successive patients admitted to hospital. The patients were then randomly divided into two groups of 96 patients each. Intervention: In the control group the routine preventive therapy for pressure sores used in the hospital was applied. In addition to this preventive treatment, the experimental group also received hyperoxygenated fatty acids according to the protocol established for the study. Results: The incidence of pressure sores in the control group was of 35% (CI 95%; 27%–47%) and 19% (CI 95%; 12%–29%) in the experimental group; with the difference being statistically significant (chi square=6.8; gl=1; p=0.007. Conclusions: The incidence of pressure sores was lower in the group receiving preventive treatment with hyperoxygenated fatty acids thereby indicating the this therapy may be useful in the prevention of the development of pressure ulcers in hospitalized patients.

Segovia Gomez T, Verdu Soriano J, et al. The effectiveness of a hyperoxygenated fatty acid compound in preventing pressure ulcers. EWMA Journal. 2005;5(2):27–31.

Objective: To compare the effects of Mepentol, a hyperoxygenated fatty acid preparation, with a placebo treatment in preventing the development of pressure ulcers. Method: The research study consisted of a multicentre double-blind randomised clinical trial. The incidence of pressure ulcers, relative risk (RR), preventable fraction and number necessary to treat (NNT) were calculated. In addition, Kaplan-Meier survival curves, with log-rank test, and Cox’s proportional hazards regression model were used to compare both groups. Results: A total of 331 patients completed the study: 167 in the control group and 164 in the study group. Pressure-ulcer incidence during the study was 7.32% in the intervention group versus 17.37% in the placebo group (p0.006). These results show that for each 10 patients treated with Mepentol one pressure ulcer was prevented (NNT = 9.95). Survival curves and the regression model showed a significant statistical difference for both groups (p</=0.001). The average cost of Mepentol during the study was euro 7.74. Conclusion: Mepentol is an effective measure for pressure ulcer prevention. It was more effective than a greasy placebo product, and was found to be cost-effective.

Torra i Bou JE, Rueda Lopez J, et al. [Heel pressure ulcers. Comparative study between heel protective bandage and hydrocellular dressing with special form for the heel]. Rev Enferm. 2002;25(5):50–56. [PubMed: 14508939]

INTRODUCTION: The heels, together with the sacra area, are one of the most frequent spots where pressure sores appear here in Spain. Any preventive measure against pressure sores on heels needs be oriented towards two main objectives: effective relief of pressure and its compatibility with localized care and skin inspection in order to detect lesions early on at least once a day. PATIENTS, MATERIALS AND METHODS: The authors planned a comparative, multi-centered, open, labeled and controlled study in which patients were assigned to two groups receiving these treatments: one received traditional preventive pressure sore treatment and a protective bandage on their heels while the other used a special Allevyn Heel hydrocellular dressing to protect their heels. The patients took part in this study over an eight week period. The response variable used to determine the effectiveness of the preventive measure in this study was the appearance of pressure sores. RESULTS: At the beginning, 130 patients were included in this study, 65 in each one of the treatment groups. In the bandage group, 50 patients finished this study while 61 in the dressing group finished this study. The appearance of pressure sores in the protective bandage group occurred in 44% of the patients, 22 out of 50, while in the dressing group, the occurrence rate was 3.3%, 2 out of 61 patients with a value of “ji” squared p < 0.001. The risk factor to develop a pressure sore brought us a value of relative risk of 13.42 (IC 95%: 3.31–54.3) in the group wearing the protective bandage compared to the group wearing the dressing. COMMENTS: The results of this study allow us to accept as valid the alternate hypothesis that there exist significant statistical differences between both treatment methods in favor of the Allevyn Heel dressing instead of the protective heel bandage. The use of this dressing, even though it is more expensive a priori than the protective bandage, in terms of unit cost for the product, has proven to be more effective in preventing pressure sores, and cheaper than the protective bandage if we bear in mind these combination of variables: time of usage, application and removal.