Branom R, Rappl L M
Span-America Medical Systems Inc., Greenville, SC 29606, USA.
Ostomy Wound Manage. 2001 Sep;47(9):38-46.
"Least costly but most effective" has never been more important to healthcare delivery than in the current healthcare environment of changing reimbursement systems. In wound care, the high costs associated with renting advanced support surfaces may be an area where expenses can be decreased if similar outcomes can be attained by using more affordable mattresses. This article compares the healing rates and eventual outcomes of wounds among two groups of patients randomly assigned to one of two support surfaces. A commonly used low-air-loss mattress was compared with the study mattress, an advanced, non-powered, air and foam surface. Subjects were patients admitted to either of two long-term healthcare settings for the treatment of wounds. The resulting two groups of 10 patients each were evenly matched for average age and percentage of patients who were nutritionally deficient as indicated by albumin or pre-albumin levels. The presence of gastrointestinal tubes and ventilator dependency also was recorded. Consistent wound care protocols were used on both groups, including turning schedules, nutrition, topical medication, and dressings. The study period covered a maximum of 8 weeks; interest was centered on the rate of wound healing and progress toward a goal rather than the length of time to completely close a wound. After 8 weeks, or upon discharge from the study pressure ulcers in the study mattress group closed at an average rate per week of 9.0% +/- 4.8 versus 5.0% +/- 3.7 in the low-air-loss mattress group. This study indicates that the study mattress can provide benefits to the wound healing process similar to or better than low-air-loss mattresses at a substantially reduced cost.
“成本最低但效果最佳”在医疗服务中从未像在当前报销系统不断变化的医疗环境中这样重要。在伤口护理中,如果使用更经济实惠的床垫能取得类似效果,那么与租用先进支撑面相关的高昂成本可能是一个可以降低开支的领域。本文比较了随机分配到两种支撑面之一的两组患者伤口的愈合率和最终结果。将一种常用的低气耗床垫与研究用床垫进行了比较,研究用床垫是一种先进的、无动力的空气和泡沫表面床垫。研究对象是入住两家长期医疗机构之一进行伤口治疗的患者。最终两组各有10名患者,在平均年龄以及根据白蛋白或前白蛋白水平表明存在营养缺乏的患者百分比方面进行了均衡匹配。还记录了胃管的使用情况和呼吸机依赖情况。两组均采用一致的伤口护理方案,包括翻身计划、营养、局部用药和敷料。研究期最长为8周;关注点在于伤口愈合率和朝着目标进展的情况,而非伤口完全闭合所需的时间。8周后,或在研究结束出院时,研究用床垫组压力性溃疡的平均每周闭合率为9.0%±4.8%,而低气耗床垫组为5.0%±3.7%。这项研究表明,研究用床垫在大幅降低成本的情况下,可为伤口愈合过程带来与低气耗床垫相似或更好的益处。