Berthe J V, Bustillo A, Mélot C, de Fontaine S
Department of Plastic and Reconstructive Surgery, Erasme University Hospital, Brussels, Belgium.
Acta Chir Belg. 2007 Mar-Apr;107(2):155-61.
Pressure ulcers are a frequent complication of bed rest. The development of an efficient and low cost pressure relieving system for the prevention of bed-sores would be of considerable hospital health and economic interest. Our study was designed to determine the effectiveness in pressure-sore prevention of an interface pressure-decreasing mattress, the Kliniplot mattress, used in our institution since 1978.
In a prospective randomised controlled 7-month clinical trial we compared the Kliniplot mattress with our standard hospital mattress in 1729 patients admitted to medical and surgical departments (neurology, cardiology, oncology-haematology, neurosurgery, thoracic surgery and orthopaedic surgery). Two groups (Klinipot mattress and standard hospital mattress) 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. Patients' characteristics and pressure-sore risk factors were similar at the baseline in both groups. Patients presenting with a pressure sore at the time of admission were excluded.
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).
Our results show that the occurrence of pressure sores is not reduced but is delayed when patients are nursed on a Kliniplot pressure-decreasing mattress.
压疮是卧床休息常见的并发症。开发一种高效且低成本的预防褥疮的减压系统对医院的健康和经济利益具有重要意义。我们的研究旨在确定自1978年起在我们机构使用的一种界面减压床垫——Kliniplot床垫在预防压疮方面的有效性。
在一项为期7个月的前瞻性随机对照临床试验中,我们将Kliniplot床垫与我们医院的标准床垫在1729名内科和外科(神经科、心脏病科、肿瘤血液科、神经外科、胸外科和骨科)住院患者中进行了比较。两组(Kliniplot床垫组和标准医院床垫组)均接受预防压疮的监测。从患者入院直至最终发生褥疮,每天对患者进行评估。两组患者的特征和压疮风险因素在基线时相似。入院时已有压疮的患者被排除。
1729名参与研究的患者中有42名(2.4%)至少发生了一处压疮。使用Kliniplot床垫护理的657名患者中有21名(3.2%)发生了褥疮,使用标准床垫护理的1072名患者中有21名(1.9%)发生了褥疮(p = 0.154)。使用Kliniplot床垫发生压疮的中位时间为31天(范围6 - 87天),使用标准床垫为18天(范围2至38天)(p < 0.001)。使用改良的埃克量表评估,两组在基线时发生褥疮的风险类别无差异(p = 0.764)。两组压疮的严重程度无差异(p = 0.918)。
我们的结果表明,当患者使用Kliniplot减压床垫护理时,压疮的发生率并未降低,但发生时间有所延迟。