Twersky Jack, Montgomery Terry, Sloane Richard, Weiner Madeline, Doyle Susan, Mathur Kavita, Francis Mary, Schmader Kenneth
Duke University, Durham, NC, USA.
Ostomy Wound Manage. 2012 Dec;58(12):18-24.
Pressure ulcer prevention is an important aspect of nursing home care. A 20-week, unblinded, randomized, controlled trial was conducted to compare the rate of nursing home-acquired pressure ulcers and adverse events between residents managed using: 1) a silk-like textile for bedding paired with high-absorbency adult incontinence briefs or 2) usual-care, plain-weave cotton/polyester bed sheets and adult incontinence briefs. All residents with an expected length of stay 30 days or more who agreed to participate were enrolled in the study and assessed daily. A total of 46 residents (all men) was enrolled; 26 (median age 72.7 years, range 54 to 95 years) in the intervention group and 20 (median age 69.5 years, range 51 to 91 years) in the usual care group. At baseline, there were no significant differences in resident demographic variables, including Braden Scale risk scores. Fewer pressure ulcers developed in the intervention (six; average follow up 75.6 days/person) than in the standard care group (20; average follow up 95.6 days/person) (hazard ratio = 0.31, 95% confidence interval 0.12, 0.78) and the number of new non-Stage I ulcers was significantly lower in the intervention group (HR = .23, 95% CI .078, .69, P = 0.0084). The number of adverse events did not differ significantly between the two groups. Additional research is warranted on use of products with the silk-like fabric, alone or in combination with highabsorbencybriefs, in larger groups and different populations.
压疮预防是疗养院护理的一个重要方面。开展了一项为期20周的非盲、随机对照试验，以比较使用以下两种方式管理的居民中，疗养院获得性压疮的发生率和不良事件：1）用于床上用品的丝绸样织物搭配高吸收性成人失禁内裤，或2）常规护理，平纹棉/聚酯床单和成人失禁内裤。所有预期住院时间为30天或更长且同意参与的居民均纳入研究并每日进行评估。共纳入46名居民（均为男性）；干预组26名（中位年龄72.7岁，范围54至95岁），常规护理组20名（中位年龄69.5岁，范围51至91岁）。基线时，居民人口统计学变量，包括Braden量表风险评分，无显著差异。干预组发生的压疮（6例；人均平均随访75.6天）少于标准护理组（20例；人均平均随访95.6天）（风险比=0.31，95%置信区间0.12，0.78），干预组新出现的非I期溃疡数量显著更低（HR = 0.23，95% CI 0.078，0.69，P = 0.0084）。两组间不良事件数量无显著差异。有必要对丝绸样织物产品单独使用或与高吸收性内裤联合使用，在更大规模人群和不同人群中开展进一步研究。
