Malgorzata Arnold, MSN, RN, CWOCN, RML, Specialty Hospital, Hinsdale, Illinois.
Cecilia Yanez, BSN, RN, CWOCN, RML, Specialty Hospital, Hinsdale, Illinois.
J Wound Ostomy Continence Nurs. 2020 May/Jun;47(3):284-290. doi: 10.1097/WON.0000000000000646.
We evaluated a new bed that updates the functionality of the current air fluidized therapy (AFT)/continuous low-pressure (CLP) pressure redistributing beds. This bed was evaluated in conjunction with standard wound care interventions in a long-term acute care hospital (LTACH). The AFT feature is designed to provide pressure distribution via a fluid-like medium that forces air though millions of tiny silicone beads that float the patient's body to achieve maximum immersion and envelopment. The CLP feature of the bed provides pressure distribution for the upper body. Standard wound care was provided that included debridement, topical treatments, and biophysical therapies such as negative pressure wound therapy, as indicated.
Our multiple case series comprised 10 medically compromised patients with 25 wounds. Their mean age was 63 years, 50% were male, and the mean cumulative Braden Scale score was 12.4 out of 23, indicating a high risk for pressure injury (PI). Seven of 10 patients were incontinent of urine, 6 had fecal incontinence, and 2 had ostomies. Types of wounds treated included 2 large tissue defects from surgical excisions for the treatment of gangrene and 23 PIs. On admission, wounds had an average surface area of 139.1 cm. The mean percentage of reduction in wound surface area was 59.3% over an average of 31.3 days of therapy. No new wounds formed during their course of care despite being at elevated risk.
Findings from this multiple case series suggest that the AFT/CLP bed facilitates healing of advanced wounds in medically complex patients when included as part of a wound care program. Despite mild to high risk, no new PIs developed, and severe PIs and large tissue defects significantly improved or completely resolved. One hundred percent of surveyed staff members recommend use of the AFT/CLP bed.
我们评估了一种新型床，该床更新了当前空气流体治疗（AFT）/连续低压（CLP）压力重新分布床的功能。该床在一家长期急性护理医院（LTACH）与标准伤口护理干预措施一起进行了评估。AFT 功能旨在通过迫使空气通过数百万个微小的硅胶珠的流体状介质提供压力分布，这些硅胶珠使患者的身体漂浮起来，以实现最大的浸没和包裹。床的 CLP 功能为上半身提供压力分布。提供了标准的伤口护理，包括清创、局部治疗和生物物理治疗，如负压伤口治疗，如有需要。
我们的多病例系列包括 10 名患有 25 处伤口的身体状况不佳的患者。他们的平均年龄为 63 岁，50%为男性，Braden 量表总分为 12.4 分（满分 23 分），表明存在发生压力性损伤（PI）的高风险。10 名患者中有 7 名尿失禁，6 名大便失禁，2 名有造口。治疗的伤口类型包括 2 个因治疗坏疽而进行手术切除的大组织缺损和 23 个 PI。入院时，伤口的平均表面积为 139.1cm。在平均 31.3 天的治疗过程中，伤口的平均表面积减少了 59.3%。尽管存在风险升高，但在治疗过程中没有形成新的伤口。
多病例系列研究的结果表明，当 AFT/CLP 床作为伤口护理计划的一部分时，可促进身体状况复杂的患者中晚期伤口的愈合。尽管存在轻度至高度风险，但未发生新的 PI，且严重的 PI 和大组织缺损显著改善或完全缓解。100%的调查员工推荐使用 AFT/CLP 床。
