title: Randomised controlled trial of two pressure-relieving systems.
abstract: The primary objective of this randomised controlled trial was to determine whether there were significant differences between two pressure-relieving systems. A secondary aim was to investigate whether the availability of extra pressure-relieving equipment would reduce the incidence of ulcers in an acute hospital setting. A total of 141 patients in a care-of-the-elderly unit, who were assessed to have a high risk of developing pressure ulcers using the Waterlow score, were recruited; 70 were nursed using Huntleigh Nimbus 3 in conjunction with the Aura cushion (Group A), and 71 using the Pegasus Cairwave Therapy System in conjunction with the Proactive 2 Seating cushion (Group B). The main outcome measure was visual assessment, supported by a photographic record. There were three main findings: for non-heel ulcers and overall improvement, there was no statistically significant difference between the two products tested; for heel ulcers there was a significant difference (P = 0.019) with more patients healing in Group A than in Group B. The average length of stay of patients who completed the trial was 21.6 days (Group A) and 21.7 days (Group B) for patients completing a live (range 1-121 days) and for patients who died 29.7 days (Group A) and 24.3 days (Group B). Routine monitoring showed that, before the trial, the incidence of hospital-acquired pressure ulcers (Torrance grade 2+) was 0.2%; during the trial, this dropped to 0.13%. The study showed differences in the efficacy of different mattress products; with a sufficiently large study, it is possible to demonstrate statistically significant results. Provision of extra pressure-relieving equipment can reduce the incidence of pressure ulcers but may not influence length of stay.
authors.affiliation: Queen's Hospital, Burton upon Trent, UK.
authors.forename: L
authors.initials: L
authors.lastname: Russell
authors.forename: T M
authors.initials: TM
authors.lastname: Reynolds
authors.forename: J
authors.initials: J
authors.lastname: Carr
authors.forename: A
authors.initials: A
authors.lastname: Evans
authors.forename: M
authors.initials: M
authors.lastname: Holmes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D011312:Pressure; D003668:Pressure Ulcer / Q000628:therapy*