Research comparing three heel ulcer-prevention devices.
OBJECTIVE
To compare 3 pressure-reduction devices for effectiveness in prevention of heel ulcers in moderate-risk to high-risk patients.


METHODS
A prospective quasi-experimental 3-group design was used.


METHODS
A sample of 338 "moderate-risk to high-risk" adult inpatients, ages 18 to 97, at 2 medical centers in South Texas were studied.


METHODS
The Braden Scale for Pressure Ulcer Risk and investigator-developed history and skin assessment tools were used.


METHODS
Subjects were randomly assigned to the High-Cushion Kodel Heel Protector (bunny boot), Egg Crate Heel Lift Positioner (egg crate), or EHOB Foot Waffle Air Cushion (foot waffle). Data are demographics, Braden scores, comorbidities, skin assessments, lengths of stay, and costs of devices. Analyses were Chi-square, analysis of variance, and regression.


RESULTS
Of 240 subjects with complete data, 77 (32%) were assigned to the bunny boot group, 87 (36.3%) to the egg crate, and 76 (31.7%) to the foot waffle. Twelve ulcers developed in 240 subjects (5% incidence). Six subjects had only 1 foot. Eleven ulcers were Stage I (nonblanchable erythema), and 1 was Stage II (partial thickness). Overall incidence was 3.9% for the bunny boot, 4.6% for the egg crate, and 6.6% for the foot waffle (not significantly different among groups). The bunny boot with pillows was most cost effective (F[3], N = 240) = 1.342, p <or= .001).


CONCLUSIONS
In this study, the bunny boot was as effective as higher-tech devices. The results, however, were confounded by nurses adding pillows to the bunny boot group.
Gilcreast
Darlene M
DM
University of Texas Health Science Center at San Antonio, USA. gilcreast@uthscsa.edu
Warren
Joseph B
JB
Yoder
Linda H
LH
Clark
Janis J
JJ
Wilson
Joyce A
JA
Mays
Mary Z
MZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D016523:Foot Ulcer / Q000451:nursing / Q000517:prevention & control*; D006365:Heel; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D003668:Pressure Ulcer / Q000451:nursing / Q000517:prevention & control*; D011446:Prospective Studies; D011482:Protective Devices / Q000191:economics; D018570:Risk Assessment; D017592:Skin Care / Q000451:nursing; D013781:Texas