[Prevention of heel pressure sores with a foam body-support device. A randomized controlled trial in a medical intensive care unit].
BACKGROUND
To assess in a prospective controlled study the efficacy and safety of a specific foam body-support device designed as to prevent heel pressure ulcers.


METHODS
A randomization table was used to allocate 70 patients into 2 groups. The control group was treated with our standard pressure sore prevention protocol (half-seated position, water-mattress and preventive massages 6 times a day); the experimental group was treated with the same standard protocol as well as with the foam body-support device being evaluated. Patients were included if their Waterlow score was >10, indicating a high risk of developing pressure ulcers and if they had no skin lesion on the heels. Foam devices, covered with jersey, were constructed for the legs and allowed the heels to be free of any contact with the bed; another foam block was arranged perpendicularly to the first, in contact with the soles, to prevent ankles from assuming an equinus position (to prevent a dropfoot condition). The principal criterion for efficacy was the number of irreversible skin lesions on the heel (that is, beyond the stage of blanching hyperemia, reversible after finger pressure); these lesions were assessed every day until the end of the study (up to 30 days).


RESULTS
The number of irreversible heel pressure ulcers was lower in the experimental (3 patients, 8.6%) than in the control group (19 patients, 55.4%) (p<0.0001). Mean time without any pressure ulcer was higher in the experimental group (5.6 days, compared with 2.8 days, p=0.01). The groups did not differ in the number of pressure sores on the sacrum and leg.


CONCLUSIONS
An anatomical foam body-support is effective in preventing heel pressure ulcers in patients on a medical intensive care unit and is well tolerated.
Cadue
Jean-François
JF
Service de réanimation médicale et médecine interne, CHU de Poitiers, Université de Poitiers, F-86021 Poitiers, France. j.f.cadue@chu-poitiers.fr
Karolewicz
Stéphane
S
Tardy
Catherine
C
Barrault
Claudie
C
Robert
René
R
Pourrat
Olivier
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016523:Foot Ulcer / Q000517:prevention & control*; D006365:Heel; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000517:prevention & control*; D011315:Preventive Medicine / Q000295:instrumentation; D011446:Prospective Studies