title: Does Improvised Waterbed Reduce the Incidence of Pressure Ulcers in Patients with Spinal Injury?
abstract: BACKGROUND
  Pressure ulcers are lesions caused by unrelieved pressure over bony prominences, resulting in damage to underlying tissues. The etiology is multifactorial including prolonged immobility. They usually complicate spinal cord injuries with long periods of bed confinement. The use of bed replacements markedly reduces the incidence of pressure ulcers, but the unaffordability of these replacements in low-income countries has necessitated the need to explore cheaper alternatives.
  
  
  OBJECTIVE
  The aim of this study was to ascertain whether the use of our cheap and locally improvised waterbeds would reduce the incidence of pressure ulcers in patients on prolonged bed confinement due to spinal injury.
  
  
  METHODS
  Over a 16-month period, 51 patients (age range 1-80 years) with spinal injuries were managed conservatively in our service using improvised waterbeds in 21 (41.2%), while using the regular hospital bed/foam in 30 (58.8%). Biodata, the time interval between injury and presentation to the hospital, nature of the injury, use of improvised waterbed and development of pressure ulcer, were collected, collated, and analyzed. Statistical significance was calculated with the Chi-square test.
  
  
  RESULTS
  Most were males (98%), in the age range of 21-30 years (25.5%), and due to fall from heights (35.3%). Of 21 patients who were managed on improvised waterbeds, 6 (28.6%) had pressure ulcers, and of the 30 who did not use the waterbed, 17 (56.7%) developed ulcers. The χ(2) = 3.9381, while P = 0.0472. This difference was statistically significant.
  
  
  CONCLUSIONS
  The improvised waterbed, which is much cheaper than the standard waterbed, was observed to have significantly reduced the incidence of pressure ulcers among our patients. Nonetheless, further studies would still be needed to confirm this observation.
authors.affiliation: Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: Jude-Kennedy C
authors.initials: JK
authors.lastname: Emejulu
authors.affiliation: Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: Uchenna V
authors.initials: UV
authors.lastname: Nwadi
authors.affiliation: Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: Henry O
authors.initials: HO
authors.lastname: Obiegbu
keywords: Neurological deficits; plastic sachet; table water