Annales de Gérontologie


Effectiveness and tolerance of a pulsed low-intensity support surface for the treatment and the prevention of pressure ulcers in high-risk patients Volume 1, numéro 1, Octobre-Novembre-Décembre 2008

Clinical Gerontology Unit, University Hospital Saint Etienne, Hôpital Charité, Gérontologie clinique, 42055 Saint-Etienne CEDEX 2

The use of curative support for the treatment of the pressure sores, simple to handle, compatible with ambulatory care, is a goal important to reach to reduce the durations of hospitalization and to support the maintenance in residence. We led an exploratory study with an alternate pressure air support. 14 patients carrying 22 pressure sores of stage 2 or more (7 had several pressure sores), of average age 68 years, analyzed in 4 hospital sites (2 of physical therapy, 2 of geriatrics), were followed according to 3 methods: healing, improvement, aggravation or appearance. The surface, depth and speed of healing, were systematically measured. In parallel, thanks to a scale of Likert on 4 levels, comfort was described by the patient thanks to 7 items (felt comfort, pain, maceration, facility of reversal, passage in sitting position, noise, impact on the sleep). According to same methodology, the conditions of use of the mattress were analyzed by 7 items (facilitated of operation, installation with the daily newspaper, technical facility of use, maintainability, facilitated for the care, safety, solidity and reliability). 13 pressure sores out of 22 evolved to the healing with an average reduction of similar surface of 4,2 cm 2 according to localizations. The average duration of healing was longer on the level of the heel than on the level of the sacrum (33 versus 18 days) and according to the initial stage (stage 3: 45 days versus 25 days for stage 2). 9 pressure sores out of 12 evolved/moved in the direction of the improvement (they were more severe forms). No pressure sores worsened. The mean velocity of healing was 0,21 cm2/day. On 79 evaluations of comfort made by the patients, the majority brought back very satisfactory appreciations. The most appreciated elements were the effect on the pain, the noise level and felt comfort. In parallel, the personnel considered to be very satisfactory the items quality of the support, facility of cleaning and facility of use at the time of the care. This prospective clinical trial multicentric, even among patients carrying pressure sores of stage 2 or more and high-risk, showed the clinical effectiveness, comfort, the handiness of mattress Barmat 2 Modena ® which is a support with alternated low air pressure likely to be used for continuous ambulatory care.