Pressure ulcer prevention in high-risk postoperative cardiovascular patients

Crit Care Nurse. 2011 Aug;31(4):44-53. doi: 10.4037/ccn2011830.

Abstract

Background: Little has been published about how to prevent pressure ulcers in severely debilitated, immobile patients in intensive care units.

Objective: To present a possible prevention strategy for postoperative cardiovascular surgery patients at high risk for development of pressure ulcers.

Methods: Staff chose to implement air fluidized therapy beds, which provide maximal immersion and envelopment as a measure for preventing pressure ulcers in patients who (1) required vasopressors for at least 24 hours and (2) required mechanical ventilation for at least 24 hours postoperatively.

Results: Only 1 of 27 patients had a pressure ulcer develop while on the air fluidized therapy bed (February 2008 through August 2008), and that ulcer was only a stage I ulcer, compared with 40 ulcers in 25 patients before the intervention.

Conclusions: Patients spent a mean of 7.9 days on the mattress, and the cost of bed rental was approximately $18000, which was similar to the cost of treatment of 1 pressure ulcer in stage III or IV (about $40000) and was considered cost-effective.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Beds* / economics
  • Cardiovascular Diseases / surgery*
  • Cost-Benefit Analysis
  • Critical Care / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care* / economics
  • Postoperative Care / methods*
  • Postoperative Care / nursing
  • Pressure Ulcer / economics
  • Pressure Ulcer / nursing
  • Pressure Ulcer / prevention & control*
  • Respiration, Artificial
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents