[Show abstract][Hide abstract] ABSTRACT: Objective:
To evaluate the interface pressure and pressure redistribution in five special surfaces for the managing pressure (SSPH) for infants.
Laboratory Study. Repeated-measures design. Using 8 neonatal simulation dolls (different cranial perimeters, weights, heights) and the X3 XSENSOR PX100:40.40.002 device, average, maximum, average in occipital zone and contact area on each surface pressure was measured. The comparison was performed using the Friedman test (α= 0.05; with post hoc analysis).
A SEMP of viscoelastic units in T (hardness: 1.6 - kPa; density: 50 - kg/m3; compression factor: 2) with lower average and maximum pressures than the rest, but only reached statistical significance (p = 0.005 a nd 0.01 respectively) as compared to another two layers of viscoelastic (hardness: 1.01 - kPa; density: 50 - kg/m3; compression factor: 2//hardness: 3.6 - kPa; density: 50 - kg/m3; compression factor: 2). A threedimensional polyester fiber device presented greater contact surface than the rest, but only reached statistical significance when compared to the devices described above (viscoelastic units in T [p < 0.001]; Viscoelastic bilayer [p = 0.01 ]). No statistically significant differences were found between devices to assess average pressures in occipital zone.
We recommend considering the addition of a top layer of three-dimensional polyester fiber to the units in T device, and to study its relief of pressure and redistribution properties in healthy subjects under clinical conditions.
24th Conference of the European Wound Management Association & X Simposio Nacional sobre Úlceras por Presión y Heridas Crónicas; 05/2014
[Show abstract][Hide abstract] ABSTRACT: Pressure between bony prominences and sleep surfaces, as well as pressure from the use of medical devices, put children admitted to pediatric intensive care units (PICUs) at risk of developing pressure ulcers (PUs). To assess the effect of two pediatric-specific, continuous and reactive low-pressure mattresses on the incidence of PUs, an observational, descriptive, prospective, longitudinal (2009-2011) study was conducted among PICU patients. The two pediatric mattresses - one for children weighing between 500 g and 6 Kg and another for children weighing more than 6 Kg - were provided to patients at risk for PUs (Braden-Q ≤16, Neonatal Skin Risk Assessment Scale [NSRAS] ≤13, or per nurse assessment of clinical need). Between 2009 and 2011, 30 children (13 [43.3%] girls and 17 [56.7%] boys), ages 0 to 10 years, at risk of developing PUs (NSRAS risk: n = 14 [13.2 ± 3.03] and Braden-Q risk: n = 10 [10.4 ± 2.4]) were placed on the study mattresses for a median of 4 (range 1 to 25) days. Primary reasons for PICU admission included disorders of the respiratory system (40%), infectious and parasitic diseases (23.3%), and illnesses of the musculoskeletal system and connective tissue (10%). All other PU prevention strategies (eg, repositioning, specialty devices) used as part of standard care protocols also were implemented. Of the 30 participants, only one (3.3%) (confidence interval [CI] 95% = 0.08 -17.2%) developed a nondevice-related PU. No adverse events occurred. A 2008 incidence study in the same PICU, before use of these special surfaces, found a cumulative incidence of 20% nondevice-related PUs. The observed incidence rate of nonmedical device-related PUs in this high-risk population placed on these mattresses is encouraging and warrants future research.