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Comparing an Alternating Air Pressure Mattress and an Air Fluidized bed in the Management of Postoperative Flap Patients: A Randomized Controlled Pilot Study
Matthew J. Finnegan, MD
Linda Gazzero, RN
James O. Finnegan, MD
Percy Lo, MD
University Hospitals/Case Medical Center and Cooper University Hospital/UMDNJ Camden
2010-04-05
Presenter: Percy Lo, MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: Pressure ulcers are a common problem for paralyzed patients, and those that require reconstructive surgery are at risk for postoperative tissue damage. Strategies for postoperative management include alternating air pressure (AP) mattresses, often used in the UK, and the air-fluidized bed (AFB), the most widely used modality in the US. We hypothesize that an AP would be an equally effective and substantially less costly surface than an AFB in the management of patients undergoing reconstruction.
Methods: 40 patients with full-thickness pressure ulcers undergoing flap reconstruction by a single surgeon were randomized to receive either the AP or the AFB for their entire 6 week postoperative course. Patients would remain at total bed-rest as an inpatient for an average of 8 days, with the balance at a skilled nursing facility or at home. Incisions and flaps were re-evaluated prior to discharge.
Results: There was no statistically significant difference between the immediate postoperative outcomes of the two groups, mainly due to the small sample size. More patients expressed dissatisfaction with the AFB, while nursing opinion was the same for either system. With an average inpatient stay of 8 days, the cost of the AP was $280 compared to $520 for the AFB, a 54% difference.
Conclusions: The alternating air pressure mattress may equal the more costly air fluidized bed in the postoperative management of pressure ulcer flap patients. As this is only a pilot study, more patients would be needed to conduct a study with more statistical significance.
