Greenwood, C, Nelson, EA, Nixon, J et al. (2 more authors) (2022) Comparative effectiveness of heel-specific medical devices for the prevention of heel pressure ulcers: A systematic review. Journal of Tissue Viability, 31 (4). pp. 579-592. ISSN 0965-206X
Abstract
Background
Pressure ulcers (PUs) impact on patient's quality of life and are costly for healthcare providers. Heels are a particular concern due to specific risk factors. Relative effectiveness of medical devices, e.g., dressings, off-loading devices, heel cushioning devices, to reduce PU development is unknown.
Methods
Systematic review of the effectiveness of heel-specific medical devices for the prevention of heel PU (HPU)s. Database searches were performed from inception to June 2021 for RCTs. The primary outcome was incidence of new HPUs. Trials were assessed for risk of bias and data analysed with risk ratios, mean difference or hazard ratios as appropriate.
Results
Fifteen RCTs (4724 participants) were identified.
Dressings, as constant low pressure (CLP) devices vs standard care: eight trials (very low quality) showed no-significant difference in effectiveness (RR 0.31, 95%CI 0.10 to 1.01).
Off-loading devices vs standard care: three trials (low quality), showed significant reduction in development of Category≥1 HPUs (RR 0.20, 95%CI 0.05 to 0.80) two trials (medium quality), showed significant reduction in development of Category≥2 HPUs (RR 0.08, 95%CI 0.01 to 0.67).
Comparisons between off-loading devices: two trials (low quality) showed no clear difference in HPU incidence.
In a paediatric post-surgical population, one trial of off-loading device and one of a dressing (CLP device), both versus standard care, showed no clear difference in HPU incidence (RR 0.19 95%CI 0.02 to 1.55 and RR 0.89 95%CI 0.56 to 1.42 respectively).
Conclusions
Off-loading devices may reduce HPU incidence, from low-quality evidence. There is insufficient evidence to suggest that dressings reduce HPU incidence.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Authors. Published by Elsevier Ltd on behalf of Tissue Viability Society / Society of Tissue Viability. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Heel; Pressure ulcer; Systematic review; Prevention; Devices |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Clinical Trials Research (LICTR) (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 17 Apr 2023 10:33 |
Last Modified: | 10 Jul 2023 16:14 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jtv.2022.09.009 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:198203 |
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Filename: Offloading devices for prevention SR JTV.pdf
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