Pressure ulcer prevention in high-risk postoperative cardiovascular patients.

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.