Original CommunicationSupport surfaces for intraoperative prevention of pressure ulcers in patients undergoing surgery: A cost-effectiveness analysis
Section snippets
Study design
We conducted a cost-effectiveness analysis using a Markov cohort simulation model. We followed guidelines for economic evaluation by the Canadian Agency for Drugs and Technologies in Health and recommendations by the Panel on Cost Effectiveness in Health and Medicine.19, 20 We simulated a cohort of patients with an average age of 63 years who underwent scheduled surgical procedures lasting ≥90 min in the supine or lithotomy position (Table I).21
The base case analysis was conducted from the
Clinical effectiveness
Table III displays results of the base case analysis. Over an average surgical duration of 4.6 h, the projected intraoperative incidence of pressure ulcers was 1.07% for patients with current practice and 0.57% for patients with the intraoperative prevention strategy, corresponding to an absolute decrease of 0.51%. On average, one needs to institute prevention for 196 surgical patients to prevent 1 pressure ulcer originated intraoperatively.
The projected incidence of stage 2–4 pressure ulcers
Discussion
According to recent systematic reviews, using the dry polymer overlays on operating tables significantly decreases the immediate postoperative incidence of pressure ulcers in patients who undergo surgical procedures lasting ≥90 min.4, 18, 21 We projected the health benefits and costs associated with the observed decrease in incidence of pressure ulcers over a 1-year period. According to our results, the intraoperative prevention strategy with the dry polymer overlays improves patient health and
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Cited by (28)
Prevention of pressure injuries in patients undergoing prolonged trauma surgery, a challenge for nursing
2021, Revista Medica Clinica Las CondesThe International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture
2019, International Journal of Orthopaedic and Trauma NursingCitation Excerpt :Carson et al., 2012; Beinlich and Meehan, 2014). Prevention protocols should consider using pressure redistributing/relieving surfaces for high risk patients across the care continuum; on nursing units, in the operating theatre, and in the emergency department (Beckett, 2010; Pham et al., 2011). There is an emerging body of evidence demonstrating the effectiveness of multilayered foam dressings over bony prominences, specifically the heels and sacrum, in preventing PU/PI in at-risk patients.
A systematic review of economic evaluations assessing interventions aimed at preventing or treating pressure ulcers
2015, International Journal of Nursing StudiesCitation Excerpt :The majority of the included studies (n = 8) evaluated the impact of mattress products for the prevention of pressure ulcers. The studies were conducted in a variety of settings: three studies (Gebhardt et al., 1996; Inman et al., 1993, 1999) were conducted in Intensive Care Units (ICUs); one in spinal injury centre (Catz et al., 2005); one in an orthopaedic unit (Price et al., 1999); one in the operating theatre (Pham et al., 2011b); one in long term care (Pham et al., 2011a); and, one included vascular, orthopaedic and medical elderly units (Iglesias et al., 2006). There were also differing definitions of pressure damage with some studies including grade 1 pressure damage (i.e. intact skin with non-blanching erythema) (Catz et al., 2005; Gebhardt et al., 1996; Price et al., 1999; Pham et al., 2011a,b), others grade 2 and above (Iglesias et al., 2006), and in the remaining studies it was unclear (Inman et al., 1993, 1999).
Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 2)
2013, International Journal of Orthopaedic and Trauma NursingComparison of interface pressures and subjective comfort of pressure-relieving overlays on the operating table for healthy volunteers
2021, International Journal of Environmental Research and Public Health
Supported in part by the Ontario Ministry of Health and Long-Term Care to the Toronto Health Economics and Technology Assessment (THETA) Collaborative.