The evolution of suspected deep tissue injuries from an initial purple bruise to a significant stage III or IV pressure ulcer may be rapid, even with optimal treatment. This case series describes our experience with air-fluidized therapy (AFT) placed upon discovery of suspected deep tissue injury (sDTI) in an acute care setting.
Five patients with 10 sDTIs were placed on AFT within 12 hours of sDTI diagnosis and evaluated for an average of 9 days. Patients were included in the series if they met the height and weight range of the bed and presented with, or developed an sDTI. Standard wound care included the use of an ointment containing trypsin, Balsam of Peru, and castor oil (Vasolex; Stratus Pharmaceuticals Inc, Miami, Florida) applied directly to both intact skin and open areas comprising the sDTI. Patients were repositioned per standard hospital care. Although we were unable to prevent skin breakdown in every case, findings suggest that interventions resulted in a reduction in the magnitude of tissue loss, including prevention of stage III to IV pressure ulceration in all 5 patients. The cost of a 9-day length of stay on the AFT bed is estimated at less than $700 per patient, which is far less than the reported cost to treat a stage III/IV wound ($10,845 US per patient in 2009 dollars).
Our experience described in these cases suggests that the use of AFT may be clinical and cost-effective for prevention of progression of sDTI in critically ill patients. Additional research in this area should be encouraged.
Lynda Allen, BSN, CWON, Manager, ET Nursing Department, Texas Health Harris Methodist Hospital, Fort Worth.
Barbara McGarrah, BSN, RN, CWOCN, CFCN, Texas Health Harris Methodist Hospital, Fort Worth.
Deborah Barrett, BSN, RN, CWOCN, CFCN, Texas Health Harris Methodist Hospital, Fort Worth.
Bethany Stenson, BS, RN, CWOCN, CFCN, Texas Health Harris Methodist Hospital, Fort Worth.
Patricia G. Turpin, PhD, RN, NEA-BC, Liaison Nurse Researcher & Clinical Associate Professor, Texas Health Fort Worth Hospital and The University of Texas at Arlington College of Nursing.
Catherine VanGilder, MBA, BS, MT, CCRA, Manager of Clinical Research, Hill-Rom, Inc., Batesville, Indiana
Correspondence: Lynda Allen, BSN, CWON, ET Nursing Department, Texas Health Harris Methodist Hospital Fort Worth, 1300 West Terrell Ave, 2nd Floor, Ft. Worth, TX 76104 (LyndaAllen@texashealth.org).
Hill-Rom, Inc, Batesville Indiana contributed funding for this project and publication assistance.