Protective bandage or hydrocellular dressing to prevent pressure ulcers on heels?
García Fernández F. P., Pancorbo Hidalgo P. L., Rodríguez Torres M. C.

SUMMARY

  Original paper: Torra i Bou JE, Rueda López J, Cañames G et al. Úlceras por presión en los talones. Estudio comparativo entre el vendaje protector y un apósito hidrocelular con forma especial para talones. Rev Rol Enferm 2002; 25 (5): 371-6.

  Clinical practice question: Is the use of a hydrocellular dressing having a special form for heels more effective and cheaper than a protective bandage for heels pressure ulcers prevention?

  Summary of the research: Multi-centered and randomized clinical trial, that compare a hydrocellular dressing with protective heel bandage and analyze cost-effectiveness of both methods. There are not differences between control and experimental group in age, gender, hours in bed, frequency of change of position, or Braden score. In bandage group the incidence of lesions was 44%, while in hydrocellular dressing group was 3% (RR= 13.42 [CI 95%= 3.31-54.3]). In the first group 2.04 ± 1.1 changes for week were made, while 0.58 0.48 in the second group. The time of nursing or caregiver needed for bandage or dressing change was 184,61 ± 179,45 minutes in control group and 26,04 ± 57,26 minutes in experimental group. The authors estimate a cost of € 84.06 for protective bandage and €38.3 for hydrocellular dressing.

  Critical comment: Although the research was founded by the manufacturer of the hydrocellular dressing, the methodology of clinical trial provides validity to this research. Furthermore, considering another published papers that demonstrate the utility of these products. Among research limitations are that pressure-relief surfaces are not used and that patients lost in control group are not replaced, which is justified by beneficence rule. The results obtained clearly say that heel protection by bandage is insufficient to prevent pressure ulcers, and that the heeladapted hydrocellular dressing (Allevyn Heel^®) reduces 13 times the risk of lesions in this area. We consider that the cost estimate by the authors for heel bandage is overvalued, however, the use of the hydrocellular dressing still suppose a decrease in the cost of the full preventive treatment.

KEY WORDS

Critical review, evidence, pressure ulcers, prevention, hydrocellular dressing, heel dressing, clinical trial.

Vol. 16 nº1-2005