Effects of different decompression device in the prevention of pressure sore: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YAO Li ^1,2 , DING Nannan ^1,2 , YANG Liping ³ , Han Chunyan ^1,2 , JIANG Lingjie ^1,2 , JIANG Biantong ^1,2 , WU Yuchen ³ , ZHANG Caiyun ¹ , TIAN Jinhui ⁴ ,  ZHANG Zhigang ³

1. Department of Nursing, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;
2. School of Nursing, Lanzhou University, Lanzhou, 730000, P.R.China;
3. Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;
4. Evidence-Based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China;

Corresponding?author：

ZHANG Zhigang, Email: zzg3444@163.com

Keywords：

Intraoperative pressure sore; Decompression device; Dressing; Decompression pad; Network meta-analysis

DOI：

10.7507/1672-2531.201806070

Video：

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Objectives To systematically review the preventive effects of different pressure relief devices. Methods Databases including PubMed, The Cochrane Library, Web of Science, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect randomized control trials (RCTs) on the preventive effects of pressure relief devices for the surgical pressure sore from inception to December 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Network meta-analysis was then performed using gemtc package of R 3.5.0 software, Stata 13.0 and JAGS 3.4.0 software. Results A total of 20 RCTs involving 4 183 patients were included. The network meta-analysis showed that micropulse dynamic pad was superior to standard pad. The gel pad was superior to sponge pad. The standard pad and cotton gauze pad. The foam dressing was superior to gel pad. All of the differences were statistically significant. The results of the ranking probability plot suggested foam dressing as an optimal resolution for preventing surgical pressure sore. Conclusions According to the network meta-analysis and rankings, foam dressing is superior to other decompression devices in preventing surgical pressure sores.

Citation： YAO Li, DING Nannan, YANG Liping, Han Chunyan, JIANG Lingjie, JIANG Biantong, WU Yuchen, ZHANG Caiyun, TIAN Jinhui, ZHANG Zhigang. Effects of different decompression device in the prevention of pressure sore: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2018, 18(10): 1086-1092. doi: 10.7507/1672-2531.201806070 Copy

1.	王彩鳳, 巫向前. 壓瘡形成機制研究進展. 護理學雜志, 2007, 22(1): 74-77.
2.	曠婉, 趙體玉, 余云紅. 術中獲得性壓瘡預防相關研究進展. 中國護理管理, 2017, 17(6): 851-855.
3.	Schoonhoven L, Defloor T, Grypdonck MH. Incidence of pressure ulcers due to surgery. J Clin Nurs, 2002, 11(4): 479-487.
4.	蔣琪霞, 瞿小龍, 郭秀君, 等. 手術患者壓瘡發生率及發生時間和影響因素研究. 中國護理管理, 2013, 13(9): 25-28.
5.	Schuurman JP, Schoonhoven L, Keller BP, et al. Do pressure ulcers influence length of hospital stay in surgical cardiothoracic patients? A prospective evaluation. J Clin Nurs, 2009, 18(17): 2456-2463.
6.	Pham B, Teague L, Mahoney J, et al. Support surfaces for intraoperative prevention of pressure ulcers in patients undergoing surgery: a cost-effectiveness analysis. Surgery, 2011, 150(1): 122-132.
7.	劉國偉, 于莉莉, 賈洪霞, 等. 系統評價中的間接比較與網狀 Meta 分析方法研究進展. 中國循證醫學雜志, 2014, 14(10): 1276-1280.
8.	周玉潔, 楊美玲, 張洪君, 等. 壓瘡分期及其護理進展. 中國護理管理, 2014, 14(7): 683-686.
9.	Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions (Version 5. 1. 0). Available at: http://handbook. cochrane.org.
10.	張超, 董圣杰, 曾憲濤. R 軟件 gemtc 程序包在網狀 Meta 分析中的應用. 中國循證醫學雜志, 2013, 13(10): 1258-1264.
11.	張超, 孫鳳, 曾憲濤. R 軟件調用 JAGS 軟件實現網狀 Meta 分析. 中國循證醫學雜志, 2014, 14(2): 241-248.
12.	張超, 鄢金柱, 孫鳳, 等. 網狀 Meta 分析一致性的鑒別與處理方法. 中國循證醫學雜志, 2014, 14(7): 884-888.
13.	Nixon J, McElvenny D, Mason S, et al. A sequential randomised controlled trial comparing a dry visco-elastic polymer pad and standard operating table mattress in the prevention of postoperative pressure sores. Int J Nurs Stud, 1998, 35(4): 193-203.
14.	Aronovitch SA, Wilber M, Slezak S, et al. A comparative study of an alternating air mattress for the prevention of pressure ulcers in surgical patients. Ostomy Wound Manage, 1999, 45(3): 34-40.
15.	Schultz A, Bien M, Dumond K, et al. Etiology and incidence of pressure ulcers in surgical patients. AORN J, 1999, 70(3): 434-437.
16.	Russell JA, Lichtenstein SL. Randomized controlled trial to determine the safety and efficacy of a multi-cell pulsating dynamic mattress system in the prevention of pressure ulcers in patients undergoing cardiovascular surgery. Ostomy Wound Manage, 2000, 46(2): 46-51.
17.	Feuchtinger J. Preventing decubitus ulcer in heart surgery interventions: visco-elastic foam layer on the operating room table-a study. Pflege Z, 2006, 59(8): 498-501.
18.	陳蕾, 任從才, 劉曉紅. 兩種不同體位墊在俯臥位脊柱手術中的應用觀察. 現代臨床護理, 2010, 9(3): 44-45.
19.	汪繼斌, 朱繡峰. 液體敷料和聚氨酯凝膠墊在手術患者壓瘡預防中的應用. 海南醫學院學報, 2010, 16(10): 1366-1368.
20.	汪琳. 美皮康貼膜用于婦科腹腔鏡截石位手術中壓瘡的預防. 護理學雜志, 2011, 26(16): 59-60.
21.	王汝娜. 水膠體減壓貼預防俯臥位手術患者面部壓瘡效果觀察. 護理學雜志, 2011, 26(16): 56-57.
22.	王莉, 陳翠玲, 吳景明, 等. 凝膠減壓墊在俯臥位手術患者預防壓瘡中的應用. 現代臨床護理, 2011, 10(6): 47-48.
23.	李錦英, 馮潤科, 莫麗梅. 凝膠體位墊在骨科側臥位手術中的作用與護理. 護理實踐與研究, 2012, 9(11): 141-142.
24.	王新鳳, 程月娥. 凝膠果凍墊預防術中患者壓瘡的效果觀察. 解放軍護理雜志, 2012, 29(1): 73-74.
25.	陸建平, 閻倩, 袁潔萍, 等. 硅膠凝膠墊預防老年患者手術中壓瘡的效果. 上海護理, 2012, 12(2): 5-7.
26.	李靜如. 軟聚硅酮泡沫敷料在預防術中骶尾部壓瘡的效果觀察. 護士進修雜志, 2012, 27(22): 2080-2081.
27.	張云鳳, 宋思賢, 梁亮芳. 醫用高分子凝膠體位墊在側臥位手術中預防急性壓瘡的效果評價. 中國實用護理雜志, 2014, 30(20): 49-50.
28.	梁馨之, 丁晨. 液體敷料在俯臥位后顱窩手術中的應用效果. 中國醫科大學學報, 2015, 44(1): 91-93.
29.	陳小花, 陶勇, 彭玉蘭, 等. 三種俯臥位墊在俯臥位手術中的應用研究. 中國實用護理雜志, 2015, 31(14): 1057-1059.
30.	楊永輝, 曹勍, 白曉霞. 泡沫敷料預防長時間術中平臥位患者骶尾部壓瘡的效果觀察. 實用醫院臨床雜志, 2016, 13(5): 206-208.
31.	繆蓉, 余華, 蘇月焦, 等. 美皮康敷貼對行側臥位顱腦手術患者壓瘡的預防效果. 現代臨床護理, 2017, 16(2): 60-62.
32.	易鳳瓊, 曾彥超, 郭宇, 等. 軟聚硅酮異型泡沫敷料對脊柱手術下頦部壓瘡預防的效果觀察. 中國實用護理雜志, 2017, 33(21): 1606-1608.
33.	郭月, 余云紅, 趙體玉. 手術室患者壓瘡臨床特點的回顧性分析. 護理學雜志, 2014, 29(24): 36-39.
34.	馬紅利, 袁曉華, 張文敏, 等. 術中壓瘡影響因素 Meta 分析. 重慶醫學, 2016, 45(31): 4389-4392.
35.	Kirkland-Walsh H, Teleten O, Wilson M, et al. Pressure mapping comparison of four or surfaces. AORN J, 2015, 102(1): 1-9.
36.	Shahin ES, Dassen T, Halfens RJ. Pressure ulcer prevalence and incidence in intensive care patients: a literature review. Nurs Crit Care, 2008, 13(2): 71-79.
37.	Defloor T, De Schuijmer JD. Preventing pressure ulcers: an evaluation of four operating-table mattresses. Appl Nurs Res, 2000, 13(3): 134-141.
38.	Brindle CT, Wegelin JA. Prophylactic dressing application to reduce pressure ulcer formation in cardiac surgery patients. J Wound Ostomy Continence Nurs, 2012, 39(2): 133-142.
39.	Black J, Clark M, Dealey C, et al. Dressings as an adjunct to pressure ulcer prevention: consensus panel recommendations. Int Wound J, 2015, 12(4): 484-488.

1. 王彩鳳, 巫向前. 壓瘡形成機制研究進展. 護理學雜志, 2007, 22(1): 74-77.
2. 曠婉, 趙體玉, 余云紅. 術中獲得性壓瘡預防相關研究進展. 中國護理管理, 2017, 17(6): 851-855.
3. Schoonhoven L, Defloor T, Grypdonck MH. Incidence of pressure ulcers due to surgery. J Clin Nurs, 2002, 11(4): 479-487.
4. 蔣琪霞, 瞿小龍, 郭秀君, 等. 手術患者壓瘡發生率及發生時間和影響因素研究. 中國護理管理, 2013, 13(9): 25-28.
5. Schuurman JP, Schoonhoven L, Keller BP, et al. Do pressure ulcers influence length of hospital stay in surgical cardiothoracic patients? A prospective evaluation. J Clin Nurs, 2009, 18(17): 2456-2463.
6. Pham B, Teague L, Mahoney J, et al. Support surfaces for intraoperative prevention of pressure ulcers in patients undergoing surgery: a cost-effectiveness analysis. Surgery, 2011, 150(1): 122-132.
7. 劉國偉, 于莉莉, 賈洪霞, 等. 系統評價中的間接比較與網狀 Meta 分析方法研究進展. 中國循證醫學雜志, 2014, 14(10): 1276-1280.
8. 周玉潔, 楊美玲, 張洪君, 等. 壓瘡分期及其護理進展. 中國護理管理, 2014, 14(7): 683-686.
9. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions (Version 5. 1. 0). Available at: http://handbook. cochrane.org.
10. 張超, 董圣杰, 曾憲濤. R 軟件 gemtc 程序包在網狀 Meta 分析中的應用. 中國循證醫學雜志, 2013, 13(10): 1258-1264.
11. 張超, 孫鳳, 曾憲濤. R 軟件調用 JAGS 軟件實現網狀 Meta 分析. 中國循證醫學雜志, 2014, 14(2): 241-248.
12. 張超, 鄢金柱, 孫鳳, 等. 網狀 Meta 分析一致性的鑒別與處理方法. 中國循證醫學雜志, 2014, 14(7): 884-888.
13. Nixon J, McElvenny D, Mason S, et al. A sequential randomised controlled trial comparing a dry visco-elastic polymer pad and standard operating table mattress in the prevention of postoperative pressure sores. Int J Nurs Stud, 1998, 35(4): 193-203.
14. Aronovitch SA, Wilber M, Slezak S, et al. A comparative study of an alternating air mattress for the prevention of pressure ulcers in surgical patients. Ostomy Wound Manage, 1999, 45(3): 34-40.
15. Schultz A, Bien M, Dumond K, et al. Etiology and incidence of pressure ulcers in surgical patients. AORN J, 1999, 70(3): 434-437.
16. Russell JA, Lichtenstein SL. Randomized controlled trial to determine the safety and efficacy of a multi-cell pulsating dynamic mattress system in the prevention of pressure ulcers in patients undergoing cardiovascular surgery. Ostomy Wound Manage, 2000, 46(2): 46-51.
17. Feuchtinger J. Preventing decubitus ulcer in heart surgery interventions: visco-elastic foam layer on the operating room table-a study. Pflege Z, 2006, 59(8): 498-501.
18. 陳蕾, 任從才, 劉曉紅. 兩種不同體位墊在俯臥位脊柱手術中的應用觀察. 現代臨床護理, 2010, 9(3): 44-45.
19. 汪繼斌, 朱繡峰. 液體敷料和聚氨酯凝膠墊在手術患者壓瘡預防中的應用. 海南醫學院學報, 2010, 16(10): 1366-1368.
20. 汪琳. 美皮康貼膜用于婦科腹腔鏡截石位手術中壓瘡的預防. 護理學雜志, 2011, 26(16): 59-60.
21. 王汝娜. 水膠體減壓貼預防俯臥位手術患者面部壓瘡效果觀察. 護理學雜志, 2011, 26(16): 56-57.
22. 王莉, 陳翠玲, 吳景明, 等. 凝膠減壓墊在俯臥位手術患者預防壓瘡中的應用. 現代臨床護理, 2011, 10(6): 47-48.
23. 李錦英, 馮潤科, 莫麗梅. 凝膠體位墊在骨科側臥位手術中的作用與護理. 護理實踐與研究, 2012, 9(11): 141-142.
24. 王新鳳, 程月娥. 凝膠果凍墊預防術中患者壓瘡的效果觀察. 解放軍護理雜志, 2012, 29(1): 73-74.
25. 陸建平, 閻倩, 袁潔萍, 等. 硅膠凝膠墊預防老年患者手術中壓瘡的效果. 上海護理, 2012, 12(2): 5-7.
26. 李靜如. 軟聚硅酮泡沫敷料在預防術中骶尾部壓瘡的效果觀察. 護士進修雜志, 2012, 27(22): 2080-2081.
27. 張云鳳, 宋思賢, 梁亮芳. 醫用高分子凝膠體位墊在側臥位手術中預防急性壓瘡的效果評價. 中國實用護理雜志, 2014, 30(20): 49-50.
28. 梁馨之, 丁晨. 液體敷料在俯臥位后顱窩手術中的應用效果. 中國醫科大學學報, 2015, 44(1): 91-93.
29. 陳小花, 陶勇, 彭玉蘭, 等. 三種俯臥位墊在俯臥位手術中的應用研究. 中國實用護理雜志, 2015, 31(14): 1057-1059.
30. 楊永輝, 曹勍, 白曉霞. 泡沫敷料預防長時間術中平臥位患者骶尾部壓瘡的效果觀察. 實用醫院臨床雜志, 2016, 13(5): 206-208.
31. 繆蓉, 余華, 蘇月焦, 等. 美皮康敷貼對行側臥位顱腦手術患者壓瘡的預防效果. 現代臨床護理, 2017, 16(2): 60-62.
32. 易鳳瓊, 曾彥超, 郭宇, 等. 軟聚硅酮異型泡沫敷料對脊柱手術下頦部壓瘡預防的效果觀察. 中國實用護理雜志, 2017, 33(21): 1606-1608.
33. 郭月, 余云紅, 趙體玉. 手術室患者壓瘡臨床特點的回顧性分析. 護理學雜志, 2014, 29(24): 36-39.
34. 馬紅利, 袁曉華, 張文敏, 等. 術中壓瘡影響因素 Meta 分析. 重慶醫學, 2016, 45(31): 4389-4392.
35. Kirkland-Walsh H, Teleten O, Wilson M, et al. Pressure mapping comparison of four or surfaces. AORN J, 2015, 102(1): 1-9.
36. Shahin ES, Dassen T, Halfens RJ. Pressure ulcer prevalence and incidence in intensive care patients: a literature review. Nurs Crit Care, 2008, 13(2): 71-79.
37. Defloor T, De Schuijmer JD. Preventing pressure ulcers: an evaluation of four operating-table mattresses. Appl Nurs Res, 2000, 13(3): 134-141.
38. Brindle CT, Wegelin JA. Prophylactic dressing application to reduce pressure ulcer formation in cardiac surgery patients. J Wound Ostomy Continence Nurs, 2012, 39(2): 133-142.
39. Black J, Clark M, Dealey C, et al. Dressings as an adjunct to pressure ulcer prevention: consensus panel recommendations. Int Wound J, 2015, 12(4): 484-488.

Chinese Journal of Evidence-Based Medicine

Effects of different decompression device in the prevention of pressure sore: a network meta-analysis

Abstract Full text Figures/Tables Video References Cited by

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