Air‐Fluidized Bed Treatment of Nursing Home Patients with Pressure Sores

There are no large studies on long‐term treatment of nursing home patients with pressure sores. A 4‐year experience of treating 95 nursing home patients on air‐fluidized beds was reviewed. Treated patients were elderly (median age 73 years) and neurologically impaired (79% with dementia, cerebral vascular accident, or anoxic encephalopathy). The index pressure sores (deepest truncal sore for each patient) were large (median surface area 35.3 cm²) and commonly located on the sacrum (41%) and trochanters (38%). Only 13 of 95 (14%) index sores healed completely, and only two small sores healed in <30 days. No others treated <30 days had ≥ 50% reduction in sore surface area. Patients were grouped according to whether or not treatment was < 30 days, and for those treated ≥ 30 days, according to whether or not ≥ 50% reduction in sore surface area occurred. None of the easily measured patient characteristics examined were associated with longer or more successful treatment. These results indicate that although air‐fluidized beds can be used to treat pressure sores successfully, even in severely debilitated nursing home patients, no simple criteria can be used to predict which patients will benefit from this treatment. Because long periods of time are necessary for treatment [median trial length 79 days and 17 of 95 (18%) trials >180 days], substantial patient‐care expenditures result. Prospective studies comparing other medical and surgical interventions with air‐fluidized bed therapy are needed before these beds are used routinely for long‐term treatment of nursing home patients with severe pressure sores. 1989 The American Geriatrics Society