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September 8, 1993

Pressure Ulcer Prevention With Low-Air-Loss Beds-Reply

Author Affiliations

Victoria Hospital Corp London, Ontario

JAMA. 1993;270(10):1197-1198. doi:10.1001/jama.1993.03510100047022

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In Reply.  —Thank you for allowing us to respond to concerns expressed by Dr Verdery regarding our article, which examined the clinical utility and cost-effectiveness of an air suspension bed in the prevention of pressure ulcers.First, he was concerned about the lack of blinding in the diagnosis and categorization of stage I ulcers. As stated in our methods, blinding was impossible. Therefore, we instituted a process to minimize this bias as much as possible. Specifically, with detection and staging of a pressure ulcer by the study nurse, our hospital's skin care team was consulted. The consultant dermatologist then independently addressed the issue of presence or absence of pressure ulcers and staged them when applicable. Our interrater agreement was good (κ>0.80).Second, Verdery noted we had not mentioned whether a specific treatment protocol was instituted. The study's objective was to address prevention, not treatment. Thus, treatment of established ulcers was