Pressure ulcers (PU) are localised injuries in the skin and/or underlying tissue initiated by a sustained impaired blood flow. An excessive or long-lasting pressure, shear or friction over the bony prominences trigger a vicious cycle with a set of stressors that is difficult to stop/revert and penetrates until bone (Grade 4).
85% of Spinal Cord Injury (SCI) patients relying on wheelchairs (380,000 in Europe with 11,000 new cases per year) will develop a PU during their lifetime, and 7-8% will die out of the associated complications. SCI sufferers do not dispose of the natural mechanisms of healthy users that prevent the formation of PU due to a) their lack of pain perception; b) their alterations in the Autonomous Nervous System (ANS); c) and their impossibility to perform postural changes. Suffering PU leads to: a) deterioration of health, b) social exclusion because of the pain and odour caused by PU, which are a stigma, c) reduction of independent living, d) diminution of the quality of life, and e) depression (due to all the aforementioned problems) .
Treating PU is difficult, risky and expensive. PU treatment costs are above €20 billion per year for the European Public Health System, and proportional costs for private insurances. However, prognosis is excellent at early stages because PU usually heal by itself once the risk is removed. Therefore, prevention and early detection are the most effective strategies with PU. While 95% of all PU are considered preventable, no concluding evidence confirms that current devices (from tilting systems to dynamic pressure release devices) are effective in the prevention of PU (38.5% of PU appeared while the person was using one of those preventive devices). The cause is that current prevention devices rely on reducing pressure without measuring real Tissue Viability (TV), and perform predefined movement patterns instead of adapting strategies to each user and context. Nowadays, only specialized care provided by trained or professional caregivers, which include frequent postural changes and physiotherapy sessions, are proven to be effective. Nevertheless, this solution has several drawbacks: they are time consuming (a postural change must be done every 20 minutes), and they cause injuries to the caregivers and/or health/social professionals that perform them, due to the high loads that they have to lift. For instance, nurse back injuries cost an estimated €16 billion annually in worker's compensation benefits; while the cost add-up of medical treatment, loss of work days, light duty and employee turnover cost an extra €10 billion.
In the aforementioned context, QIMOVA, one of the most innovative companies on personalised and adapted wheelchair solutions, solved the problem. Extensive research and development has been conducted by the company, giving as a result a validated prototype of ICT PU prevention system embedded on a wheelchair that demonstrated its unprecedented effectiveness for PU prevention. i-LiveRest system, the commercial product based on the PUMA prototype, will provide the following benefits:
• To Patients: To avoid the aforementioned health and social problems.
• To Caregivers: Ease the caregiving process and avoid injuries due to load manipulation.
• To health system: To minimize costs due to PU prevention & treatment (≈€20 billion/year)
• To society: To integrate T-SCI patients to society.
Economic benefits for stakeholders:
There are key features of our PU prevention system which can result in direct or indirect pecuniary benefits for the different players related to this product. Hereunder we summarize the most relevant i-LiveRest selling points that provide an added value to these segments as well as other related economic advantages.
1. Public Authorities:
• Reduction of public healthcare system costs: Estimated PU reduction due to i-LiveRest of 20% (20 million €) and leave free over 3,200 hospital beds per year. It is based on mean PU cost of 1.6-16.6 k€ per day (PU Grade 1-2) and mean PU heal days of 28-155.
• Reduction of 25% of injuries on health professionals due to repositioning of users.
• Labour force of a) SCI due ensuring the working capacity of 3,500 T-SCI people 30% of people with SCI retake labour after the injury, of whom 36% full-time, 25% part-time and the remaining 39% non-remunerated; b) T-SCI relatives who are expending most of their time, especially in the South of Europe, providing support and provide care to T-SCI.
2. Insurance companies and private hospitals: Proportional expense savings to Public Authorities due to health costs and time off work of their professionals and relatives with private insurance.
3. T-SCI users: Increases sitting time of TSCI (70%), which enhances independent living, social inclusion, employment and health preserving; as well improves quality of life and employability of relatives who support T-SCI users most of their time.
