Prophylactic Dressing Application to Reduce Pressure Ulcer Formation in Cardiac Surgery Patients

Wound Care Team, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society / WOCN (Impact Factor: 1.18). 03/2012; 39(2):133-42. DOI: 10.1097/WON.0b013e318247cb82
Source: PubMed


PURPOSE: We sought to determine if a silicone border foam dressing could decrease the incidence of sacral pressure ulcers in an intensive care unit. SUBJECTS AND SETTING: The study setting was an intensive care unit located in a 303-bed hospital with a designation of level 2 trauma. The unit specializes in the care of critically ill medical and postoperative adults. Two hundred seventy-three patients participated in the study; their mean age was 65 years (range, 18–105 years). METHODS: Baseline sacral hospital-acquired pressure ulcer (HAPU) incidence was determined during a period of 35 months; skin care representatives examined all patients in our critical care unit for HAPUs on a monthly basis. Based on this baseline incidence, we studied the effect of application of a silicone-bordered foam dressing applied to the sacrum. The observation period for our study intervention was 6 months; the sacral area was examined twice daily during this period. RESULTS: The average baseline sacral HAPU prevalence during the 35-month observation was 13.6% as compared to an incidence of 1.8% during a 6-month prospective study. Three of the 5 patients developed suspected deep tissue injuries and subsequently expired. The remaining 2 subjects developed stage 2 pressure ulcers, one of whom also expired. CONCLUSION: Following application of a silicone-bordered foam dressing, we were able to achieve a HAPU of 1.8%.

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Available from: C. Tod Brindle, Mar 02, 2014

  • No preview · Article · Mar 2012 · Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society / WOCN
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    ABSTRACT: The prevention of hospital acquired pressure ulcers in critically ill patients remains a significant clinical challenge. The aim of this trial was to investigate the effectiveness of multi-layered soft silicone foam dressings in preventing intensive care unit (ICU) pressure ulcers when applied in the emergency department to 440 trauma and critically ill patients. Intervention group patients (n = 219) had Mepilex® Border Sacrum and Mepilex® Heel dressings applied in the emergency department and maintained throughout their ICU stay. Results revealed that there were significantly fewer patients with pressure ulcers in the intervention group compared to the control group (5 versus 20, P = 0·001). This represented a 10% difference in incidence between the groups (3·1% versus 13·1%) and a number needed to treat of ten patients to prevent one pressure ulcer. Overall there were fewer sacral (2 versus 8, P = 0·05) and heel pressure ulcers (5 versus 19, P = 0·002) and pressure injuries overall (7 versus 27, P = 0·002) in interventions than in controls. The time to injury survival analysis indicated that intervention group patients had a hazard ratio of 0·19 (P = 0·002) compared to control group patients. We conclude that multi-layered soft silicone foam dressings are effective in preventing pressure ulcers in critically ill patients when applied in the emergency department prior to ICU transfer.
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