Effect of a prophylactic dressing for sacral pressure injuries in non‐critically ill patients after general surgery: A randomized controlled trial

Abstract

Background Hospital‐acquired pressure injuries are strongly associated with surgeries performed under general anesthesia. Aims The aim of this study was to evaluate the effects of using a prophylactic multi‐layer soft silicone foam dressing in non‐critically ill patients with a Braden Scale score of ≤18 after undergoing routine surgery without sacral pressure injuries. Methods This randomized controlled trial included 156 patients who were admitted for surgery under general anesthesia in a tertiary general hospital. The patients were divided into a control group and an intervention group. A 5‐layer soft silicone foam dressing was applied to the sacrum of patients in the intervention group immediately after surgery. For the control group, standard pressure injury prevention activities were performed alongside standard care without preventive dressings. Results There were no significant differences in general and clinical characteristics between the two groups; however, the incidence of pressure injury and blanching erythema was higher in the control group, showing a significant difference from the experimental group. Factors influencing the development of pressure injuries and blanching erythema through multivariate regression analysis were prophylactic dressing application and Braden Scale score at the time of admission. A statistically significant difference was noted in survival time from pressure injury between both groups. Linking Evidence to Action The incidence of pressure injuries and blanching erythema was lower when the prophylactic dressing was applied with standard protocol for general ward patients after surgery. Accurate evaluation of the patient's skin condition and pressure injury risk assessment before surgery are important. Progressive prophylactic dressings to prevent pressure injuries are effective, and tailored nursing interventions based on accurate assessment of patient's skin condition and risk factors are essential for maintaining skin integrity.

The efficacy of sacral foam dressing in preventing sacral pressure injury: A systematic review and meta‐analysis

“…Ultimately, nine articles comparing the efficacy of sacral foam dressing in preventing SPI were included in the meta‐analysis. 8 , 9 , 11 , 12 , 22 , 23 , 24 , 25 , 26 Figure 1 presents the PRISMA flow diagram illustrating the selection process.…”

“…Nonetheless, the discourse around the superiority of sacral foam dressings is accompanied by a degree of controversy. 11,12 Previous meta-analyses on this topic have encompassed studies of different designs, 13 including retrospective studies, and have examined various types of dressings applied to different body sites. 14 These analyses, while informative, lack the specificity required to conclusively determine the effectiveness of sacral foam dressings in preventing SPI.…”

“…Nonetheless, the discourse around the superiority of sacral foam dressings is accompanied by a degree of controversy. 11 , 12 …”