Effectiveness of a multi-layer silicone-adhesive polyurethane foam dressing as prevention for sacral pressure ulcers in at-risk in-patients: Randomized controlled trial

Forni, Cristiana; Gazineo, Domenica; Allegrini, Elisabetta; Bolgeo, Tatiana; Brugnolli, Anna; Canzan, Federica; Chiari, Paolo; Evangelista, Andrea; Grugnetti, Anna Maria; Grugnetti, Giuseppina; Guberti, Monica; Mezzalira, Elisabetta; Pierboni, Lara; Prosperi, L; Sofritti, Barbara; Tovazzi, Cristina; Vincenzi, Silvia; Zambiasi, Paola; Zoffoli, Carlotta; Ambrosi, Elisa; Bandi, Fabiola; Batani, Manuela; Bertin, Giovanna; Bianchi, Luana; Carmagnini, Monica; Cedioli, Silvia; Colognese, Stefano; Consuelo, Morena; D'Alessandro, Fabio; Fontana, M.; Galassi, Ludovica; Gridelli, M; Magnani, Paola; Morri, Mattia; Ortolani, Barbara; Scialla, Maurizio; Stanga, Pamela; Toselli, Paola; Zanelli, Sarah

doi:10.1016/j.ijnurstu.2022.104172

Cited by 14 publications

(26 citation statements)

References 25 publications

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“…Although not statistically significant, there was a difference in the incidence of pressure injury between the two groups, and in the univariable and multivariable logistic regression, the experimental group was effective in preventing pressure injury and blanching erythema. This is in line with the results of previous studies on the effectiveness of prophylactic dressings in medical‐surgical ward patients (Beeckman et al, 2021; Forni et al, 2022). However, in a previous study conducted on patients in a similar setting, the use of a prophylactic dressing was not effective in reducing the incidence of pressure injuries, but in a subgroup analysis of high‐risk groups with a score of ≤12 on the Braden Scale, prevention of pressure ulcers was observed (Borojeny et al, 2020; Haisley et al, 2020).…”

Section: Discussionsupporting

confidence: 91%

“…The studies published to date have mainly applied prophylactic foam dressings for the prevention of sacral pressure injuries in critically ill patients and have demonstrated their effectiveness (Gaspar et al, 2019; Haisley et al, 2020; Lin et al, 2022). Recent studies have reported that prophylactic dressings are effective in preventing pressure injuries even in medical‐surgical ward patients as well as critically ill patients or high‐risk groups (Beeckman et al, 2021; Forni et al, 2022). However, most interventional studies were conducted in the intensive care unit, and there are few randomized trials in which prophylactic dressings were applied to patients admitted to wards after general surgery.…”

Section: Introductionmentioning

confidence: 99%

“…However, most interventional studies were conducted in the intensive care unit, and there are few randomized trials in which prophylactic dressings were applied to patients admitted to wards after general surgery. Moreover, although updated guidelines suggest the effectiveness of prophylactic dressings on ambulatory subjects in general wards after general surgery, there are still differing opinions about the effects according to the experiences of health professionals (Beeckman et al, 2021; Forni et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

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

Yeo

Hwang

Lee

et al. 2023

Worldviews Ev Based Nurs

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yeo

Hwang

Lee

et al. 2023

Worldviews Ev Based Nurs

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“…Several dressings were investigated to prevent and manage PIs, including commonly employed polyurethane and hydrocolloid dressings; however, these dressings had drawbacks such as poor conductivity and high rigidity. [290][291][292][293][294][295] In this context, hydrogel dressings have received a lot of attention for their ability to minimize pressure and maintain a moist environment for the skin to prevent PIs. [296][297][298] Moreover, hydrogels with piezoelectric properties provide significant advantages due to their outstanding mechanical-to-electrical response, regulation of blood flow, and stimulation of angiogenesis.…”

Section: Polymers-based P-pegsmentioning

confidence: 99%

Perspectives on recent advancements in energy harvesting, sensing and bio-medical applications of piezoelectric gels

et al. 2023

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“…At present, lessening pressure and maintaining a moist microenvironment for skin are the major strategies to prevent PIs/PUs in the clinical field . Various dressings are applied to prevent and manage PIs/PUs for reducing tissue load and internal deformations of the supporting surface. , Polyurethane and hydrocolloid dressings are common, − but the hydrocolloid dressing is too stiff and the polyurethane dressing has poor thermal conductivity. , The thermal conductivity and long-term stiffness of hydrogel match those of human skin, demonstrating that the hydrogel dressing has the potential for preventing PIs/PUs.…”

Section: Introductionmentioning

confidence: 99%

Piezoelectric Hydrogel for Prophylaxis and Early Treatment of Pressure Injuries/Pressure Ulcers

Guan

et al. 2022

ACS Biomater. Sci. Eng.

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Pressure injuries/pressure ulcers (PIs/PUs) are a critical global healthcare issue and represent a considerable burden on healthcare resources. Prevention of PIs/PUs is the least costly approach and minimizes the patient suffering compared with treatment. Besides, sustained tissue load alleviation and microenvironment management are the most crucial properties for dressings in PI/PU prevention. Hydrogel dressings have attracted a lot of attention to prevent PIs/PUs because of their unique mechanical properties and ability to manage the microenvironment of skin. However, auxiliary prophylaxis and early treatment of PIs/PUs remain a challenge and an acute clinical demand. Here, we report on an electroactive hydrogel with large stretchability (∼380%) and skinlike ductility, and Young's modulus (0.48 ± 0.03 MPa) matches that of human skin (0.5−1.95 MPa). The hydrogel displayed piezoelectric properties and mechanical−electric response stability and sensitivity. Our results indicated that the hydrogel was able to promote in vitro angiogenesis under piezoelectric stimulation and exhibited biocompatibility, which has the potential for forming fine vessels at the damaged sites of PIs/PUs. Furthermore, finite element analysis and pressure dispersion experiments demonstrated that the hydrogel was suitable for preventing PIs/PUs by redistributing force, reducing tissue distortion, and maintaining the microenvironment for skin. This work offers a new strategy for designing and evaluating the dressing for prophylaxis and the early treatment of PIs/PUs.

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Effectiveness of a multi-layer silicone-adhesive polyurethane foam dressing as prevention for sacral pressure ulcers in at-risk in-patients: Randomized controlled trial

Cited by 14 publications

References 25 publications

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

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

Perspectives on recent advancements in energy harvesting, sensing and bio-medical applications of piezoelectric gels

Piezoelectric Hydrogel for Prophylaxis and Early Treatment of Pressure Injuries/Pressure Ulcers

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