Effectiveness of prophylactic sacral protective dressings to prevent pressure injury: A systematic review and meta-analysis

Fulbrook, Paul; Mbuzi, Vainess; Miles, Sandra

doi:10.1016/j.ijnurstu.2019.103400

Cited by 41 publications

(52 citation statements)

References 24 publications

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“…Present study indings supported by the study conducted by Fulbrook et al (2019) on prophylactic sacral protective dressings. The purpose of the study to ind out the effectiveness of prophylactic sacral care to prevent pressure injury incidence with an overall relative risk indicating that the intervention decreases pressure injury risk by 70% (Fulbrook et al, 2019). The study has revealed statistically signi icant reduced pressure injury incidence in the intervention group.…”

Section: Resultssupporting

confidence: 77%

Effectiveness of Prophylactic Sacral Care on Prevention of Pressure Ulcer among Pressure Ulcer High-Risk Patients in the Intensive Care Unit

2020

ijrps

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Patients in intensive care units are usually at high risk of mortality, not only from their illness but also from a secondary complication such as pressure ulcer. Problems of the integumentary system are common can be severe. It can present itself as a life-threatening condition. A pressure ulcer is a restricted physical issue to the skin as well as fundamental tissue as a rule over a noticeable hard quality, because of pressure or pressure in blend with shear. The newer treatment modalities of cancer for the treatment of pressure ulcers incorporate the function of nourishment, pressure-discharge gadgets, for example, pads and sleeping cushions, cleaning the injury, debridement, streamlined dressings, part of anti-toxins and reconstructive medical procedure as an aspect of the therapy calculation for forestalling and fast recuperating cycle of these injuries. Hence the study aims to assess the effectiveness of prophylactic sacral care on prevention of pressure ulcer among pressure ulcer high-risk patients in the experimental and control group. A quasi-experimental design was employed with 60 samples which matched the inclusion criteria were selected by convenience sampling technique. Demographic variables data were collected by using a structured questionnaire followed by assessing the effectiveness of prophylactic sacral care on prevention of pressure ulcer among pressure ulcer high-risk patients by using the questionnaire. The findings of the study revealed prophylactic sacral care could significantly reduce the risk of pressure ulcer. Based on findings, further studies can be conducted to correlate the pre-test and post-test score of prevention of pressure ulcer among pressure ulcer high-risk patients between the experimental and control group.

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Section: Resultssupporting

confidence: 77%

Effectiveness of Prophylactic Sacral Care on Prevention of Pressure Ulcer among Pressure Ulcer High-Risk Patients in the Intensive Care Unit

2020

ijrps

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“…Noteworthy is the structural stiffness of the tested dressings in compression, which not only varied across products in the dry condition, but was also not necessarily consistent between the dry and moist test conditions for the same product (Figure 3). For example, the RSB dressing which was shown to be relatively soft and compliant at a dry (new) state ( Figure 3A) has approximately doubled its structural stiffness after being exposed to moisture and became the stiffest product in compression ( Figure 3B), likely due to a swelling effect in its backing film 4 (Figures 2,3).…”

Section: Resultsmentioning

confidence: 99%

“…3 The static COF corresponds to the maximum torque that must be overcome to initiate motion between the fixed and rotating parts of the tribometer. 4 Since only the mattress-facing surface ("backing film") of the dressings was moistened and the backing film of the RSB dressing is made of polyurethane (PU) film which is waterproof, that is, no liquid could be transported through the backing film into the fluff core of the RSB (with the embedded superabsorbent particles there), the stiffening of the moist RSB dressing with respect to its dry behaviour (Figure 2) is likely due to swelling of the PU backing film itself. 5 A COF of the backing film which is too low may contribute to migration of patients in their bed and thereby, to an increase in the tissue shearing levels at body regions not protected by the dressing, 38 for example, when the heels, not protected by dressings, slide towards the foot of the bed.…”

Section: Discussionmentioning

confidence: 99%

The biomechanical efficacy of a dressing with a soft cellulose fluff core in prophylactic use

Gefen

Krämer

Brehm³

et al. 2020

International Wound Journal

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In this work, we developed an experimental‐computational analysis framework which facilitated objective, quantitative, standardised, methodological, and systematic comparisons between the biomechanical efficacies of two fundamentally different dressing technologies for pressure ulcer prevention: A dressing technology based on cellulose fibres used as the core matrix was evaluated vs the conventional silicone‐foam dressing design concept, which was represented by multiple products which belong in this category. Using an anatomically‐realistic computer (finite element) model of a supine female patient to whom the different sacral dressings have been applied virtually, we quantitatively evaluated the efficacy of the different dressings by means of a set of 3 biomechanical indices: The protective efficacy index, the protective endurance, and the prophylactic trade‐off design parameter. Prior rigorous experimental measurements of the physical and mechanical behaviours and properties of each tested dressing, including tensile, compressive, and friction properties, have been conducted and used as inputs for the computer modelling. Each dressing was evaluated for its tissue protection performances at a new (from the package) state, as well as after exposure to moisture conditions simulating wet bedsheets. Our results demonstrated that the dressing with the fluff core is at least as‐good as silicone‐foams but importantly, provides the best balance between protective performances at its “new” condition and the performance after being exposed to moisture. We conclude that preventative dressings are not equal in their prophylactic performances, but rather, the base technology, the ingredients, and their arrangement in the dressing structure shape the quality of the delivered tissue protection.

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“…In this context, no manufacturer currently claims that their dressings have been designed specifically for prophylaxis or that their dressings are recommended for just this purpose. On the contrary, some manufacturers recommend dressings developed originally for treatment to now be considered as dualuse, for prevention as well as treatment, 12,[38][39][40] which is advantageous in some aspects, such as allocation of manufacturing resources, logistics and storage (at both the manufacturer and client ends). Under these circumstances, however, it is yet unclear if certain dressing design concepts would perform better in prevention than in treatment or vice versa, and this requires laborious bioengineering research to study.…”

Section: Application Of the Theory To Evaluation Of Different Dressinmentioning

confidence: 99%

“…The concept of using dressings which were originally developed for wound treatment applications prophylactically, for PUP (as opposed to using dressings that are specifically designed for prophylaxis as in the Clark study 11 ), is relatively new but is gaining popularity (the number of peer-reviewed journal publications focusing on this topic appears to have doubled every three years since 2012). A metaanalysis of the relevant clinical trials to date (Fulbrook et al 12 ) concluded that prophylactic sacral dressings decrease the relative sacral PU risk by 70% in general wards and by 83% in intensive care units (ICUs); this has been confirmed in a large German trial which appeared soon afterwards (Hahnel et al 13 ).…”

mentioning

confidence: 95%

Pressure ulcer prevention dressing design and biomechanical efficacy

Gefen

2020

J Wound Care

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The objective of this educational article is to explain in non-technical terms how the engineering considerations in the design of prophylactic dressings for pressure ulcer (PU, also known as pressure injury) prevention eventually determine the associated clinical and cost-benefit outcomes. The article specifically describes a bioengineering algorithm for quantitative evaluation of the biomechanical efficacy of different prophylactic dressing designs, which is exemplified for two fundamentally different dressing technologies, one based on superabsorbent cellulose core versus the conventional silicone-foam dressing design. A set of three biomechanical indices is described and employed for the above comparative evaluation, namely, the protective efficacy index, the protective endurance and the prophylactic trade-off design parameter. It is demonstrated that the dressing with the superabsorbent cellulose core is at least as good as silicone-foams but, importantly, provides a good balance between its protective performance in its ‘new’ condition, as opposed to its ‘used’ condition, i.e., after being exposed to moisture. Most notably, we show that preventative dressings are never equal in their performances; the underlying structure and the dressing ingredients together determine the extent of the delivered tissue protection and its durability.

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Effectiveness of prophylactic sacral protective dressings to prevent pressure injury: A systematic review and meta-analysis

Cited by 41 publications

References 24 publications

Effectiveness of Prophylactic Sacral Care on Prevention of Pressure Ulcer among Pressure Ulcer High-Risk Patients in the Intensive Care Unit

Effectiveness of Prophylactic Sacral Care on Prevention of Pressure Ulcer among Pressure Ulcer High-Risk Patients in the Intensive Care Unit

The biomechanical efficacy of a dressing with a soft cellulose fluff core in prophylactic use

Pressure ulcer prevention dressing design and biomechanical efficacy

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