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

Abstract

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.

What makes a hydrogel‐based dressing advantageous for the prevention of medical device‐related pressure ulcers

“…3,29,30 In the context of preventing MDRPUs, our research group extensively studied the biomechanical protective effects of different dressing types, as well as an alternative approach of using a cyanoacrylate skin protectant. 9,10,[31][32][33] In particular, in the aforementioned works, we have characterised the mechanical properties and behaviours of dressing materials and structures; the coefficient of friction (COF) at the dressing-skin interface, including under the effect of skin moisture; and the thermal conductivity of dressings intended for prophylactic use. The latter thermal property, which is critically important for assessing the expected microclimate environment induced by dressings in prophylactic use, has been investigated by means of a custom-made heat-flow meter as well as by using infrared thermography (IRT).…”

Evaluation of facial tissue stresses under medical devices post application of a cyanoacrylate liquid skin protectant: An integrated experimental‐computational study

“…Volumetric tissue exposure to effective stresses was selected as the primary outcome measure for evaluating the biomechanical protective effect of the CLSP on skin and subdermal tissues, consistent with our other published work in the field of PU prevention 18,31,47‐54 . For both model types (ear and mouth), and in each variant (with CLSP versus no CLSP), volumetric soft tissue exposures to effective stresses were calculated and plotted for visual and quantitative comparisons of the tissue loading states post application of the CLSP versus the no‐CLSP case.…”

Applying the Nightingale Pledge in Reducing Health Disparities: A Hospital-Acquired Pressure Injury Case Study

“…Healthcare facilities have determined that nurses-by virtue of the direct care they provide to patients, such as applying skin barrier topical ointments and creams, applying dressings, managing nutrition, and repositioning-can prevent HAPIs within healthcare facilities. When nurses have been taught to assess variations in skin color (eg, use of Munsell color charts to objectively measure skin tones) in conjunction with the aforementioned nursing treatment interventions, patients with darker skin tones, who statistically have higher mortality and morbidity [9][10][11][12][13] attributed to HAPIs, may have better health outcomes.…”