Efficacy of the prophylactic use of silicone foam dressing for the prevention of pressure ulcers in patients: an observational study in a 24 bed cardiovascular and cardiac intensive care unit

In the acute care setting, the critical care units report the highest numbers of Hospital Acquired Pressure Ulcers (HAPUs).  In 2009, the U.S. benchmark for HAPU rates in intensive care cardiovascular and cardiac units was reported to be at 6.2 % and 8.8% respectively, only a small improvement from previous years despite the implementation of evidence-based guidelines. Although it was thought that dressings decreased friction and shear, a new hypothesis indicates that dressing play a greater role in preventing ulcers.  Ongoing studies demonstrate that certain characteristics of soft silicone foams have been shown to decrease pressure ulcers in the extremely ill surgical trauma patient.  

The purpose of this study was to evaluate whether the addition of soft silicone foam to established pressure ulcer prevention protocols would reduce the rates of HAPUs in Cardiovascular Intensive Care Unit Cardiac/Critical Care Unit (CVICU/CCU).

The study included 166 patients admitted during a two month study period.  Participants ranged from 19 to 103 years of age and had an average Braden Scale Score of 14. All patients participated with the exception of those who refused or had a pressure ulcer present on admission.  Soft silicone foam was applied over the sacral area and peeled back every twelve hours to observe skin integrity.

When compared with HAPU rates prior to the study, a decrease of HAPU was noted with the application of the soft silicone foam dressing.  Only one patient, who underwent induced hypothermia, developed a pressure ulcer on the sacrum.  

Wound clinicians in the acute care units are challenged to find new ideas to prevent the development of pressure ulcers.  The findings of the study support the addition of soft silicone foam dressing to the armamentarium of interventions as part of the ongoing effort to prevent HAPUs. These results can contribute to broaden current knowledge.