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Purpose: To evaluate silicone foam border post-op dressing versus traditional island dressings, for ease of application, removal, adherence and skin integrity following cardiac surgery. Review of the literature showed post-surgical dressings causing skin disruption greatly increase risk for hospital acquired infection and surgical site infection. Infection results in an increase in post-operative length of stay and increase in associated cost. Patients with multiple comorbidities and thinner skin are at higher risk for dressing-associated complications.
Objective: To decrease the incidence of blisters, and skin tears with scarring, due to friction and shear forces of island dressings, which a non-conformable fabric that absorbed environmental moisture and did not absorb exudate. Our goal was to evaluate an absorbent dressing that could provide atraumatic incisional care that is better tolerated by patients, and can also decrease healthcare worker burden due to frequent dressing changes. Studies comparing acrylate, silicone, hydrocolloids, and polyurethane showed hydrocolloid required the largest energy to detach with silicone requiring the lowest energy. Hydrocolloid reported highest pain with removal while silicone reported lowest.
Evaluation and Outcomes – During a 60-day trial window, 141 cardiac surgical patients were evaluated by bedside nursing staff. Submission to the IRB determined that this project was consistent with a product evaluation and approval was obtained. Evaluation of the silicone border foam post-op dressing included ease of application, adherence, perceived patient distress and maintenance of skin integrity. Results showed significant reduction in patient discomfort perceived by the nursing staff during dressing changes and it was noted that there were no instances of skin stripping as compared to acrylic island dressings. These patients experienced no post-operative scarring from this dressing.