After the Fact: Use of a Multi-layered Hydrocellular Foam in the Prevention of Reinjuring Recently Resolved Pressure Ulcers

Background: Foam dressings have been shown to efficacious in prevention of pressure ulcers (PU) when applied as part of a bundled comprehensive prevention program. ^1,2  Little literature exists on their role in maintaining skin integrity after the PU has resolved, as many times these dressings are removed, while the rest of the bundle remains unchanged. Silicone interface dressings have been shown to improve long-term skin outcomes in the burn patient³, it is unknown if this transfers to the pressure ulcer population.

Program Description: An evaluation of 20 patients with history of repeated reinjury at the PU site in long-term care settings which use a 30 day three times daily application of moisture barrier creams or ointments after pressure ulcer resolution instead received a multi-layered hydrocellular foam dressing* (MLHCFD) applied to the affected site for 30 days. Dressings were changed weekly or if needed for loss of integrity. Weekly skin checks occurred for 4 weeks then for an additional 4 weeks after the multi-layered hydrocellular foam was discontinued and the patient was transitioned to usual care.

Results: Previous pressure ulcer sites remained intact while receiving the MLHCFD. The majority of dressings in the sacral area remained in place for 7 days. Only one patient reopened the site of the previous PU after transitioning back to a moisture barrier ointment.

Conclusion: The action of the MLHCFD to promote skin integrity after injury is unknown but maybe related to injured area remodeling, as seen in the use of silicone application to the burn patient. Although success is most likely multi-faceted, dressing construction design may be a defining factor. Further studies are warranted.

*Allevyn Life^² , Trademark of Smith and Nephew, Inc., Andover, Massachusetts