Quantifying the interface pressures between prophylactic dressings and three different support surfaces

Topic

Multi-layered foam dressing has been recommended for prophylactic use in pressure injury (PI) prevention. With the availability of different foam dressings, operating room (OR) nurses select their preferred prophylactic dressings. There is a concern that these inconsistent practices may lead to suboptimal pressure preventive strategies to minimize occurrence of OR PI.

Purpose

This study examined the interface pressures between selected prophylactic dressings in combinational use with available support surfaces for reduction in interface pressure (peak pressure and average pressure).

Method

A mechanical study with descriptive, comparative with repeated measures design was adopted. Study materials included four weight loads (2kg solid, 5kg solid, 1.8kg ball bearing, and 2.8kg foot model with ankle weight), three support surfaces (acrylic board, couch bed and operating room (OR) bed), and three different prophylactic dressings (polyurethane foam with Apertured silicone (Safetac™) wound contact layer (SF), hydrocellular foam (HF) and polyurethane foam with Hydrofiber™ wound contact layer (FH) were applied. Pressures were measured between each load with/without a dressing applied and a support surface using a third-party Pressure Mapping System.

Outcomes

The three-way repeated measures ANOVA showed interaction significances in mean differences for average pressure, F(18, 144)=111.43, p<0.05) and peak pressure, F(18, 144)=15.15, p<0.05) between the loads, support surfaces and dressings. However, the HF dressing and OR bed have the lowest interface pressures (p<0.05). There was no statistical difference between the interface pressures of the SF and FH; and also the couch and OR bed.

Conclusion

Different prophylactic dressings interacted with support surfaces that influenced the interface pressures measured. Both polyurethane foams (SF and HF) have similar influences on the interface pressures as with the OR and couch bed. The combination use of OR bed and HF was the most effective in reducing peak and average pressures.