Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit.

Autor:	Kalowes P; Peggy Kalowes is director, Nursing Research, Innovation and Evidence-Based Practice. pkalowes@memorialcare.org., Messina V; Valerie Messina is a certified wound care nurse and director of the wound care program; and, Li M; Melanie Li is a certified wound ostomy continence nurse, Long Beach Memorial, Miller Children's and Women's Hospital, Long Beach, California.
Jazyk:	angličtina
Zdroj:	American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2016 Nov; Vol. 25 (6), pp. e108-e119.
DOI:	10.4037/ajcc2016875
Abstrakt:	Background: In critically ill patients, prevention of pressure ulcers is a challenge because of the high risk for multiple comorbid conditions, immobility, hemodynamic instability, and increased use of medical devices. Objectives: To compare the difference in incidence rates of hospital-acquired pressure ulcers (HAPUs) in critically ill patients between those treated with usual preventive care and a 5-layered soft silicone foam dressing versus a control group receiving usual care. Secondary goals were to examine risk factors for HAPUs in critically ill patients and to explicate cost savings related to prevention of pressure ulcers. Methods: A prospective, randomized controlled trial in the intensive care units at a 569-bed, level II trauma hospital. All 366 participants received standard pressure ulcer prevention; 184 were randomized to have a 5-layered soft silicone foam dressing applied to the sacrum (intervention group) and 182 to receive usual care (control group). Results: The incidence rate of HAPUs was significantly less in patients treated with the foam dressing than in the control group (0.7% vs 5.9%, P = .01). Time to injury survival analysis (Cox proportional hazard models) revealed the intervention group had 88% reduced risk of HAPU development (hazard ratio, 0.12 [95% CI, 0.02-0.98], P = .048). Conclusion: Use of a soft silicone foam dressing combined with preventive care yielded a statistically and clinically significant benefit in reducing the incidence rate and severity of HAPUs in intensive care patients. This novel, cost-effective method can reduce HAPU incidence in critically ill patients. (©2016 American Association of Critical-Care Nurses.)
Databáze:	MEDLINE
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