Prophylactic Sacral Dressing for Pressure Ulcer Prevention in High Risk Patients
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There are many factors that lead to development of pressure ulcers in high-risk patients. As a result, effective preventive measures also have to address all these factors collectively. According to Bryne et al (2016), most of these factors develop because of hemodynamic instability as well as activity orders for bed rest.
Bed rest in a significant part of the treatment process for all patients in ICU because it mainly invokes the aspects of sedation, intubation, surgical procedures, paralysis, low flow states, poor nutrition and even poor circulation. This means that high-risk patients are at the predisposition of the development as well as the progression of pressure ulcers.
…. This research looks at both clinical evidence and mathematical models because “what may appear simple, complex or an unbelievable problem in healthcare may also be simply innovative requiring taking existence materials and then applying them in a new way (Brindle & Wegelin 2012).”
Many healthcare practitioners are aware that a patient’s heel tends to be the most common site where deep-tissue injuries and hospital-acquired pressure ulcers occur.
…According to Santamaria et al (2016), this concept aims at reducing the chances of developing hospital-acquired pressure ulcers by providing some mechanical cushion and reducing friction at the dressing-support interface. Furthermore, it also aims at minimizing compressive as well as shear deformations in the subdermal tissues.
…. These study echoes finding from another mathematical model of study that had been conducted by Levy, Frank & Gefen (2015) on the matter. Although in other studies different types of dressing materials were used, any form of dressing reduces the incidence rate of developing facility-acquired pressure ulcers.
According to Walker et al (2015), prophylactic sacral dressing can change the microclimate at the dressing/skin interface. Another multi-intervention cohort study carried out in a surgical ICU by Brindle proved that there were many benefits of prophylactic sacral dressing in high risk patients. Another study conducted by Wegelin and Brindle in a cardiac surgery where they used a prophylactic multilayered soft silicone as a border foam sacral dressing proved to reduce shear and pressure friction (Brindle & Wegelin, 2012).
According to Byrne et al (2016), there was another study that was carried out in 3 intensive care units at an academic centre and at an urban tertiary care hospital. ..
The results showed decreased incidence rates after use of dressings were initiated. This was by about 3.4 to 7.6 in every 1000 patient days they were in the hospital and dressings were used depending on the unit of study (Byrne et al, 2016). This study also showed that prophylactic sacral dressings can help in preventing hospital-acquired sacral pressure ulcers.
….Finite modeling is some sort of computational method that is highly used in biomechanics research as well as traditional engineering and in developing medical products. According to these authors, finite element modeling is used for determining a….
When it comes to solving biophysical issues, it is always advisable to start by dividing the studied structures into small elements (‘finite’ elements) with similar variants. Thereafter, a powerful computer is used to solve the set of quotations that govern state of deformation as well as the loads in the tissues (or structures) in every element, and between elements. This results into a map showing distributions of the recorded deformations and loads within and across ….
These authors compared exposures of the soft tissues loaded in the heel to deformations including the ones with and without multilayer dressing. These authors found that the use of multilayer prophylactic sacral dressing considerably reduced internal soft issues exposures consistently. This was to elevated deformation levels on all support surfaces, at the posterior heel and even when considering shears, for instance due to elevated head side of the bed.
Brindle & Wegelin (2012) feel that while many clinicians may not need to know the concept behind mathematical modeling, they should know that it explains why it works. These authors also argue that clinicians…. matter have all shown minimized incidence rates regardless of the dressing material used.
References
Brindle, C. T., & Wegelin, J. A. (2012). Prophylactic dressing application to reduce pressure ulcer formation in cardiac surgery patients. Journal of Wound Ostomy & Continence Nursing, 39(2), 133-142.
Byrne, J., Nichols, P., Sroczynski, M., Stelmaski, L., Stetzer, M., Line, C., & Carlin, K. (2016). Prophylactic Sacral Dressing for Pressure Ulcer Prevention in High-Risk Patients. American Journal of Critical Care, 25(3), 228-234.
Call, E., Pedersen, J., Bill, B., Black, J., Alves, P., Brindle, C. T., … & Clark, M. (2015). Enhancing pressure ulcer prevention using wound dressings: what are the modes of action?. International wound journal, 12(4), 408-413.
Levy, A., Frank, M. B. O., & Gefen, A. (2015). The biomechanical efficacy of dressings in preventing heel ulcers. Journal of tissue viability, 24(1), 1-11.
Santamaria, N., Liu, W., Gerdtz, M., Sage, S., McCann, J., Freeman, A., … & Knott, J. (2015). The cost‐benefit of using soft silicone multilayered foam dressings to prevent sacral and heel pressure ulcers in trauma and critically ill patients: a within‐trial analysis of the Border Trial. International wound journal, 12(3), 344-350.
Walker, R., Aitken, L. M., Huxley, L., & Juttner, M. (2015). Prophylactic dressing to minimize sacral pressure injuries in high‐risk hospitalized patients: a pilot study. Journal of advanced nursing, 71(3), 688-696.
