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. 2014 Oct;11(5):460-71.
doi: 10.1111/iwj.12212. Epub 2014 Jan 29.

Systematic review of the use of prophylactic dressings in the prevention of pressure ulcers

Michael Clark  1 , Joyce Black, Paulo Alves, Ct Brindle, Evan Call, Carol Dealey, Nick Santamaria
Affiliations

Systematic review of the use of prophylactic dressings in the prevention of pressure ulcers

Michael Clark et al. Int Wound J. 2014 Oct.

Abstract

This systematic review considers the evidence supporting the use of prophylactic dressings for the prevention of pressure ulcer. Electronic database searches were conducted on 25 July 2013. The searches found 3026 titles and after removal of duplicate records 2819 titles were scanned against the inclusion and exclusion criteria. Of these, 2777 were excluded based on their title and abstract primarily because they discussed pressure ulcer healing, the prevention and treatment of other chronic and acute wounds or where the intervention was not a prophylactic dressing (e.g. underpads, heel protectors and cushions). Finally, the full text of 42 papers were retrieved. When these 42 papers were reviewed, 21 were excluded and 21 were included in the review. The single high-quality randomised controlled trial (RCT) and the growing number of cohort, weak RCT and case series all suggest that the introduction of a dressing as part of pressure ulcer prevention may help reduce pressure ulcer incidence associated with medical devices especially in immobile intensive care unit patients. There is no firm clinical evidence at this time to suggest that one dressing type is more effective than other dressings.

Keywords: Pressure ulcer prevention; Prophylactic dressings.

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Figures

Figure 1
Figure 1
Flow chart showing records identified, screened and included in the synthesis.
Figure 2
Figure 2
Funnel plot to ascertain risk of publication bias within the nine studies that compared pressure ulcer prevention with or without prophylactic dressings.
Figure 3
Figure 3
Forest plot synthesising the three studies that compared nasal pressure ulcer prevention with or without prophylactic dressings.
Figure 4
Figure 4
Forest plot synthesising the four studies that compared sacral pressure ulcer prevention with or without prophylactic dressings.
See this image and copyright information in PMC

References

    1. National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel . Prevention and treatment of pressure ulcers: clinical practice guideline. Washington, DC: National Pressure Ulcer Advisory Panel, 2009.
    1. Clark M. The effect of a pressure‐relieving wound dressing on the interface pressures applied to the trochanter. Decubitus 1990;3:43–6. - PubMed
    1. Wounds International . Pressure ulcer prevention. Pressure, shear, friction and microclimate in context. London: Wounds International; URL http://www.woundsinternational.com/pdf/content_8925.pdf [accessed on 11 December 2012], 2010.
    1. Gefen A. How do microclimate factors affect the risk for superficial pressure ulcers: a mathematical modeling study. J Tissue Viability 2011;20:81–8. - PubMed
    1. Clark M, Cullum N. Matching patient need for pressure sore prevention with the supply of pressure redistributing mattresses. J Adv Nurs 1992;17:301–16. - PubMed

Publication types