Use of prophylactic silicone adhesive dressings for maintaining skin integrity in intensive care unit patients: A randomised controlled trial

Abstract

The aims of this randomised controlled study were to determine whether the application of silicone adhesive dressings with standard preventive care would reduce the impairment of skin integrity and to evaluate the subepidermal moisture (SEM) value in anatomical locations to predict impairment of skin integrity. Of the 71 intensive care unit patients enrolled, 35 and 31 were randomly assigned to the intervention and control groups, respectively. The SEM value was measured at each site (the coccyx, sacrum, and both buttocks) repeatedly three times at every dressing change. Collected data were analysed by multivariate linear regression, and least square means analysis was used to compare the SEM value at the sites of pressure injury (PI) and blanching erythema. There were fewer PIs (1 vs 9) and incidences of blanching erythema (5 vs 6) in the intervention group than in the control group (P = 0.006). The SEM value and difference of the SEM value from the initial value was higher in the group with PIs than in the group without PIs (P < 0.0001 and P = 0.001, respectively). There was a statistically significant difference in the incidence of impaired skin integrity between the groups. The SEM value may be an indicator for detecting impairment of skin integrity.

Keywords: intensive care unit; pressure injury; randomised controlled trial; silicone adhesive dressing.