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Review
. 2023 Dec 22:57:e20230039.
doi: 10.1590/1980-220X-REEUSP-2023-0039en. eCollection 2023.

Pressure injury prevention measures: overview of systematic reviews

[Article in English, Portuguese]
Franciele Soares Pott  1 , Marineli Joaquim Meier  1 , Janislei Giseli Dorociaki Stocco  2 , Francislene de Fátima Cordeiro Petz  1 , Hellen Roehrs  1 , Patricia Klarmann Ziegelmann  3
Affiliations
Review

Pressure injury prevention measures: overview of systematic reviews

[Article in English, Portuguese]
Franciele Soares Pott et al. Rev Esc Enferm USP. .

Abstract
in English, Portuguese, Spanish

Objective: Summarizing the evidence from systematic reviews regarding the comparison the effectiveness of interventions to prevent pressure injuries.

Method: Overview of systematic reviews conducted in accordance with Cochrane guidelines. A search was performed in databases, repositories and systematic review registration sites.

Results: 15 reviews were included in this overview. The sensitivity analysis showed a reduction in the incidence of pressure injuries with nutritional supplementation compared to the standard hospital diet (Relative Risk (RR) = 0.83; 95% Confidence Interval (CI): 0.72-0.95). There was evidence of the superiority of constant low-pressure surfaces (RR = 0.38; 95% CI;0.24-0.61), alternating pressure devices (RR = 0.31; 95% CI:0.17-0.58) and alternative foams (RR = 0.40; 95% CI:0.21-0.74) when compared to the standard hospital mattress or standard foam. The use of a silicone cover reduced the incidence of pressure injuries by 75% (RR = 0.25; 95%CI:0.16-0.41) when compared to no cover.

Conclusion: Although some interventions have been shown to be effective in reducing the incidence of pressure injury, the evidence is limited or very limited and subject to change. Registration CRD42017064586.

Objetivo:: Sumarizar as evidências de revisões sistemáticas sobre a comparação da efetividade de intervenções para prevenção de lesão por pressão.

Método:: Overview de revisões sistemáticas conduzida de acordo com as recomendações Cochrane. Realizou-se busca em bases de dados, repositórios e site de registro de revisões sistemáticas.

Resultados:: Foram incluídas 15 revisões nesta overview. A análise de sensibilidade demonstrou redução na incidência de lesão por pressão com a suplementação nutricional comparada a dieta hospitalar padrão (Risco Relativo (RR) = 0,83; Intervalo de Confiança(IC) 95%:0,72–0,95). Evidenciaram-se superioridade das superfícies de baixa pressão constante (RR = 0,38; IC 95%;0,24–0,61), dos dispositivos de pressão alternada (RR = 0,31; IC95%:0,17–0,58) e das espumas alternativas (RR = 0,40; IC95%:0,21–0,74) quando comparadas ao colchão hospitalar padrão ou de espuma padrão. O uso de cobertura de silicone reduziu em 75% a incidência de lesão por pressão (RR = 0,25; IC95%:0,16–0,41) quando comparada a nenhuma cobertura.

Conclusão:: Embora algumas intervenções demonstrem-se efetivas na redução da incidência da lesão por pressão, as evidências são limitadas ou muito limitadas e sujeitas a alteração. Registro CRD42017064586.

Objetivo:: Resumir las pruebas de las revisiones sistemáticas sobre la comparación de la efectividad de las intervenciones para prevenir las lesiones por presión.

Método:: Resumen de las revisiones sistemáticas realizadas de acuerdo con las recomendaciones Cochrane. Se realizó una búsqueda en bases de datos, repositorios y sitios de registro de revisiones sistemáticas.

Resultados:: Se incluyeron 15 revisiones en esta revisión. El análisis de sensibilidad mostró una reducción de la incidencia de lesiones por presión con la suplementación nutricional en comparación con la dieta hospitalaria estándar (riesgo relativo [RR] = 0,83; intervalo de confianza [IC] del 95%: 0,72–0,95). Hubo pruebas de la superioridad de las superficies de baja presión constante (RR=0,38; IC del 95%:0,24–0,61), los dispositivos de presión alternante (RR = 0,31; IC del 95%:0,17–0,58) y las espumas alternativas (RR = 0,40; IC del 95%:0,21–0,74) en comparación con el colchón hospitalario estándar o la espuma estándar. El uso de una funda de silicona redujo la incidencia de lesiones por presión en un 75% (RR = 0,25; IC del 95%:0,16–0,41) en comparación con la ausencia de funda.

Conclusión:: Aunque algunas intervenciones han demostrado ser eficaces para reducir la incidencia de lesiones por presión, las pruebas son limitadas o muy limitadas y están sujetas a cambios. Registro CRD42017064586.

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Figures

Figure 1
Figure 1. Flowchart for the identification, selection and inclusion of Systematic Reviews according to the Prisma criteria – Curitiba, PR, Brazil 2023.
See this image and copyright information in PMC

References

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