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. 2024 Dec 3;12(12):CD009362.
doi: 10.1002/14651858.CD009362.pub4.

Dressings and topical agents for preventing pressure ulcers

Declan Patton  1 , Zena Eh Moore  1 , Fiona Boland  2 , Wendy P Chaboyer  3 , Sharon L Latimer  3 , Rachel M Walker  4 , Pinar Avsar  1
Affiliations

Dressings and topical agents for preventing pressure ulcers

Declan Patton et al. Cochrane Database Syst Rev. .

Abstract

Background: Pressure ulcers occur when people cannot reposition themselves to relieve pressure over bony prominences. They are difficult to heal, costly, and reduce quality of life. Dressings and topical agents (lotions, creams, and oils) for pressure ulcer prevention are widely used. However, their effectiveness is unclear. This is the third update of this review.

Objectives: To evaluate the effects of dressings and topical agents on pressure ulcer prevention, in people of any age without existing pressure ulcers, but at risk of developing one, in any healthcare setting.

Search methods: We used the Cochrane Wounds Specialised Register, CENTRAL, MEDLINE, two other databases, and two trial registers, together with reference checking, citation searching, and contact with study authors to identify the studies that are included in the review. The latest search date was November 2022. We imposed no restrictions on language, publication date, or setting.

Selection criteria: We included randomised controlled trials that enroled people at risk of developing a pressure ulcer.

Data collection and analysis: We used standard Cochrane methodological procedures.

Main results: In this update, we added 33 new studies, resulting in a total of 51 trials (13,303 participants). Of these, 31 studies involved dressings, 16 topical agents, and four included both dressings and topical agents. All trials reported the primary outcome of pressure ulcer incidence. Dressings Pressure ulcer incidence We made a total of 13 comparisons with 9027 participants. We present seven prioritised comparisons in the summary of findings (SoF) tables, as follows: silicone foam dressing versus no dressing (18 trials, 5903 participants; risk ratio (RR) 0.50, 95% confidence interval (CI) 0.33 to 0.77); foam dressing versus film dressing (3 trials, 569 participants; RR 0.72, 95% CI 0.20 to 2.67); hydrocellular foam dressing versus hydrocolloid dressing (1 trial, 80 participants; RR not estimable); silicone foam dressing type 1 versus silicone foam dressing type 2 (2 trials, 376 participants; RR 0.80, 95% CI 0.56 to 1.15); foam dressing versus fatty acid (2 trials, 300 participants; RR 1.67, 95% CI 0.49 to 5.72); polyurethane film versus hydrocolloid dressing (1 trial, 160 participants; RR 0.58, 95% CI 0.24 to 1.41); and hydrocolloid dressing versus no dressing (2 trials, 230 participants; RR 0.60, 95% CI 0.46 to 0.78). All low or very low-certainty evidence. The evidence is very uncertain about the effect of dressings on pressure ulcer development. Pressure ulcer stage Three comparisons reported pressure ulcer (PU) stage. Silicone foam dressing versus no dressing: PU stage 1 (8 trials, 1823 participants; RR 0.32, 95% CI 0.13 to 0.79); PU stage 2 (10 trials, 2873 participants; RR 0.47, 95% CI 0.30 to 0.73); PU stage 3 (3 trials, 718 participants; RR 0.45, 95% CI 0.06 to 3.21); PU stage 4 (2 trials, 610 participants; RR 0.21, 95% CI 0.02 to 1.77); unstageable PU (1 trial, 366 participants; RR 0.20, 95% CI 0.01 to 4.09); deep tissue injury (3 trials, 840 participants; RR 0.32, 95% CI 0.09 to 1.08). Foam dressing versus film dressing: PU stage 1 (1 trial, 270 participants; RR 0.56, 95% CI 0.39 to 0.80); PU stage 2 (1 trial, 270 participants; RR 1.00, 95% CI 0.06 to 15.82); deep tissue injury (1 trial, 270 participants; RR 0.67, 95% CI 0.11 to 3.93). Hydrocolloid dressing versus no dressing: PU stage 1 (1 trial, 108 participants; RR 0.54, 95% CI 0.31 to 0.94); PU stage 2 (1 trial, 108 participants; RR 0.86, 95% CI 0.28 to 2.66). All low or very low-certainty evidence. The evidence is very uncertain about the effect of dressings on different stages of pressure ulcer development. Adverse events One comparison reported adverse events: silicone foam dressing versus no dressing (3 trials, 2317 participants; RR not estimable; very low-certainty evidence). Silicone foam dressings may have little to no effect on the incidence of adverse events, but the evidence is very uncertain. Topical agents Pressure ulcer incidence We evaluated seven comparisons with 4276 participants. We present five prioritised comparisons in the SoF tables as follows: fatty acid versus placebo (6 trials, 2201 participants; RR 0.86, 95% CI 0.54 to 1.36); fatty acid versus usual care (7 trials, 1058 participants; RR 0.64, 95% CI 0.46 to 0.84); cream versus fatty acid (1 trial, 120 participants; RR 3.00, 95% CI 0.32 to 28.03); cream versus placebo (3 trials, 513 participants; RR 1.18, 95% CI 0.59 to 2.36); and cream versus usual care (1 trial, 47 participants; RR 1.60, 95% CI 0.84 to 3.04). All very low-certainty evidence. It is very uncertain whether they make any difference to PU development. Pressure ulcer stage Two comparisons reported PU stage. Fatty acid versus usual care: PU stage 1 (2 trials, 180 participants; RR 1.00, 95% CI 0.49 to 2.03); PU stage 2 (2 trials, 180 participants; RR 0.19, 95% CI 0.07 to 0.53). Cream versus placebo: PU stage 3 (1 trial, 258 participants; RR 1.25, 95% CI 0.34 to 4.55); PU stage 4 (1 trial, 258 participants; RR 0.33, 95% CI 0.01 to 8.11). Both low or very low-certainty evidence. It is uncertain whether they make any difference to the stage of PU development. Adverse events One comparison reported adverse events: fatty acid versus placebo (3 trials, 967 participants; RR 4.38, 95% CI 0.50 to 38.30; very low-certainty evidence). Fatty acid may have little to no effect on the incidence of adverse events compared to placebo, but the evidence is very uncertain. Risk of bias and imprecision were the main reasons for downgrading the certainty of the evidence.

Authors' conclusions: The included studies tested a wide variety of dressings and topical agents. The evidence for all interventions is uncertain or very uncertain; thus, it is unclear whether any of the dressings or topical agents studied make any difference to pressure ulcer development. Future studies should engage with stakeholders to determine priority interventions.

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Conflict of interest statement

Declan Patton: no declarations of interest.

Zena Moore: has received an honorarium for speaking at a professional meeting for 3M, for Smith & Nephew Inc, and for HARTMANN USA, INC; advisor on a wound assessment tool for Smith & Nephew, Inc.

Rachel Walker: has declared a grant to her institution, Griffith University, from Becton, Dickinson and Co. Involvement in conducting a study eligible for inclusion in the review (Walker 2015). Therefore, did not make study eligibility decisions about, extract data from, carry out the risk of bias assessment for, or perform GRADE assessments of that study.

Wendy Chaboyer: no declarations of interest.

Sharon Latimer: Wounds Australia membership, editorial board member of Wounds Practice and Research.

Fiona Boland: no declarations of interest.

Pinar Avsar: no declarations of interest.

Figures

1
1
Study flow diagram
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
4
4
Funnel plot: silicone dressing versus no dressing, outcome: 1.1 Any pressure ulcer
5
5
Funnel plot: silicone dressing versus no dressing, outcome: 1.2 Pressure ulcer stage
1.1
1.1. Analysis
Comparison 1: Silicone dressing versus no dressing, Outcome 1: Pressure ulcer
1.2
1.2. Analysis
Comparison 1: Silicone dressing versus no dressing, Outcome 2: Pressure ulcer stage
1.3
1.3. Analysis
Comparison 1: Silicone dressing versus no dressing, Outcome 3: Time to pressure ulcer development
1.4
1.4. Analysis
Comparison 1: Silicone dressing versus no dressing, Outcome 4: Anatomical location of pressure ulcer development
2.1
2.1. Analysis
Comparison 2: Foam dressing versus film dressing, Outcome 1: Pressure ulcer
2.2
2.2. Analysis
Comparison 2: Foam dressing versus film dressing, Outcome 2: Pressure ulcer stage
3.1
3.1. Analysis
Comparison 3: Hydrocellular foam dressing versus hydrocolloid dressing, Outcome 1: Pressure ulcer
4.1
4.1. Analysis
Comparison 4: Silicone foam dressing 1 versus silicone foam dressing 2, Outcome 1: Pressure ulcer
5.1
5.1. Analysis
Comparison 5: Foam dressing versus fatty acid, Outcome 1: Pressure ulcer
6.1
6.1. Analysis
Comparison 6: Polyurethane film versus hydrocolloid dressing, Outcome 1: Pressure ulcer
7.1
7.1. Analysis
Comparison 7: Hydrocolloid dressing versus no dressing, Outcome 1: Pressure ulcer
7.2
7.2. Analysis
Comparison 7: Hydrocolloid dressing versus no dressing, Outcome 2: Pressure ulcer stage
8.1
8.1. Analysis
Comparison 8: Kang' huier dressing versus no dressing, Outcome 1: Pressure ulcer
9.1
9.1. Analysis
Comparison 9: Silicone foam dressing versus silicone foam dressing with Sanyrene, Outcome 1: Pressure ulcer
9.2
9.2. Analysis
Comparison 9: Silicone foam dressing versus silicone foam dressing with Sanyrene, Outcome 2: Pressure ulcer stage
10.1
10.1. Analysis
Comparison 10: Pressure ulcer preventative dressing versus no dressing, Outcome 1: Pressure ulcer
11.1
11.1. Analysis
Comparison 11: Polyurethane foam dressing versus padded bandage, Outcome 1: Pressure ulcer
12.1
12.1. Analysis
Comparison 12: Gauze soaked in olive oil versus gauze soaked in fish oil, Outcome 1: Pressure ulcer
13.1
13.1. Analysis
Comparison 13: Hydroactive dressing versus tape, Outcome 1: Pressure ulcer
14.1
14.1. Analysis
Comparison 14: Fatty acid versus placebo, Outcome 1: Pressure ulcer
14.2
14.2. Analysis
Comparison 14: Fatty acid versus placebo, Outcome 2: Anatomical location of pressure ulcer development
14.3
14.3. Analysis
Comparison 14: Fatty acid versus placebo, Outcome 3: Adverse event
15.1
15.1. Analysis
Comparison 15: Fatty acid versus usual care, Outcome 1: Pressure ulcer
15.2
15.2. Analysis
Comparison 15: Fatty acid versus usual care, Outcome 2: Pressure ulcer stage
15.3
15.3. Analysis
Comparison 15: Fatty acid versus usual care, Outcome 3: Time to pressure ulcer development
15.4
15.4. Analysis
Comparison 15: Fatty acid versus usual care, Outcome 4: Anatomical location of pressure ulcer
16.1
16.1. Analysis
Comparison 16: Cream versus fatty acid, Outcome 1: Pressure ulcer
17.1
17.1. Analysis
Comparison 17: Cream versus placebo, Outcome 1: Pressure ulcer
17.2
17.2. Analysis
Comparison 17: Cream versus placebo, Outcome 2: Pressure ulcer stage
18.1
18.1. Analysis
Comparison 18: Cream versus usual care, Outcome 1: Pressure ulcer
19.1
19.1. Analysis
Comparison 19: Aloe vera versus aloe vera and oil, Outcome 1: Pressure ulcer
19.2
19.2. Analysis
Comparison 19: Aloe vera versus aloe vera and oil, Outcome 2: Pressure ulcer stage
19.3
19.3. Analysis
Comparison 19: Aloe vera versus aloe vera and oil, Outcome 3: Anatomical location of pressure ulcer
20.1
20.1. Analysis
Comparison 20: Gel versus placebo, Outcome 1: Pressure ulcer
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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    1. NCT01356459. Pressure ulcer prevention in intensive care unit (ICU) [A prospective randomised controlled trial of the effectiveness of absorbent silicone self adherent dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill ED/ICU patients]. https://classic.clinicaltrials.gov/ct2/show/NCT01356459 (first received 19 May 2011).
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    1. Santamaria N, Liu W, Gerdtz M, Sage S, Mccann J, Freeman A, et al. 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 2015;12(3):344-50. [DOI: 10.1111/iwj.12160] - DOI - PMC - PubMed
Santamaria 2018 {published data only}
    1. Santamaria N, Gerdtz M, Kapp S, Wilson L, Gefen A. A randomised controlled trial of the clinical effectiveness of multi-layer silicone foam dressings for the prevention of pressure injuries in high-risk aged care residents: the Border III Trial. International Wound Journal 2018;15(3):482-90. - PMC - PubMed
Smith 1985 {published data only}
    1. Smith RG, Everett E, Tucker L. A double blind trial of silicone barrier cream in the prevention of pressure sores in elderly patients. Journal of Experimental Gerontology 1985;7(4):337-46.
Sonmez 2020 {published data only}
    1. Sonmez M, Yapucu Gunes U. Preventive effect of extra virgin olive oil on pressure injury development: a randomized controlled trial in Turkey. Complementary Therapies in Clinical Practice 2020;40(10):1208. - PubMed
Stankiewicz 2019 {published data only}
    1. Stankiewicz M, Gordon J, Dulhunty JM, Brown W, Pollock H, Barker-Gregory N. A cluster-controlled clinical trial of two prophylactic silicone sacral dressings to prevent sacral pressure injuries in critically ill patients. Wound Practice & Research 2019;27(1):21-6.
Torra i Bou 2005 {published data only}
    1. Torra i Bou J, Gomez TS, Soriano JV, Bonmati AN, Lopez JR, Arboix i Perejamo M. The effectiveness of a hyper-oxygenated fatty acid compound in preventing pressure ulcers. Journal of Wound Care 2005;14(3):117-21. - PubMed
Van Der Cammen 1987 {published data only}
    1. Van Der Cammen TJ, O'Callaghan U, Whitefield M. Prevention of pressure sores: a comparison of new and old pressure sore treatments. British Journal of Clinical Practice 1987;41(11):1009-11. - PubMed
Verdu 2012 {published data only}
    1. Verdu J, Soldevilla J. IPARZINE-SKR study: randomized, double-blind clinical trial of a new topical product versus placebo to prevent pressure ulcers. International Wound Journal 2012;9(5):557-65. - PMC - PubMed
Walker 2015 {published data only}
    1. ACTRN12613001328763. Prophylactic dressing to minimise sacral pressure injuries in high risk hospitalised patients: a pilot study [A pilot study comparing prophylactic dressing with routine care versus routine care alone to minimise sacral pressure injuries in hospitalised patients at high risk of developing pressure injury]. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=1261... (first received 28 November 2013).
    1. Walker R, Aitken LM, Huxley L, Juttner M. Prophylactic dressing to minimize sacral pressure injuries in high-risk hospitalized patients: a pilot study. Journal of Advanced Nursing 2015;71(3):688-96. [DOI: 10.1111/jan.12543] - DOI - PubMed
Wang 2016 {published data only}
    1. Wang L, Zhao Y, Ma J. Effect of prevention of adhesive dressing (ALLEVYN) to use of noninvasive ventilator caused by pressure ulcers. Chest 2016;1:A161.
Yang 2020 {published data only}
    1. Yang G, Gao C, Cai J. Prevention of nasal ala pressure injuries with use of hydroactive dressings in patients with nasotracheal intubation of orthognathic surgery: a randomized controlled trial. Journal of Wound, Ostomy, and Continence Nursing 2020;47(5):484‐8. - PubMed
Yanping 2018 {published data only}
    1. Yanping WU, Xinli LIU. Effects of Comfeel foam dressing on pressure ulcer prevention in high-risk patients. Nursing of Integrated Traditional Chinese and Western Medicine 2018;4(11):152-4.

References to studies excluded from this review

Alvarez Vázquez 2014 {published data only}
    1. Alvarez Vázquez JC, Estany Gestal A, Álvarez Suárez T, Mosquera J, Castro Prado J, Gutiérrez Moeda E, et al. Prevention of deterioration of the cutaneous integrity in the sacral area through the application of an atraumatic self-adherent foam dressing. Metas de Enfermería 2014;17(2):14-20.
Callaghan 1998 {published data only}
    1. Callaghan S, Trapp M. Evaluating two dressings for the prevention of nasal bridge pressure sores. Professional Nurse 1998;13(6):361-4. - PubMed
Declaire 1997 {published data only}
    1. Declaire V. The usefulness of topical application of essential fatty acids (EFA) to prevent pressure ulcers. Ostomy/Wound Management 1997;43(5):48-54. - PubMed
Duimel‐Peeters 2007 {published data only}
    1. Duimel-Peeters IG, Halfensa RJ, Ambergen AW, Houwing RH, Berger MP, Luc HE, et al. The effectiveness of massage with and without dimethyl sulfoxide in preventing pressure ulcers: a randomized, double-blind cross-over trial in patients prone to pressure ulcers. International Journal of Nursing Studies 2007;44(8):1285-95. - PubMed
Garcia Fernandez 2005 {published data only}
    1. Garcia Fernandez FP, Pancorbo Hidalgo PL, Rodriguez Torres MC. Protective bandage or hydrocellular dressing to prevent pressure ulcers on heels? Gerokomos 2005;16(1):54-8.
Genc 2022 {published data only}
    1. Genc A, T Yildiz. The impact of two distinct endotracheal tube fixation on the formation of pressure ulcer in the intensive care unit: a randomised controlled trial. International Wound Journal 2022;19(6):1594-603. - PMC - PubMed
Guo 2015 {published data only}
    1. Guo H. Effect comparison of nursing of foam dressing in prevention of pressure sores in patients with preoperative and postoperative ambulatory surgery in the department of orthopedics. Chinese Community Doctors 2015;31(34):130-1.
Hsu 2011 {published data only}
    1. Hsu MY, Hsiu SR, Chung HC, Chang SC, Tang M, Tai CH. Evaluating dressings for the prevention of facial pressure ulcers caused by the application of noninvasive positive pressure ventilation: a pilot study. EWMA Journal 2011;11(Suppl):213.
Huang 2009 {published data only}
    1. Huang TT, Tseng CE, Lee TM, Yeh JY, Lai YY. Preventing pressure sores of the nasal ala after nasotracheal tube intubation: from animal model to clinical application. Journal of Oral and Maxillofacial Surgery 2009;67(3):543-51. - PubMed
Kalowes 2013 {published data only}
    1. Kalowes P, Li M, Carlson C, Carr L, Llantero L, Lukaszka D, et al. Use of a silicone border sacrum dressing to reduce pressure ulcer formation in critically ill patients: a randomized clinical trial. EWMA Journal 2013;13(1 Suppl):63. [Abstract 88]
Kim 2016 {published data only}
    1. Kim H, Lee SM, Choi HY, Min, YK, Jung YJ. Prophylactic effect of transparent film dressing on sacrum and coccyx in SICU patients. Journal of Korean Academy of Fundamentals of Nursing 2016;23(3):256.
Kuisma 1987 {published data only}
    1. Kuisma I, Tamelander G. Mucopolysaccharide polysulphate cream in the prevention of pressure sores-a double blind study. Annals of Clinical Research 1987;19(6):374-7. - PubMed
Lockwood 2022 {published data only}
    1. Lockwood I, Walker RM, Chaboyer W, Cooke M, Whitty JA, Thalib L, et al. Process evaluation of an intervention to test the effectiveness of foam border dressings in preventing hospital-acquired sacral pressure injuries (the EEPOC trial): a protocol. Journal of Tissue Viability 2022;31(1):158-63. - PubMed
Miraj 2020 {published data only}
    1. Miraj S, Pourafzali S, Ahmadabadi ZV, Rafiei Z. Effect of olive oil in preventing the development of pressure ulcer grade one in intensive care unit patients. International Journal of Preventive Medicine 2020;11:23. - PMC - PubMed
Park 2014a {published data only}
    1. Park KH. The effect of a silicone border foam dressing for prevention of pressure ulcers and incontinence-associated dermatitis in intensive care unit patients. Journal of Wound, Ostomy, and Continence Nursing 2014;41(5):424-39. - PubMed
Park 2014b {published data only}
    1. Park KH. The effect of a ceramide-containing dressing in preventing pressure ulcers. Journal of Wound Care 2014;23(7):347-53. [DOI: ] - PubMed
Poursadra 2019 {published data only}
    1. Poursadra E, Anvari-Tafti M, Dehghani A, Eghbali-Babadi M, Rafiei Z. Comparing the effect of henna oil and olive oil on pressure ulcer grade one in intensive care units patients. Advances in Biomedical Research 2019;27(8):68. - PMC - PubMed
Santamaria 2013 {published data only}
    1. Santamaria N, Gerdtz M, Vassiliou T, Knott J, DeVincentis S, Sage S, et al. The border trial: a prospective randomised controlled trial of the effectiveness of multi-layer silicone dressings in preventing intensive care unit pressure ulcers. EWMA Journal 2013;13(1 Suppl):93. [Abstract 147]
Smith 2010 {published data only}
    1. Smith G, Ingram A. Clinical and cost effectiveness evaluation of low friction and shear garments. Journal of Wound Care 2010;19(12):535-42. - PubMed
Stoker 1990 {published data only}
    1. Stoker FM. A major contributor. Evaluation of Comfeel pressure relieving dressing. Professional Nurse 1990;5(12):644-53. - PubMed
Torra i Bou 2009 {published data only}
    1. Torra i Bou JE, Narváez EH, Martinez-Esparza EH, Segovia Gómez T, López JR, Blanco Blanco J, et al. Preventing pressure ulcers on the heel: a Canadian cost study. Dermatology Nursing 2009;21(5):268-72. - PubMed
Wen‐Yi 2013 {published data only}
    1. Wen-Yi T, Shu-Fen L, Harmod T, Ru-Ping L. A comparison of the efficacy of different wound dressing management techniques in preventing pressure ulcers. Journal of Nursing (Zhonghua Hu Li Za Zhi) 2013;60(4):65-75. [DOI: 10.6224/JN.60.4.65] - DOI - PubMed
Yang TY 2020 {published data only}
    1. Yang TY, Shin SH. Effect of soft silicone foam dressings on intraoperatively acquired pressure injuries: a randomized study in patients undergoing spinal surgery. Wound Management and Prevention 2020;66(11):22-9. - PubMed

References to ongoing studies

ACTRN12619000763145 {published data only}
    1. Gillespie B. Effectiveness of Prophylactic foam dressings in the prevention of sacral pressure injuries in at-risk hospitalised patients: The EEPOC Trial. ACTRN12619000763145. Australian New Zealand Clinical Trials Registry. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377447&... 2022. - PMC - PubMed
ACTRN12620000875909 {published data only}
    1. Latimer S. Prophylactic sacral dressings to prevent hospital-acquired pressure injuries in adult intensive care unit patients: A pilot randomised controlled trial. ACTRN12620000875909. Australian New Zealand Clinical Trials Registry. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379696 2024.
ACTRN12621001072808 {published data only}
    1. Hunt L. A randomised controlled phase II trial to examine the feasibility of using hyperoxygenated fatty acids (HOFA) to prevent facial pressure injuries from medical devices among adults admitted to intensive care – a research protocol.. ACTRN12621001072808. Australian New Zealand Clinical Trials Registry. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001... 2024. - PMC - PubMed
ACTRN12622000728730 {published data only}
    1. Petkovska G. Multilayer Silicone Dressings as Compared with Standard Care for Prevention of Sacral Pressure Injuries in Community Cancer Patients: A Cluster Randomised Control Trial. ACTRN12622000728730. Australian New Zealand Clinical Trials Registry https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384006 2022.
ACTRN12622000793718 {published data only}
    1. Latimer S. Testing the efficacy of two sacral dressings in preventing pressure injuries(z) in adult intensive care population: TOWARDS ZERO pilot study. ACTRN12622000793718. Australian New Zealand Clinical Trials Registry. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384112&... 2022.
ACTRN12622001360707 {published data only}
    1. Ryan H. A single blinded, multi-centre randomised controlled trial (RCT) will be conducted to investigate the effectiveness of a twice-daily application of a barrier wipe (contiplan) on the incidence of pressure injuries (PI) in residential aged care facilities (RACF). ACTRN12622001360707. Australian New Zealand Clinical Trials Registry. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384714&... 2022.
ChiCTR2100050305 {published data only}
    1. Xiaodan L. Intervention of skin microclimate on intraoperative pressure injury. ChiCTR2100050305. Chinese Clinical Trial Registry. https://www.chictr.org.cn/indexEN.html 2021.
CTRI/2021/11/038231 {published data only}
    1. Thanigainathan S. Does intermittent nasal massage with coconut oil reduce nasal injury in neonates on nasal CPAP compared with nasal barrier dressing. CTRI/2021/11/038231. Clinical Trials Registry - India. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2021/11/038231 2021.
IRCT20150519022320N20 {published data only}
    1. Mirzaei T. Comparative investigating of the Effect of Aloe Vera gel and Olive Oil on Incidence of pressure ulcer in patients Hospitalized. IRCT20150519022320N20. Iranian Registry of Clinical Trials. https://irct.behdasht.gov.ir/trial/38444 2019.
IRCT20160110025929N23 {published data only}
    1. Vardanjani M. Study of the effect of fish oil in prevention of pressure ulcer of hospitalized patients admitted to intensive care unit. IRCT20160110025929N23. Iranian Registry of Clinical Trials. https://irct.behdasht.gov.ir/trial/38897 2019.
IRCT20210317050732N1 {published data only}
    1. Maboudi A. The effect of topical application of black seed oil on the prevention of bedsores in patients admitted to the intensive care unit. IRCT20210317050732N1. Iranian Registry of Clinical Trials. https://irct.behdasht.gov.ir/trial/55110 2021.
IRCT20220110053683N1 {published data only}
    1. Ahmadi P. Comparison of the effect of olive oil and sesame oil on the prevention of pressure ulcers in ICU patients. RCT20220110053683N1. Iranian Registry of Clinical Trials. https://irct.behdasht.gov.ir/trial/61205 2022.
JPRN‐UMIN000024609 {published data only}
    1. Sanada H. Prevention effect of wound dressings for pressure sores in high-risk patients. JPRN-UMIN000024609 . www.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000024609 2018.
KCT0006781 {published data only}
    1. Jang I. A randomised controlled trial of the effectiveness of multi‐layer silicone foam dressings for the prevention of pressure injuries in postoperative patients. KCT0006781. Korean Clinical Trial Registry. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=20904&search_... 2022.
NCT02565745 {unpublished data only}
    1. Cortes OL. Impact of the use of dressings versus lubrication of the skin with cream to prevent pressure ulcers: clinical trial (PENFUP). NCT02565745. clinicaltrials.gov/ct2/show/NCT02565745 2015.
NCT04682925 {published data only}
    1. Yesilyurt M. Effect of Evidence-Based Skin Care and Hydrocolloid Dressing in the Prevention of Nasogastric-Related Pressure Injury. NCT04682925. ClinicalTrials.gov. https://clinicaltrials.gov/study/NCT04682925 2022. - PubMed
NCT05198167 {published data only}
    1. Maculet-García L. Efficacy of HOFA Versus Hydrocolloid Dressings in the Prevention of PUs in Critically Ill Prone Patients. NCT05198167. ClinicalTrials.gov. https://clinicaltrials.gov/study/NCT05198167 2021.
NCT05578638 {published data only}
    1. Soliman AF. Comparing Aloe Vera Gel and Rosemary Oil in Pressure Injury Prevention. NCT05578638. ClinicalTrials.gov. https://clinicaltrials.gov./study/NCT05578638?term=NCT05578638&rank=1 2022.
RBR‐4s8qjx {published data only}
    1. Soares RS. Effect of soft silicone foam dressing compared to film transparent dressing in pressure ulcer prevention. RBR-4s8qjx. www.who.int/trialsearch/Trial2.aspx?TrialID=RBR-4s8qjx 2017.

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