Evaluation of a new pressure ulcer preventive dressing containing ceramide 2 with low frictional outer layer.
OBJECTIVE
This paper is a report of an evaluation of the effectiveness of a newly developed dressing for preventing persistent erythema and pressure ulcer development and improving the water-holding capacity without increasing the skin pH in bedridden older patients.


BACKGROUND
Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development. To eliminate these risks, we developed a dressing to reduce shear forces and improve the water-holding capacity. However, the effects of this dressing in clinical settings remain unknown.


METHODS
An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development. The dressing was randomly applied to the right or left greater trochanter for 3 weeks. No dressing was applied to the opposite side as a control. The skin was monitored weekly during the 3-week application for persistent erythema and pressure ulcer development. Skin hydration and pH were also assessed during the intervention and for 1 week after dressing removal.


RESULTS
The incidence of persistent erythema was significantly lower in the intervention area than the control area [P = 0.007, RR 0.18 (95% CI: 0.05-0.73) and NNT 4.11 (2.50-11.63) ]. No pressure ulcers occurred in either the intervention or control area. Skin hydration increased significantly during dressing application and remained high after removal (P < 0.001) relative to the control area. Skin pH decreased significantly during the application (P < 0.001) but returned to control levels after removal (P = 0.38).


CONCLUSIONS
This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers.
Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, University of Tokyo, Japan Society for the Promotion of Science [corrected] Tokyo, Japan. gojiron-tky@umin.ac.jp
Gojiro
G
Nakagami
Hiromi
H
Sanada
Chizuko
C
Konya
Atsuko
A
Kitagawa
Etsuko
E
Tadaka
Yutaka
Y
Matsuyama
D000369:Aged, 80 and over; D001458:Bandages; D001696:Biomechanical Phenomena; D002518:Ceramides / Q000494:pharmacology / Q000627:therapeutic use*; D002908:Chronic Disease; D004643:Emollients / Q000494:pharmacology / Q000627:therapeutic use*; D004890:Erythema / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D017276:Friction; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D003668:Pressure Ulcer / Q000503:physiopathology / Q000517:prevention & control*; D012867:Skin / Q000503:physiopathology; D015595:Skin Aging; D016896:Treatment Outcome; D014870:Water Loss, Insensible / Q000187:drug effects
D002518:Ceramides; D004643:Emollients