Hydrocellular foam is a cost-effective dressing for preventing pressure ulcers: A randomized controlled study

INTRODUCTION: Pressure ulcers add significant morbidity to the surgical patient. In a recent open‐label study, we elucidated that hydrocellular foam dressing is effective in preventing pressure ulcers. Building on our initial positive results, we carried out a randomized controlled trial to assess the effectiveness of foam dressing in reducing pressure ulcers in the surgical ICU (SICU). METHODS: Patients admitted to SICU from July to November 2014 were included in the study. The patients were randomized to the control group or to have a gel adhesive hydrocellular foam dressing applied to the sacrum. Patients were followed prospectively until being discharged or transferred from the SICU. Standard care bundles to prevent pressure ulcers were continued. The buttocks and the sacrum were examined daily and the dressing was replaced as needed. RESULTS: A total of 80 patients were included (treatment group, n=35; control group, n=45); 35 patients were women. Mean age was 62 ± 17.2 years, with a mean Braden score of 15.1. The foam dressing was applied for a mean of 5.71 ± 8.3 days. Six patients developed sacral ulcers in the control group, none in the treatment group (p =0.0247). The average treatment cost of a pressure ulcer is $43,000. The mean cost of the hydrocellular dressing per patient stay was $16.8±$24.5. CONCLUSIONS: Hydrocellular dressing is a cost effective tool that significantly prevents the development of pressure ulcers. The mechanism of action has not been completely elucidated. Possible reduction in shear, temperature, friction, moisture and pressure play a role in decreasing hospital‐acquired pressure ulcers.