Abstract
PURPOSE: We measured the effect of a silicone border foam dressing on the development of pressure ulcers (PUs) and incontinence-associated dermatitis in intensive care unit (ICU) patients.
DESIGN: Nonrandomized comparison cohort (quasi-experimental) study.
SUBJECTS AND SETTINGS: One hundred and two patients (>40 years of age) with a Braden Scale score of 16 or less who were admitted to 2 ICUs at the Samsung Medical Center in Seoul, South Korea, participated in the study.
INSTRUMENTS: Pressure ulcer development was determined based on 2009 Guidelines from the National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Incontinence-associated dermatitis was measured using the Incontinence Associated Dermatitis and its Severity (IADS) instrument.
METHODS: Fifty-two subjects were assigned to the experimental group (standard PU preventive care routine plus application of the silicone border foam dressing), and 50 subjects were assigned to the control group (standard PU preventive care alone). The number of patients who developed PU in the experimental group was compared with that from the control group using the chi-square test ([chi]2). The IADS score of the experimental group was measured and compared with those of the control group, using an independent t test. Logistic regression was carried out to analyze the relationship between the IADS score and PU development.
RESULTS: Both the incidence of PU development and IADS scores were significantly lower ([chi]2 = 21.722, P < .001, and t = 2.166, P < .033, respectively) in patients assigned to the experimental group as compared to those in the control group. The incidence of PU development significantly increased as the IADS score increased (odds ratio = 1.900, 95% CI = 1.237-2.917). A logistic regression analysis revealed that PU development was related to IADS score (P = .003) and that the risk of developing a pressure increased 1.9-fold for every 1-point increase in IADS score.
CONCLUSION: The application of a silicone border foam dressing decreased PU development and reduced the IADS score. Pressure ulcer development was found to be related to IADS score; the incidence of PU development significantly increased as IADS score increased.