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Polyurethane film dressings and ceramide 2-containing hydrocolloid dressing reduce the risk of pressure ulcer development in high-risk patients undergoing surgery: a matched case-control study

Authors Kohta M, Sakamoto K, Oh-i T

Received 5 November 2014

Accepted for publication 25 December 2014

Published 13 February 2015 Volume 2015:2 Pages 23—30


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Marco Romanelli

Masushi Kohta,1 Kazumi Sakamoto,2 Tsunao Oh-i3

1Medical Engineering Laboratory, ALCARE Co, Ltd, Sumida-ku, Tokyo, 2Department of Nursing, 3Department of Dermatology, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, Japan

Background: Numerous clinical challenges regarding adhesive dressings have shown that using an adhesive dressing could minimize or prevent superficial skin loss in patients at risk of developing pressure ulcers. However, evidence that polyurethane film dressings and ceramide 2-containing hydrocolloid dressing can reduce the risk of pressure ulcer development in high-risk patients undergoing surgery is limited. Therefore, we assessed the effects of application of these dressings for reducing the risk of pressure ulcer development in these patients and identified other risk factors.
Methods: A matched case-control study was conducted involving 254 patients at high risk for pressure ulcer development at one acute care hospital in Japan. No patients in this study had a pressure ulcer at the start of the study. Thirty-one patients developed a pressure ulcer during surgery, and these patients were defined as cases. Controls were randomly matched for sex and age (±4 years), from which 62 patients were selected. Medical records were obtained for preoperative factors, including age, sex, body mass index, diabetes mellitus, albumin, total protein, C-reactive protein, white cell count, red cell count, and hemoglobin, and for intraoperative factors, including dressing application, operation time, body position, and surgery type. The odds ratio (OR) and 95% confidence interval (CI) were determined to identify risk factors for pressure ulcer development in patients undergoing surgery.
Results: By multiple logistic regression analysis, there was a significantly reduced risk of pressure ulcer development for patients who had dressing applications as compared with those without dressing applications (OR 0.063; 95% CI 0.012–0.343; P=0.001). Prone position (OR 8.791; 95% CI 1.630–47.400; P=0.01), prolonged operation time (OR 1.684; 95% CI 1.189–2.385, P=0.003), and reduced body mass index (OR 0.774; 95% CI 0.584–0.948; P=0.02) were also significant predictive risk factors for development of a pressure ulcer.
Conclusion: Application of film dressing and ceramide 2-containing hydrocolloid dressing reduced the risk of pressure ulcer development in high-risk patients undergoing surgery.

Keywords: pressure ulcer prevention, operating room, wound dressing, friction

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