Silicone adhesive multilayer foam dressings prevent sacral pressure ulcers in at-risk hospitalized adults (NNT = 50)

Reference

Beeckman D, Fourie A, Raepsaet C, et al. Silicone adhesive multilayer foam dressings as adjuvant prophylactic therapy to prevent hospital-acquired pressure ulcers: a pragmatic noncommercial multicentre randomized open-label parallel-group medical device trial. Br J Dermatol 2021;185(1):52-61.

Synopsis

To date, there have been several randomized trials of silicone adhesive multilayer foam dressings (SAMFDs) to prevent pressure ulcers, but studies have largely been in critically ill patients, have been industry-sponsored, and have had inconsistent findings. This study randomized 1633 inpatients at 8 Belgian hospitals to 1 of 3 groups: (1) Allevyn Life SAMFD, (2) Mepilex Border SAMFD, or (3) standard of care. Standard of care in these hospitals was quite comprehensive, and included an initial assessment for pressure ulcer risk, a tailored repositioning plan based on a patient's risk, use of devices to redistribute pressure, and attention to nutrition. Patients in any hospital location could be included if they were at risk for pressure ulcers based on their Braden Score, didn't currently have a pressure ulcer, and had no contraindications to the use of a SAMFD. The mean age of participants was 80 years, 58% were women, and 87% were from non-ICU wards. The researchers combined the 2 treatment groups; the combined treatment group had a lower overall risk for any pressure ulcer than the standard care group (4.0% vs 6.3%; relative risk [RR] 0.64; 95% CI 0.41 - 0.99; number needed to treat [NNT] = 43 to prevent one pressure ulcer). Sacral ulcers were also significantly less common in the treatment group (2.8% vs 4.8%; RR 0.59; 0.35 - 0.98; NNT = 50). There was no significant difference in the incidence of heel or trochanteric ulcers. The SAMFDs were well tolerated, with skin tears or stripping as the primary adverse event (11 patients [1%]).