Pressure ulcer prevention

Prevention strategies

By: Mölnlycke Health Care, April 25 2012Posted in: Pressure ulcer prevention

A pressure ulcer prevention strategy should always include risk and skin assessments, provision of correct nutritional support and pressure redistribution strategies. An emerging strategy is that of utilising a protective dressing such as Mepilex^® border when used as part of a pressure ulcer prevention protocol.

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Learn more about... Key elements in... Reducing the Risks of... Managing the Skin... Clinical Evidence... References

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Learn more about prevention strategies

Prevention of pressure ulcers is a complex multifactoral process – evidence based recommendations should be followed which are applicable to the specific environment after careful consideration by the health care practitioner
Risk of litigation is discussed in a number of publications – importantly not only lack of prevention programmes but violation of recognised guidelines are reported
Most recently issued are the Pressure Ulcer Prevention and Treatment Clinical Practice Guidelines developed by NPUAP/EPUAP

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Key elements in prevention

Key elements in prevention – adapted from National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: clinical practice guideline. Washington DC: National Pressure Ulcer Advisory Panel; 2009.¹

Risk Assessment – not only should a risk assessment policy be implemented in a structured manner but importantly the health care team should be educated on both the use of the tool and the basics in pressure ulcer related issues. All risk assessment must be carefully documented and reassessments undertaken.

Skin assessment – condition of the skin such as moisture can increase the risk of damage; therefore a structured assessment as part of an overall risk assessment should be implemented and practical precautions initiated where needed

Nutrition – assessment of nutritional status, referral to dietician when required for nutritional support and assessment of hydration status are all key steps.

Repositioning – a key step in reducing the impact of pressure - frequency will depend upon individual's general health status, skin condition and support surface insitu. Repositioning should be undertaken in a manner that ensures pressure is relieved or redistributed whilst avoiding shear/ friction forces. Consider use of 30 degree tilted side lying position. Ensure documentation is meticulous and the health care team are educated correctly.

Support surfaces – select the appropriate device based on the individual's requirements – reassess frequently- pay particular attention to heels whereby they are relieved of pressure completely if possible by use of pillows correctly positioned. Note: The NPUAP has defined the characteristics of the various support surfaces.

Consider the implications of specialist groups – for example patients undergoing surgery, elderly, patients in critical care, paediatrics – all of whom may need additional care.

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Reducing the Risks of Shear Forces — using Mepilex Border

Mepilex^® Border is an absorbent self adhesive dressing that is now indicated for the treatment and prevention of pressure ulcers - Mepilex Border through its unique 5 layer structure and patented soft silicone adhesive Safetac^® technology has been demonstrated to add three way protection against the risk factors present in pressure ulcer formation and provide less pain during dressing change.

Safetac^® technology allows you to lift and replace the dressing without adherent properties being lost. Therefore, you can check the skin condition on a regular basis to match many current pressure ulcer prevention protocols without having to change the dressing.

In-vitro test results demonstrate that Mepilex^® Border can help decrease the effects of shear forces on tissue by up to 50% during wear time. Without Mepilex^® Border, unprotected skin is exposed to the damaging effects of shear stress²².

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Managing the Skin Microclimate — using Mepilex Border

In-vitro testing reveals that Mepilex^® Border has the best ability to absorb, retain and release moisture, maintaining proper moisture balance to keep skin dry, when compared to a range of other dressings – ensuring the skin remains in the optimal condition to help prevent pressure ulcer formation.²³

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Clinical Evidence Demonstrating Positive Outcomes

Numerous healthcare practitioners have now added the use of Mepilex Border to their prevention protocols and have documented the impact in outcome improvement programmes.
15 case studies have now been documented involving almost 1000 high acuity patients.

Please note. The use of dressing’s with Safetac technology does not preclude the need for a comprehensive pressure ulcer prevention program (i.e. support surfaces, positioning, nutrition, hydration, skin care, mobility).

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