Pressure ulcer prevention

Pressure ulcer 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 prevention strategies

  • Prevention of pressure ulcers is a complex multifactoral process – evidence-based recommendations should be followed that are applicable to the specific environment after careful consideration by the healthcare practitioner.
  • Risk of litigation is discussed in a number of publications – importantly not only lack of prevention programs but violations of recognized guidelines are reported.
  • 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 healthcare 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 in situ. Repositioning should be undertaken in a manner that ensures pressure is relieved or redistributed whilst avoiding shear/friction forces. Consider use of a 30-degree-tilted side lying position. Ensure documentation is meticulous and the healthcare team is 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 using correctly positioned pillows. 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 indicated for the treatment and prevention of pressure ulcers. Mepilex Border, through its unique five-layer structure and unique soft silicone adhesive Safetac® interface, has been demonstrated to add three-way protection against the risk factors present in pressure ulcer formation and provide less pain during dressing change.

Dressings with Safetac allow you to lift and replace the dressing without its losing its adhesive properties. 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 percent during wear time. Without Mepilex Border, unprotected skin is exposed to the damaging effects of shear stress2.

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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 formation3.

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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 programs. Fifteen case studies have now been documented involving almost 1,000 high-acuity patients.


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

References

  1. 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.
  2. Wound Dressing Shear Test Method (Bench) Providing Results Equivalent to Humans.Bill B et al. Poster Presentation at the EPUAP Congress, Oporto, 2011.
  3. Wound Dressings, Measuring the Microclimate They Create, Call E. Oral Presentationat the EPUAP Congress, Oporto, 2011.

References in image (Mepilex Border):

9. Bill, B. et al. Wound Dressing Shear Test Method (Bench) Providing Results Equivalent to Humans. For Mölnlycke Health Care.
22. Call, E.et al. In vitro comparison of the prophylactic properties of two leading commercially available wound dressings. Poster presentation at Symposium on Advanced Wound Care Fall, Baltimore, Maryland, United States of America, 2012.
23. Call, E, et al International Panel Studies Creation of Guidance on Dressing Use in Prevention of Pressure Ulcers. Poster presentation SAWC spring 2012.
24. Call E, et al.. Enhancing pressure ulcer prevention using wound dressings: what are the modes of action?. Int Wound J 2013; doi: 10.1111/iwj.12123.

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