Reduction of Sacral Pressure Ulcers in the Intensive Care Unit Using a Silicone Border Foam Dressing

PURPOSE: We sought to determine if a silicone border foam dressing could decrease the incidence of sacral pressure ulcers in an intensive care unit. SUBJECTS AND SETTING: The study setting was an intensive care unit located in a 303-bed hospital with a designation of level 2 trauma. The unit specializes in the care of critically ill medical and postoperative adults. Two hundred seventy-three patients participated in the study; their mean age was 65 years (range, 18-105 years). METHODS: Baseline sacral hospital-acquired pressure ulcer (HAPU) incidence was determined during a period of 35 months; skin care representatives examined all patients in our critical care unit for HAPUs on a monthly basis. Based on this baseline incidence, we studied the effect of application of a silicone- bordered foam dressing applied to the sacrum. The observation period for our study intervention was 6 months; the sacral area was examined twice daily during this period. RESULTS: The average baseline sacral HAPU prevalence during the 35-month observation was 13.6% as compared to an incidence of 1.8% during a 6-month prospective study. Three of the 5 patients developed suspected deep tissue injuries and subsequently expired. The remaining 2 subjects developed stage 2 pressure ulcers, one of whom also expired. CONCLUSION: Following application of a silicone-bordered foam dressing, we were able to achieve a HAPU of 1.8%.