Preventing Perioperative Pressure Ulcers – Evaluation of a Sacral Dressing and an Active Overlay
Presented at Fall SAWC, Las Vegas, NV, October 7-9, 2016. Poster Number: CR-056
Reprinted by Dabir Surfaces Inc. with Permission
Almost 23% of hospital acquired pressure ulcers (HAPUs) are acquired intra-operatively during surgeries that last more than three hours, and the average estimated cost of treatment is $750 million ~ $1.5 billion per year. The current standard of care for PU prevention relies on turning and repositioning patients at least every 2 hours or using powered surfaces to effectively redistribute body weight – however these strategies cannot be implemented during surgeries. Most operating room (OR) support surfaces are static foam-based mattresses and do not provide active pressure management for body areas at high risk for PUs. Sacral dressings are sometimes used as a preventative measure in ORs to provide pressure redistribution and shear reduction.
To evaluate the effectiveness of Dabir Surgical Surface (F/K/A DabirAIR®) alternating pressure (AP) overlay in off-loading body areas at high risk for pressure ulcer during surgeries when used over various types of operating room (OR) table pads and in conjunction with sacral dressing.
Twelve healthy young and elderly adults (age range: 23-80yrs, BMI range: 19.5-27.4) participated. The interface pressures (IP) for three types of OR support surfaces were measured with and without the AP overlay. All subjects had a foam-based protective dressing applied on their sacrum. The three types of OR pads evaluated were: 1) 2” thick highly resilient foam OR pad, 2) 1.5” thick highly resilient foam OR pad with a 0.5” layer of viscoelastic foam, and 3) 1.5” thick highly resilient foam OR pad with a 0.5” layer of gel. IP data was collected in the supine position for 60 minutes. The peak and average IP under the sacrum was analyzed.
The AP overlay (in combination with sacral dressing), when placed over the three types of OR pads, provided almost complete off-loading at the sacrum (average and peak interface pressures were below 20mmHg) during the deflation cycles compared to a constant IP of 42mmHg while using the OR pads alone. Use of sacral dressing did not reduce the average and peak interface pressure at the sacrum for all three types of OR pads.
The low profile AP overlay provided almost complete off-loading during the deflation cycles, thus allowing the tissues to decompress and reperfuse before any lasting damages can happen. This periodic off-loading is important to reduce the risk for developing pressure ulcers during surgeries and post-operatively.