Multi-layer Silicone SAP dressings for wound prophylaxis

Introduction: Tissue breakdown risk can be mitigated through suitable cushioning materials to disperse surface and internal tissue stresses. The objective is to examine the impact of emerging evidence on current use of prophylactic dressings for wound prevention including the attitudes towards and use of multi-layer silicone SAP dressings.Methods:Multiple groups of wound specialists convened in locations across the US to evaluate the biomechanical protective performance of SAP dressings for pressure injury prophylaxis. Principal practice environment, secondary practice environments, and size of healthcare system were examined. Additional variables evaluated include the anatomic locations of prophylactic dressing usage, dressing categories utilized, use of a PIP bundle, and inclusion of prophylactic dressings within the PIP bundle. Following generalized discussion on wound prophylaxis and PIP emerging evidence on use of multi-layer SAP dressings versus other dressing categories was catechized.Results: Additional data is under collection and analyzation; initial group results are as follows. Most common practice environment was acute care, outpatient/clinic, long-term care; 58% practice in multiple practice environments. Participants (91%; n=11) reported using a pressure injury prevention bundle in their primary practice environment, and 90% (n=10) of pressure injury prevention bundles included prophylactic dressings. Pre-survey barriers to usage ranked by participants: patient presentation, administrative/systems, cost, concerns regarding user error, reimbursement structures. Post-survey barriers to prophylactic dressing usage ranked by participants: patient presentation, cost, administrative systems, reimbursement structures, concerns regarding user errors. Patient presentations influencing needed dressing performance mechanisms were elucidated to include incontinence, diaphoresis, and excessive friction. Required dressing performance measures identified include moisture management, adhesiveness, offloading, and dual wound treatment ability. Prior to completing education on SAP dressings for wound prophylaxis 100% of respondents selected the foam category as utilized for PIP and 30% selected SAP dressings; after education 100% of respondents selected both categories.Discussion: Some wound dressings are more suited for skin protection; the protective performance of dressings is known to vary within dressing categories, amongst dressings categories, and over time (i.e., new vs. used dressings). Word associations prior to education on SAP for PIP were primarily foam based, and following education demonstrated more diverse thought processes with terms such as “worthwhile” “options” ”helpful” and “protective”. Ranking barriers to utilizing dressings for PIP varied before and after education. This was potentially due to the consideration of available product, in consideration of the increasing difficulties in trialing novel products, and an increased consideration of barriers to prophylactic dressing usage outside of acute care environments.References:1. Gefen A. Pressure ulcer prevention dressing design and biomechanical efficacy. J Wound Care. 2020;29(Sup12):S6-S15. doi:10.12968/jowc.2020.29.Sup12.S6 2. Orlov A, Gefen A. Differences in prophylactic performance across wound dressing types used to protect from device-related pressure ulcers caused by a continuous positive airway pressure mask. Int Wound J. 2023;20(4):942-960. doi:10.1111/iwj.13942 3. Singh G, Byrne C, Thomason H, McBain AJ. Investigating the microbial and metalloprotease sequestration properties of superabsorbent wound dressings. Sci Rep. 2022;12(1):4747. Published 2022 Mar 19. doi:10.1038/s41598-022-08361-3