Evaluation of a new pressure ulcer preventive dressing containing ceramide 2 with low frictional outer layer

Authors

  • Gojiro Nakagami,

    1. Gojiro Nakagami RN MHS Research Fellow Japan Society for the Promotion of Science, Tokyo, Japan
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  • Hiromi Sanada,

    1. Hiromi Sanada PhD RN WOCN Professor Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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  • Chizuko Konya,

    1. Chizuko Konya PhD RN WOCN Associate Professor Department of Clinical Nursing, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
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  • Atsuko Kitagawa,

    1. Atsuko Kitagawa PhD RN Assistant Professor Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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  • Etsuko Tadaka,

    1. Etsuko Tadaka PhD RN PHN Lecture Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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  • Yutaka Matsuyama

    1. Yutaka Matsuyama PhD Associate Professor Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Errata

This article is corrected by:

  1. Errata: Erratum Volume 60, Issue 3, 357, Article first published online: 28 September 2007

Gojiro Nakagami: e-mail: gojiron-tky@umin.ac.jp

Abstract

Title. Evaluation of a new pressure ulcer preventive dressing containing ceramide 2 with low frictional outer layer

Aim.  This paper is a report of an evaluation of the effectiveness of a newly developed dressing for preventing persistent erythema and pressure ulcer development and improving the water-holding capacity without increasing the skin pH in bedridden older patients.

Background.  Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development. To eliminate these risks, we developed a dressing to reduce shear forces and improve the water-holding capacity. However, the effects of this dressing in clinical settings remain unknown.

Method.  An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development. The dressing was randomly applied to the right or left greater trochanter for 3 weeks. No dressing was applied to the opposite side as a control. The skin was monitored weekly during the 3-week application for persistent erythema and pressure ulcer development. Skin hydration and pH were also assessed during the intervention and for 1 week after dressing removal.

Findings.  The incidence of persistent erythema was significantly lower in the intervention area than the control area [P = 0·007, RR 0·18 (95% CI: 0·05–0·73) and NNT 4·11 (2·50–11·63) ]. No pressure ulcers occurred in either the intervention or control area. Skin hydration increased significantly during dressing application and remained high after removal (P < 0·001) relative to the control area. Skin pH decreased significantly during the application (P < 0·001) but returned to control levels after removal (P = 0·38).

Conclusion.  This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers.

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