Journal Club Research Article I select was a randomized controlled trial comparing the effectiveness and safety of hydrocellular and hydrocolloid dressings for treatment of category II pressure ulcers in patients at primary and long-term care institutions.
Pressure ulcers cause a lot of pain and suffering to patients and can significantly decrease the quality of life. In addition, the cost of treating ulcers can be considerable. Numerous clinical guidelines recommend hydrocellular and hydrocolloid dressings for treatment of non-infected category II pressure ulcers. There is no clear evidence on which type of dressing is more effective for treating pressure ulcers.
A multicenter, randomized clinical trial with two treatment arms was conducted to compare hydrocolloid and hydrocellular dressings in patients with category II pressure ulcers, all of whom received the usual preventive measures (postural changes, moist healing and/or pressure management). A total of 169 patients were enrolled in this study; 84 patients of were treated with hydrocellular dressings and 85 patients were treated with hydrocolloid dressings.
Chamorro, A., Vidal Thomas, M., Mieras, A., Leiva, A., MartÃnez, M., & Hernández Yeste, M. (2019). Multicenter randomized controlled trial comparing the effectiveness and safety of hydrocellular and hydrocolloid dressings for treatment of category II pressure ulcers in patients at primary and long-term care institutions. International Journal of Nursing Studies, 94, 179-185.
Patients at risk for pressure ulcers are those that are bedridden, use a wheelchair, or are unable to physically change their position while in bed. Other risk factors include lack of sensory perception such as spinal cord injuries, neurological disorders, and other conditions that result in loss of sensation; poor nutrition and hydration; and medical conditions affecting blood flow such as diabetes and vascular disease (Mayo Clinic, 2018).
Da Silva Augusto et al. (2019) compared hydrocellular foam and hydrocolloid plate dressing. These were applied to intact skin over the sacrum and trochanters which were changed weekly over 8 weeks (Da Silva Augusto et al., 2019). They found that none of the patients developed a pressure injury (Da Silva Augusto et al., 2019). They concluded that standard preventative measures combined with the use of either hydrocellular foam or hydrocolloid plate contributed to the prevention of pressure injuries in at-risk patients, with hydrocolloid plate being associated with significantly more discomfort during dressing removal (Da Silva Augusto et al., 2019).
Nurses need to remember to turn their patients hourly to prevent pressure ulcers. Prevention is critical and patient education about reducing pressure is important.
Da Silva Augusto, F., Blanes, L., Ping, P., Saito, C., & Masako, F. L. (2019). Hydrocellular foam versus hydrocolloid plate in the prevention of pressure injuries. Wounds, 31(8), 193-199.
Mayo Clinic. (2018, May 9). Bedsores (pressure ulcers). https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893
I agree, that preventing pressure ulcers is critical. As this study noted that pressure ulcers affect the physical, emotional, mental, and social life of patients, and can have a considerable negative impact on the quality of life of patients and their caregivers. Its imperative for nurses to be very proactive in pressure ulcer prevention.