Alternatives and preferences for materials in use for pressure ulcer prevention: An experiment‐reinforced literature review

Abstract

Alleviation of localised, sustained tissue loads and microclimate management are the most critical performance criteria for materials in use for pressure ulcer prevention, such as in prophylactic dressings, padding or cushioning. These material performance criteria can be evaluated by calculating the extents of matching between the material stiffness (elastic modulus) and the thermal conductivity of the protective dressing, padding or cushioning with the corresponding properties of native skin, separately or in combination. Based on these bioengineering performance criteria, hydrocolloids, which are commonly used for prophylaxis of medical device‐related pressure ulcers, exhibit poor stiffness matching with skin. In addition, there is remarkable variability in the modulus and thermal conductivity matching levels of different material types used for pressure ulcer prevention, however, it appears that among the materials tested, hydrogels provide the optimal matching with skin, followed by gels and silicone foams. The stiffness matching for hydrocolloids appears to be inferior even to that of gauze. This article provides quantitative performance criteria and metrics for these evaluations, and grades commonly used material types to biomechanically guide clinicians and industry with regards to the selection of dressings for pressure ulcer prevention, both due to bodyweight forces and as a result of applied medical devices.

Newborn and elderly skin: two fragile skins at higher risk of pressure injury

“…These different injury mechanisms can interact to induce various impacts. Cell deformation, inflammation and/or ischemia and reperfusion damage can form a vicious circle as described by Gefen (2018) and Gefen & Soppi (2020). This leads to PI formation beginning either at the skin or mucosa level or in deeper tissues (Loerakker et al ., 2011; Oomens et al ., 2015; EPUAP, NPIAP & PPIAP, 2019).…”

Perspectives on recent advancements in energy harvesting, sensing and bio-medical applications of piezoelectric gels

“…Several dressings were investigated to prevent and manage PIs, including commonly employed polyurethane and hydrocolloid dressings; however, these dressings had drawbacks such as poor conductivity and high rigidity. [290][291][292][293][294][295] In this context, hydrogel dressings have received a lot of attention for their ability to minimize pressure and maintain a moist environment for the skin to prevent PIs. [296][297][298] Moreover, hydrogels with piezoelectric properties provide significant advantages due to their outstanding mechanical-to-electrical response, regulation of blood flow, and stimulation of angiogenesis.…”

Piezoelectric Hydrogel for Prophylaxis and Early Treatment of Pressure Injuries/Pressure Ulcers

“…11,12 Polyurethane and hydrocolloid dressings are common, 13−15 but the hydrocolloid dressing is too stiff and the polyurethane dressing has poor thermal conductivity. 16,17 The thermal conductivity and long-term stiffness of hydrogel match those of human skin, 18 demonstrat-ing that the hydrogel dressing has the potential for preventing PIs/PUs.…”

“…At present, lessening pressure and maintaining a moist microenvironment for skin are the major strategies to prevent PIs/PUs in the clinical field . Various dressings are applied to prevent and manage PIs/PUs for reducing tissue load and internal deformations of the supporting surface. , Polyurethane and hydrocolloid dressings are common, − but the hydrocolloid dressing is too stiff and the polyurethane dressing has poor thermal conductivity. , The thermal conductivity and long-term stiffness of hydrogel match those of human skin, demonstrating that the hydrogel dressing has the potential for preventing PIs/PUs.…”