The vision and scope of the prophylactic dressing standard initiative of the European Pressure Ulcer Advisory Panel and National Pressure Injury Advisory Panel

The frictional energy absorber effectiveness and its impact on the pressure ulcer prevention performance of multilayer dressings

“…The above issues make it difficult for clinicians, regulators, payors and manufacturers to make informed decisions about how to develop, evaluate and make purchase decisions regarding wound dressings for preventing PUs. 18 For multilayer dressings, the FEAE should be included in a metrics of performance that can also potentially further include durability, thermal performance, moisture management and adhesiveness properties, as proposed by the PDSI. The current work further provides guidance for a new type of dressing that is not dual-purpose, that is, dressings designed solely for PUP, for which the FEAE can be further increased through certain design features without potentially compromising other dressing features that are critical in treatment of wounds (but are irrelevant in prevention), primarily fluid handling but also antimicrobial features, T A B L E 1 Means and standard deviations of the internal displacements d i,iþ1 and the relative contributions of the baseline (L) and bonded (LB) ALLEVYN ® LIFE dressing configurations for the moist condition and for both new and used dressings.…”

“…2,[11][12][13][14][15] In addition to the existing standard of care, various medical devices are used to minimize tissue exposure to sustained mechanical stress concentrations: those include low-friction surfaces, offloading devices such as heel boots and importantly, prophylactic dressings. 3,6,[16][17][18] Specifically, the prophylactic application of multilayer dressings has emerged as a promising approach with demonstrated clinical efficacy in pressure ulcer prevention (PUP) and large cohort data demonstrating reduction in PU incidence in patients who received these dressings are reported in the literature. 19,20 Indeed, their benefits include pressure redistribution, friction reduction and related inflammation modulation, as well as moisture management, which altogether enhance their efficiency in mitigating the PU risk.…”

Differences in prophylactic performance across wound dressing types used to protect from device‐related pressure ulcers caused by a continuous positive airway pressure mask

“…Whilst awareness to MDRPUs, and specifically, to CPAPrPUs and the possibility to prevent them using prophylactic dressings has been established over the last decade among critical/acute care nurses, mostly thanks to organisations such as the European Pressure Ulcer Advisory Panel (EPUAP, http://epuap.org) and the US National Pressure Injury Advisory Panel (NPIAP; http://npiap.com), through activities such as the Prophylactic Dressing Standard Initiative (PDSI) Co‐Chaired by the Senior Author, 41 training and education efforts are still required among other medical/clinical communities not necessarily engaged in the EPUAP or NPIAP activities. In particular, knowledge regarding computational (FE) modelling and the functionality of prophylactic dressings should be communicated and disseminated among respiratory therapists.…”

Testing the effectiveness of a polymeric membrane dressing in modulating the inflammation of intact, non‐injured, mechanically irritated skin

“…14,[16][17][18] However, the prophylactic use of dressings is still in its early days, particularly because the dressings that are currently used for prevention were in fact developed for treating wounds, and hence, their properties relevant for prevention, for example, management of perspiration and thermal performance to release metabolic heat from the skin, are still subject to bioengineering laboratory research. 19 Modulating and focusing the inflammatory process within the relevant tissue space and time frame to help heal wounds while avoiding excess or stalled inflammation is an established concept in wound care, [20][21][22] which requires monitoring of the inflammatory process, its intensity and time course behaviour. A relatively recent laboratory research approach for early identification of an inflammatory response in skin is the measurement of the concentration of IL-1 alpha, an inflammatory cytokine (small signalling protein molecule) thought to be involved in the pathogenesis of chronic inflammatory diseases.…”

“…An additional important component in contemporary preventative bundles is the use of prophylactic dressings, which may provide local alleviation of mechanical stresses in skin and subdermal tissues to protect from PUs/PIs, typically at the sacral and heel regions 14,16–18 . However, the prophylactic use of dressings is still in its early days, particularly because the dressings that are currently used for prevention were in fact developed for treating wounds, and hence, their properties relevant for prevention, for example, management of perspiration and thermal performance to release metabolic heat from the skin, are still subject to bioengineering laboratory research 19 …”