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cardiac surgery, critical care, deep-tissue pressure injuries, foam dressings, pressure injury, pressure ulcer, silicone foam



  1. Strauss, Robyn ACNS-BC, MSN, RN, WCC
  2. Preston, Ave ACNS-BC, MSN, RN, CWOCN
  3. Zalman, Demetra C. MSN, CRNP, WCC
  4. Rao, Aditi D. PhD, RN


OBJECTIVE: To evaluate the effect of silicone foam dressings, placed preoperatively, on the incidence of postoperative sacral deep-tissue pressure injuries.


DESIGN, SETTING, AND PATIENTS: An uncontrolled before-and-after quality improvement method was used. Within a single, urban academic medical center, consecutively admitted adult cardiac surgery patients were included in the pre- and postintervention groups; only those receiving elective procedures were included.


INTERVENTION: Nurses applied a sacral silicone foam dressing preoperatively. This dressing was maintained on the patient's sacrum intraoperatively and postoperatively for up to 5 days in the intensive care and step-down units.


MAIN RESULTS: This project demonstrated a clinically significant decrease (P < .02) in the incidence of postoperative sacral deep-tissue pressure injuries from 2.3% (preintervention, n = 300) to 0% (postintervention, n = 224). These results were sustained for 24 months after the trial was completed.


CONCLUSIONS: The use of silicone foam dressings may be an effective prophylactic intervention to reduce the incidence of perioperative deep-tissue pressure injuries among cardiac surgery patients, a high-risk population.