Effectiveness and Value of Prophylactic 5-Layer Foam Sacral Dressings to Prevent Hospital-Acquired Pressure Injuries in Acute Care Hospitals: An Observational Cohort Study.

The study used hospital-level data, not patient-level data, so it cannot show that the dressings caused fewer pressure injuries. The researchers assumed hospitals used the purchased dressings as indicated. Hospitals served as their own controls before and after dressing purchase, with no concurrent control hospital group. Hospitals that purchased zero dressings were not specified, and other branded prophylactic dressings may have been used without being captured. The third quarter of 2012 was omitted because of missing data. Pressure injury counts depended on administrative coding of PSI-03, which is less accurate than surveillance data. The outcome counted all PSI-03 pressure injuries, not only sacral injuries, so changes may reflect factors other than sacral dressings. The study only examined 5-layer foam sacral dressings, so it cannot compare other dressing types. Other prevention changes, case-mix, time, and CMS policy were tested, but the design cannot fully rule out confounding.

Mölnlycke Health Care, a manufacturer of foam sacral dressings, provided quarterly hospital-level purchase volume and cost data. The paper does not state that the company funded, designed, or wrote the study.

Do not conclude that prophylactic 5-layer foam sacral dressings alone caused the reduction in pressure injuries. The study observed hospital purchase of dressings, assumed use, and hospitals also followed broader prevention protocols, so the effect of the dressings cannot be separated from other prevention measures.