Prophylactic dressings for preventing nasal pressure ulcer in premature newborns: an effectiveness review.
Cibelle Mello Viero, Paulo Jorge Pereira Alves, Oclaris Lopes Munhoz and 6 others
PMID 41328728WHAT IT FOUND
Hydrocolloid dressings and 1.8 mm silicone gel sheets appear to reduce nasal pressure ulcers in preterm newborns using CPAP or non-invasive ventilation, compared with no dressing or routine care.
Evidence quality is low, so monitor skin closely.
Key findings
01Hydrocolloid dressings reduced nasal pressure ulcer risk compared with no intervention in the network meta-analysis (RR 0.60; 95% CI 0.38, 0.93).
021.8 mm silicone gel sheets reduced nasal pressure ulcer risk compared with no intervention (RR 0.29; 95% CI 0.09, 0.85).
03The certainty of evidence for nasal pressure ulcer prevention was rated low.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The network meta-analysis was restricted to preterm newborns, although the review planned to include newborns in general. Six studies were missing data needed for extraction, and only one author supplied the requested results. Randomized trials could not blind the person applying the dressing, and several did not report adequate randomization or allocation concealment. Observational studies had inconsistent results and incomplete follow-up or confounding issues. Dressings and comparators were heterogeneous, so direct comparisons across materials were limited. The certainty of evidence was low.
The easy way to misread this
Do not conclude that any prophylactic dressing prevents nasal pressure ulcers in all newborns. The network meta-analysis was limited to preterm newborns, and the certainty of evidence was low.