Effectiveness of a Single-Use Polyurethane Foam Positioning Pad Compared With Five-Layer Foam Sacral Dressing for Pressure Ulcer Prevention in the Operating Room: A Randomized Controlled Clinical Trial.

BACKGROUND AND AIMS

Among cardiac surgery patients, risk factors for pressure ulcers include prolonged pressure exposure during lengthy surgeries, vascular disease, and postoperative vasopressor use. Conventional pressure ulcer prevention methods may be inadequate for these high-risk patients. This study evaluated the effectiveness of polyurethane foam (pink pad) versus a five-layer sacral foam dressing in preventing pressure ulcers in the operating room.

METHODS

A randomized controlled trial was conducted at a tertiary care hospital in Western Saudi Arabia, including 100 cardiac surgery patients undergoing procedures lasting over 4 h. Patients were randomly allocated (1:1) to receive either a polyurethane foam pink pad ( = 50) or a five-layer foam sacral dressing ( = 50), with all receiving standard pressure ulcer prevention per hospital policy. The head of the wound management team conducted wound assessments using the Bates-Jensen wound assessment tool immediately postoperatively and on days 3 and 7. This study was conducted in accordance with the CONSORT guidelines. The data were analyzed using SPSS version 26 employing a Chi-square test and Fisher's exact test (significance level:  < 0.05).

RESULTS

In total, 111 patients were screened for eligibility, and 100 patients were included and allocated to both groups. Results showed that 6% of patients in the polyurethane foam group developed Stage I pressure ulcers, while no cases were observed in the five-layer foam sacral dressing group, with no statistically significant difference ( > 0.24). No statistically significant relationship was found between pressure ulcer development and demographic or health data (all  > 0.05). Regarding the surgery length, no statistically significant difference was found between both groups (-test 0.69,  = 0.48).

CONCLUSION

Both dressings were effective in minimizing pressure ulcer incidence, although the five-layer foam sacral dressing showed slightly better performance, achieving complete pressure ulcer prevention.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT06790277).