Cai JY, Zha ML, Chen HL, et al.
Wound management & prevention. Date of publication 2019 Feb 1;volume 65(2):30-38.
1. Wound Manag Prev. 2019 Feb;65(2):30-38.
Use of a Hydrocolloid Dressing in the Prevention of Device-related Pressure
Ulcers During Noninvasive Ventilation: A Meta-analysis of Randomized Controlled
Trials.
Cai JY(1), Zha ML(1), Chen HL(1).
Author information:
(1)Nantong University, Nantong City, Jiangsu Province, PR China.
Use of a hydrocolloid dressing (HCD) is generally recommended to help prevent
pressure ulcers (PUs) in high-risk patients, including ulcers caused by
noninvasive ventilation (NIV).PURPOSE: The study was conducted to compare the
effect of preventive use of HCD to other methods in the rate of facial PUs caused
by NIV.
METHODS: PubMed, Web of Science, China National Knowledge Infrastructure, and
Wanfang Data were searched from date of index inception to August 2018 without
language restrictions to identify randomized controlled trials (RCTs) that
compared HCD use to other NIV-related PU prevention measures. Publications were
systematically reviewed, data were extracted, and study quality was assessed
using the Jadad scale. Odds ratio (OR) with 95% confidence intervals (CIs) for PU
incidence in patients using HCD versus patients managed with gauze or standard
skin care procedures (control) were calculated using a fixed-effects model.
RESULTS: The search yielded 80 publications; 40 met the study criteria for
full-text and 22 met the meta-analysis inclusion criteria (total study
participants = 2519). Patients who used a HCD (n = 1260) had a significantly
decreased incidence of PU (OR = 0.15; 95% CI: 0.11-0.20) compared with control
group patients (n = 1259). Subgroup analysis by age showed a lower incidence in
children (OR = 0.09; 95% CI: 0.01-0.81) and adults (OR = 0.16; 95% CI: 0.12-0.22)
in the HCD group than in the control group. PU incidence using HCD was lower
compared to gauze (OR = 0.17; 95% CI: 0.10-0.28) and regular skin care (OR =
0.13; 95% CI: 0.09-0.19). Funnel plot diagrams suggested a risk of bias.
Sensitivity analysis using a random-effects model did not change the result of
the main meta-analysis.
CONCLUSION: Using a HCD significantly decreased the incidence of facial PUs
caused by NIV. Additional high-quality, prospective research to confirm the
effectiveness of HCD in preventing NIV-related PUs is warranted.
PMID: 30730303
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