Protective Effect of Silicone Pad on Pressure Ulcer among Patients undergoing Coronary Artery Bypass Graft

Abstract

Abstract: Background: Pressure ulcer incidence is common in coronary artery bypass graft (CABG) patients. Pressure-reducing surfaces are prominent intervention to prevent of pressure ulcers during surgery. This study aimed to investigate the effectiveness of a silicon protective pad on pressure ulcer among patients undergoing CABG surgery. Methods: Using a randomized controlled trial, 164 patients with coronary artery diseases and candidate for CABG surgery were randomly assigned either to an experimental group (82) to apply a silicon protective pad on the operating room table or to a standard mattress group (82). Data were collected on patient demographics, and pressure ulcer was assessed by the Torrance skin assessment scale at baseline, 24 hours and 48 hours after the surgery as well as during discharge period from the hospital. The collected data were analysed by using descriptive and inferential statistics. The logistic regression analysis for ordinal variables was used to predict the factors affecting the incidence of pressure ulcers and for analysing confounding variables covariance. Results: The silicon protective pad significantly diminished the incidence rates of sacral pressure ulcers on compare to standard mattress (p=0.01, effect size=0.23-0.34). According to the logistic regression analysis for ordinal variables, the pressure ulcer incidence, 24 hours after the surgery was predicted by cigarette smoking (OR=0.16, 95% CI=0.03- 0.76), history of taking opioid drugs (OR=11.12, 95% CI: 1.19-103.92) and the obtained data among high and moderate economical conditions were (OR=0.04, 95% CI=0.003-0.67) and (OR=0.25, 95% CI=0.07-0.81) respectively. Similarly the pressure ulcer incidence after 48 hours of surgery was predicted in high and moderate economical conditions (OR=0.08, 95% CI=0.01-0.75) and (OR=0.16, 95%=0.04-0.65) respectively. Conclusions: After CABG the silicon protective pad had significant effect in prevention of pressure ulcer. It is recommended for the first few days after surgery, the health care providers should focus on addicted, smoking habitual and economic condition of patients. Trial registration: The study protocol was assigned in Iranian center of clinical trial registration web site (No. IRCT2015110619919N3).