Support surfaces play a significant role in the prevention of pressure injuries, addressing some of the extrinsic factors of pressure, friction, shear, moisture and heat. Support surfaces used in a wheelchair are covered in the wheeled mobility chapter. The one article in this new subsection suggests that there is research supporting the use of a multi-layer foam dressing to protect high risk people against developing sacral ulcers; however the research is not specific to the SCsI population. This study explores a multi-layer foam dressing versus a gel mattress for prevention of pressure injuries in the SCI population while waiting for spinal stabilization surgery.
Richard-Denis et al. (2017) study reports that research suggest the pre-operative use of multi-layer dressings can improve the protection of the skin and decrease the occurrence of pressure injuries pre-operatively in critically ill patients, Richard-Denis’ study suggests otherwise. His findings indicate that for patients sustaining acute SCI, this preventive measure is not superior to the conventional use of a gel mattress pre-operatively. The study authors suggest that if used, the multi-layer dressings should be used with caution in SCI patients, particularly with people who sustained a complete tetraplegia.
There is level 2 evidence (from one cohort study; Richard-Denis et al. 2017) that indicated, for pre-operative prevention for the SCI population, a multi-layer foam dressing is not superior in preventing sacral pressure injuries compared to viscoelastic polymer gel mattress over a foam stretcher pad.
Products and surfaces used for prevention should be combined with other preventative measures/strategies to optimize the potential to reduce risk of pressure injury development.