Prophylactic dressing in the prevention of bedsore: A Network Meta-analysis

Pressure sores, also known as pressure ulcers, present a critical health-care challenge, with a prevalence of 5%-20% in Western countries and annual costs exceeding $26.8 billion in the US. This study evaluates the effectiveness of various dressings in preventing pressure ulcers, aiming to improve patient care and reduce health-care expenditures.

A comprehensive literature search was conducted across Embase, PubMed, and Cochrane databases, spanning publications from 1974 to November 2023. Keywords related to pressure ulcers and dressing materials guided the search, resulting in 1041 articles initially screened, with 15 ultimately included in the analysis.

The systematic review encompassed studies from diverse global locations, analyzing data from 5,324 patients to assess the effectiveness of prophylactic dressings. Silicone dressings were highlighted for their superior performance in preventing pressure ulcers. The network meta-analysis of 15 studies revealed a significant preference for silicone over polyurethane film (IV= 2.87, CI 95%, 1.01-8.13) and control (IV= 2.69, CI 95%, 1.65-4.39), showcasing very low heterogeneity. Silicone sheets emerged as the prophylactic dressing of choice with a 90.72% probability of being the most effective, outperforming polyurethane foam, fatty acid oils, control, polyurethane film, and hydrocolloid in surface under the cumulative ranking curve ranking.

The comparative effectiveness of prophylactic dressings highlights silicone dressings as the optimal choice for preventing pressure ulcers. This finding suggests a strategic shift toward using silicone-based dressings in clinical settings to enhance patient outcomes and reduce the burden of pressure ulcers on health-care systems.