***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Pressure injuries are key clinical indicators of care st and ard . In Australia , pressure injuries increase length of hospital stay by 4.31 and cost $ 285 million annually . This pilot study examined the effectiveness of sacral dressing in reducing the prevalence of pressure injuries in older , high-risk patients . A non r and omised one- sample experimental design was used in this study comprising of four phases . Of the 51 patients recruited to the study , one patient developed a sacral pressure injury compared to six patients identified in a known group with similar demographics who were not approached to participate in the study . The results indicated that patients in the known group were 5.4 times more likely to develop a pressure injury than the intervention group . Findings suggest that applying a protective sacral dressing with a low shear backing as part of a simple st and ardised prevention injury prevention regime commencing in the Emergency Department was beneficial in the prevention of pressure injury in older ' at high risk ' medical patients PURPOSE : The study was design ed to determine if application of a self-adherent silicone border foam dressing would reduce pressure ulcer incidence when compared to st and ard preventive interventions among patients managed in a cardiac surgery intensive care unit ( CSICU ) . SUBJECTS AND SETTING : One hundred consecutive patients in the CSICU at Virginia Commonwealth University Medical Center in Richmond participated in the study . Fifteen were subsequently excluded due to incomplete data or failure to remain in the CSICU for at least 48 hours . Of the 100 subjects consecutively enrolled , 56 subjects were assigned to the intervention group with attrition of 6 subjects ( 6/56 ) , and 39 were assigned to the st and ard care comparison group with attrition of 4 subjects ( 4/39 ) . Five study forms were lost and the group assignment of those subjects is unknown . METHODS : Patients admitted to the CSICU were assigned to either st and ard treatment or an intervention group consisting of st and ard preventive care plus application of the silicone border foam dressing . The assignment of subjects to these groups was done in a nonr and om manner , via pre study room design ation ( 7 intervention rooms/7 st and ard practice rooms ) and room availability on call from the operating room . The charge nurse and bed management staff were unaware of room design ation , and staff did not know which group the subjects were assigned to until they admitted the patient and opened the bedside chart that indicated group assignment . Twenty-one covariates were compared between the 2 groups . A Cox proportional hazards model was computed to compare the hazard ( risk per unit time ) of developing a pressure ulcer between these groups . Propensity score covariate adjustment was performed to adjust for any imbalance between the groups . RESULTS : Nine pressure ulcers developed during the course of the study . Eight pressure ulcers developed in 4 out of 35 patients who received st and ard preventive care ; 5 were classified as suspected deep tissue injuries and 3 were classified as stage II pressure ulcers . One pressure ulcer developed in 1 out of 50 patients in the intervention group ; it was classified as suspected deep tissue injury . No statistically significant difference in any covariate was found between the groups ( all P > .058 ) . The group that received st and ard care had a hazard ratio of 3.6 in relation to the intervention group , but this difference was not statistically significant ( P = .3 ) . CONCLUSION : Pressure ulcer incidence was lower than anticipated over the study period for both groups . No statistically significant difference in pressure ulcer incidence between the intervention and control groups was found . A r and omized controlled trial based on a power analysis is needed to more precisely determine the efficacy of a silicone border foam dressing for prevention of pressure ulcers in the intensive care unit OBJECTIVE In acute respiratory failure , non-invasive ventilation ( NIV ) treatment is used to prevent the need for intubation . NIV applied through a face mask may contribute to the development of facial skin lesions . This study was conducted to compare the efficacy of protective dressings and of using no material s for pressure ulcer prevention . METHODS There were 90 participants in this study . The participants were assigned into three groups : control group , tegasorb group , and tegaderm group . RESULTS The tegasorb group and tegaderm group , in contrast to the control group , had fewer pressure ulcers based on our statistics and occurrence duration time ( p<.01 ) . However , there were no significant difference in occurrence duration time between the tegasorb group and tegaderm group . CONCLUSIONS This result revealed that tegasorb and tegaderm could be used on the face of NIV patients to prevent pressure ulcers OBJECTIVE A trial of a self-adhesive hydropolymer foam dressing ( Tielle , Johnson & Johnson ) demonstrated that it prevented the development of friction-generated pressure ulcers on the heels of ICU patients . Following the trial , use of the foam dressing became a st and ard preventive measure in the ICU and the prevalence of heel ulcers decreased by 72 % in two years . This follow-up study evaluated the foam 's effectiveness in preventing heel  pressure ulcers in surgical patients . METHOD A total of 140 surgical patients were screened over a four-month period . They were assigned to one of two groups , depending on their pressure ulcer risk score and the anticipated length of the surgical procedure . The foam dressing was used as a barrier on the heels , depending on the patient 's risk status , which was assessed using a modified Norton scale , and the duration of their surgery . Heels were inspected on a daily basis for up to 10 days . All 23 patients in the group whose surgery lasted less than 90 minutes dropped out of the study as they were discharged with insufficient data . RESULTS A 76.7 % reduction in heel pressure ulcers was achieved with this preventive measure . CONCLUSION Use of an adhesive foam dressing on surgical patients can prevent heel ulcers . Research is needed on the effects of friction on the heel during the transfer and movement of surgical patients . DECLARATION OF INTEREST This study was sponsored by Johnson & Johnson Medical AIM The aim of this study was to test the effectiveness of polyurethane foam in contact with the heel inside a plaster cast to decrease the rate of pressure sores in the population at most risk . BACKGROUND The rate of pressure sores caused by the plaster cast is reported to be 14 - 15 % in the paediatric population , 33.3 % in patients having undergone chemotherapy for bone tumours and 43 % in orthopaedic patients who already have sore skin when the cast is applied ( grade 1 lesion ) to the heel . DESIGN Controlled clinical trial . METHODS From November 2007-January 2009 , all consecutive subjects requiring lower limb casts having undergone chemotherapy and /or presenting heel soreness received polyurethane foam in contact with the skin of the heel before applying the cast . The results were compared with those of patients with the same risk factors but were not administered the foam and were enrolled from May 2005-August 2006 . RESULTS In total , 156 patients were enrolled , 85 in the control group and 71 in the experimental group . In the experimental group , 2 of the 56 patients ( 3.6 % ) with sore skin developed a pressure sore compared with 21 of 49 ( 42.9 % ) in the control group without polyurethane foam ( p < 0.0005 ) . In the experimental group , one of the 24 patients ( 4.2 % ) patients undergoing chemotherapy developed a pressure sore compared with 18 of 54 ( 33.3 % ) in the control group ( p = 0.005 ) . CONCLUSIONS Placing polyurethane foam in contact with the skin of the heel inside a plaster cast prevents the formation of pressure sores . RELEVANCE TO CLINICAL PRACTICE This study provides evidence that using polyurethane foam to prevent sores even inside plaster casts in population s at most risk is a simple and cost-effective strategy and decreases the discomfort , pain and risks in these patients Nasal intermittent positive pressure ventilation ( NIPPV ) can provide symptom control and improved quality of life for patients with acute and chronic respiratory failure . Many patients using a Respironics mask for NIPPV  develop nasal bridge pressure sores . Two dressing were compared for effectiveness in preventing such sores . Patients using Granuflex had less skin deterioration over time compared to a comparison group and patients using Spenco Dermal PURPOSE Nasal-ala pressure sores induced by nasotracheal intubation are common complications of oral and maxillofacial surgery , but are easily ignored . To determine whether such sores could be prevented , we studied the effects of a combination of cushioning material in an animal model , and then analyzed the efficacy of this combination clinical ly . MATERIAL S AND METHODS Four pigs received nasotracheal intubation .  Each pig received intubation for 4 , 8 , 12 , or 16 hours . Outcomes from pigs undergoing 500-gram-weight compression on each nostril were compared : one nostril received an application of cushioning material s , and the contralateral nostril did not . After the required study period , clinical assessment and further evaluation were performed by measuring pressure-sore dimensions and performing incisional biopsies . Clinical applications of this protective technique were then undertaken . Eight patients who underwent intubation without Soft Liner ( GC Co , Tokyo , Japan ) and DuoDERM CGF ( ConvaTec , Inc , Princeton , NJ ) protection , and 10 patients with Soft Liner and DuoDERM protection , were evaluated . RESULTS The protective efficacy of the cushioning material s was significant in the animal model as well as in clinical practice . Pressure sores were avoided on the protected side , with severe tissue necrosis documented on the control side . CONCLUSION We found that the combined use of Soft Liner and DuoDERM reduced the size and severity of nasal-ala pressure sores attributable to nasotracheal intubation during oral and maxillofacial surgery AIM This paper is a report of an evaluation of the effectiveness of a newly developed dressing for preventing persistent erythema and pressure ulcer development and improving the water-holding capacity without increasing the skin pH in bedridden older patients . BACKGROUND Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development . To eliminate these risks , we developed a dressing to reduce shear forces and improve the water-holding capacity . However , the effects of this dressing in clinical setting s remain unknown . METHOD An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development . The dressing was r and omly applied to the right or left greater trochanter for 3 weeks . No dressing was applied to the opposite side as a control . The skin was monitored weekly during the 3-week application for persistent erythema and pressure ulcer development . Skin hydration and pH were also assessed during the intervention and for 1 week after dressing removal . FINDINGS The incidence of persistent erythema was significantly lower in the intervention area than the control area [ P = 0.007 , RR 0.18 ( 95 % CI : 0.05 - 0.73 ) and NNT 4.11 ( 2.50 - 11.63 ) ] . No pressure ulcers occurred in either the intervention or control area . Skin hydration increased significantly during dressing application and remained high after removal ( P < 0.001 ) relative to the control area . Skin pH decreased significantly during the application ( P < 0.001 ) but returned to control levels after removal ( P = 0.38 ) . CONCLUSION This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers PURPOSE : We sought to determine if a silicone border foam dressing could decrease the incidence of  sacral pressure ulcers  in an intensive care unit . SUBJECTS AND SETTING : The study setting was an intensive care unit located in a 303-bed hospital with a design ation of level 2 trauma . The unit specializes in the care of critically ill medical and postoperative adults . Two hundred seventy-three patients participated in the study ; their mean age was 65 years ( range , 18–105 years ) . METHODS : Baseline sacral hospital-acquired pressure ulcer ( HAPU ) incidence was determined during a period of 35 months ; skin care representatives examined all patients in our critical care unit for HAPUs on a monthly basis . Based on this baseline incidence , we studied the effect of application of a silicone-bordered foam dressing applied to the sacrum . The observation period for our study intervention was 6 months ; the sacral area was examined twice daily during this period . RESULTS : The average baseline sacral HAPU prevalence during the 35-month observation was 13.6 % as compared to an incidence of 1.8 % during a 6-month prospect i ve study . Three of the 5 patients developed suspected deep tissue injuries and subsequently expired . The remaining 2 subjects developed stage 2 pressure ulcers , one of whom also expired . CONCLUSION : Following application of a silicone-bordered foam dressing , we were able to achieve a HAPU of 1.8 % Little is known about the cost-benefit of soft silicone foam dressings in pressure ulcer ( PU ) prevention among critically ill patients in the emergency department ( ED ) and intensive care unit ( ICU ) . A r and omised controlled trial to assess the efficacy of soft silicone foam dressings in preventing sacral and heel PUs was undertaken among 440 critically ill patients in an acute care hospital . Participants were r and omly allocated either to an intervention group with prophylactic dressings applied to the sacrum and heels in the ED and changed every 3 days in the ICU or to a control group with st and ard PU prevent 
    Output:
    
The single high- quality r and omised controlled trial ( RCT ) and the growing number of cohort , weak RCT and case series all suggest that the introduction of a dressing as part of pressure ulcer prevention may help reduce pressure ulcer incidence associated with medical devices especially in immobile intensive care unit patients .
There is no firm clinical evidence at this time to suggest that one dressing type is more effective than other dressings