When it’s cold outside, it’s common sense to dress in layers, each addressing a specific need, whether moisture, warmth or water-resistance. A similar theory provides the basis for a five-layer foam wound care dressing. Each layer has a purpose in helping the body’s natural healing process. “These dressing can be used as part of pressure injury prevention protocol specifically for the patient’s sacrum and heels, two of the most common areas to find stage 4 pressure injuries.1
Pressure injuries at the sacrum and heels can develop through a number of interrelated contributing factors, but two major causes are friction and shear, which often go hand in hand.
Effects of friction…
In terms of skin breakdown, friction is defined as “the mechanical force exerted when skin is dragged across a coarse surface such as bed linens” in an article by Cathy Thomas Hess, BSN, RN, CWOCN, in Advances in Skin & Wound Care.2 Although some friction is required for a patient to comfortably sit up in bed, gravity soon causes problems. As gravity pulls on the upper torso, skin resists the movement because of the friction with the surface. Hess goes on to explain that this extra stress on the body, particularly on the sacral area and heels, “can cause damage to the inner layer of connective tissue and limits blood flow to the region, resulting in tissue necrosis.”2
The internal damage caused by shear is not often visible, but friction can cause surface damage on the skin and lead to tears and fissures. Often exacerbating the decline in skin integrity is a less-than-optimal microclimate between the body and the surface.3
Why use a multilayer dressing?
As a clinician, you have many options to help control friction and shear and manage microclimate. One of those is the five-layer foam dressing. “The material is unique in that it can compress and redistribute shear across the dressing and beyond,” says Dr. Kevin Woo, PhD, RN, NSWOC, FAPWCA, Medline consultant and associate professor, Queen’s University, School of Nursing, School of Rehabilitation Therapy in Kingston, Ontario, Canada.
“The five-layer foam dressing helps manage the frictional forces associated with pressure injury development, which will also help to lower the potential for shear,” emphasizes Medline Clinician Patricia Turner, BSN, RN, CWOCN, CWS, adding, “These dressings also manage microclimate, which is the temperature and humidity of the skin and the dressing interface.”