An evaluation of an adhesive hydrocellular foam dressing and a self-adherent soft silicone foam dressing in a nursing home setting.

To assess the performance of two wound dressings in the management of chronic wounds, a 5-year retrospective descriptive study was conducted involving 4,200 wounds in 1,891 residents of 30 nursing homes in the state of Florida. Wound and patient variables were abstracted from charts completed by the wound care clinicians providing care in the nursing homes. The chart abstraction time period was chosen to capture a change in wound dressing regimens in these nursing homes. Patient demographic and wound assessment variables, including evidence of surrounding skin stripping information, were abstracted from the database. The majority of wounds were classified as pressure ulcers (3,579 out of 3,795 [94%] hydrocellular-dressing treated wounds; 339 of 352 [96%] silicone dressing-treated wounds, and 51 of wounds managed with both dressings). The majority of wounds were classified as Stage II or III ulcers. Wounds in the hydrocellular group were larger (mean area 7.53 cm2) and took longer to heal (mean 70.1 days) than those in the silicone dressing group (mean area 5.5 cm2, 39.2 days) but the proportion of ulcers healed was the same (63%) in both groups. Skin stripping was rare with either dressing (1% to 2% of wounds). Problems with adhesion and infections occurred more frequently in the silicone dressing group than in the hydrocellular dressing group. The results of this study show that most chronic wounds managed with either dressing will heal after an average of 70 days, that differences between the two dressings are minimal, and that periwound skin stripping is uncommon. Ease of use characteristics and the ability of dressings to remain in place appeared to differ, possibly affecting infection rates and costs of care.