What is the most effective topical method for preventing presacral pressure sores that occur after hip fractures?

Abstract

Pressure sores are frequently observed in patients hospitalized due to hip fractures. This condition is caused by pressure, shearing forces, and friction on the skin and subcutaneous tissues. During the preoperative preparation period leading up to surgery, patients often remain immobile due to pain, lie in a supine position, and must use incontinence products because they cannot meet their toileting needs. Incontinence-related dermatitis is observed in patients using incontinence products, which constitutes a fundamental cause for pressure sore development. Since hip fractures are generally seen in the elderly population, advanced age, nutritional disorders, moist skin, infection, and metabolic diseases (e.g., diabetes, kidney failure) are frequently associated, serving as additional factors that facilitate pressure sore formation. Once a pressure sore develops, its treatment is lengthy and costly. Therefore, reducing pressure and addressing risk factors is crucial for prevention and treatment. The choice of treatment methods may vary according to the severity of the wound. In addition to systemic treatments, local topical treatments, including alleviating pressure and shearing forces, wound care, prevention of incontinence-related dermatitis, and nutritional regulation, are essential. Surgical treatment procedures may be necessary in advanced cases. Comparison of local topical treatment alternatives that can be applied before surgical treatment has not been conducted in the literature. This study aims to find the most effective method to address this significant problem by comparing three different materials and a control group applied in our clinic. This study particularly focuses on the topical treatment of presacral pressure sores occurring after hip fractures and is the first and only study in the literature. Presacral pressure sores are frequently observed in hip fractures, and the most effective method for preventing their formation and maceration is the application of barrier cream pads and barrier spray after isotonic cleansing.