Soft Silicone Foam Dressing for Preventing Intraoperative Pressure Injuries: A Randomized Controlled Trial.

BACKGROUND: Intraoperative pressure injuries (IPIs) are preventable complications that increase postoperative morbidity and healthcare costs. Soft silicone foam dressings have been shown to redistribute pressure and reduce shear, but randomized evidence in surgical settings remains limited. PURPOSE: To evaluate the effectiveness of prophylactic soft silicone foam dressing in preventing IPIs among adult patients undergoing elective surgery lasting ≥1 h in the supine or lithotomy position. METHODS: This single-center randomized controlled trial enrolled 134 adult patients undergoing elective surgery under general anesthesia. Participants were randomized 1:1 to receive either standard preventive care alone (control group) or additional soft silicone foam dressing applied to the sacral area (experimental group). The primary outcome was the incidence of IPIs, assessed according to National Pressure Injury Advisory Panel (NPIAP) staging. RESULTS: The overall incidence of IPIs was 11.2% (15/134). The experimental group showed a significantly lower incidence than the control group (3.0% vs. 19.4%, χ²=9.083, p=0.002). All IPIs were stage I and resolved spontaneously within 48 h. Logistic regression analysis confirmed that the absence of silicone dressing independently increased IPI odds by 6.5-fold (odds ratio 6.50, 95% confidence interval 1.53-27.70, p=0.011). CONCLUSIONS: Prophylactic application of a soft silicone foam dressing effectively reduced IPIs and promoted rapid recovery of stage I injuries. This simple, low-risk intervention can be integrated into standard perioperative skin protection protocols to improve surgical patient safety.