Use of wipes with emollient and barrier properties for the prevention of pressure injuries: a multicentre randomised controlled trial

Abstract

Objective: To evaluate the effectiveness of a twice-daily application of a wipe impregnated with emollient and barrier ingredients in reducing incidence of pressure injury (PI) in aged care consumers. Design: A single-blinded, multicentre randomised controlled trial. Randomisation was stratified by facility, using simple 1:1 randomisation within each stratum. Setting: 20 residential aged care facilities in Rural and Metropolitan New South Wales and the Australian Capital Territory, Australia. Participants: 858 aged care consumers aged ≥65 years at risk of developing a PI. Intervention: Participants were randomised 1:1 to receive either standard hygiene practices, repositioning and use of pressure redistribution surfaces (standard care) or twice-daily applications of a pre-packaged wipe impregnated with emollient and barrier ingredients (Contiplan) to the sacrum, buttocks and heels in addition to standard care for the study duration. Primary outcome and analysis: The primary outcome was the incidence of PIs per 1000 consumer days. Treatment effects were estimated using an intention-to-treat approach, with the absolute difference and 95% CI estimated using the Wald method. The relative difference in the incidence of PIs was estimated using a negative binomial regression model (with log link). Results: 858 participants were included in the study. There was a 50% relative reduction in the incidence of PI in the intervention compared with the control (95% CI 0.31 to 0.81, p=0.005), with an absolute rate difference of 0.31 fewer PIs per 1000 consumer days (95% CI 0.11 to 0.51). Conclusion: The use of wipes with emollient and barrier properties significantly reduced the incidence of PIs and prolonged the time to first PI, demonstrating efficacy as a PI preventive strategy in aged care. Trial registration: Australian and New Zealand Clinical Trials Registry, ACTRN12622001360707.