(CS-084) Cyanoacrylate Used for Prevention of Pressure Injuries

Introduction: Foam and gel dressing are often used to protect against pressure injuries (PIs) however, repetitive dressing removal can cause trauma to the skin (Fumarola et. al, 2020).  Hospital acquired pressure injuries (HAPIs) occur in 3 to 34% of patients admitted to the hospital, lead to longer hospital stays, increased morbidity, and decreased overall quality of life (Iderden et. al., 2017).  HAPIs effect approximately 2.5 million patients in the United States annually at a cost of approximately$26.8 million (Padula and Delarmente, 2019).

Methods: Three post-acute rehab facilities (1,2, and 3) were included in a study that compared the prevention of HAPIs using standard of care (baseline during 2021), a first cyanoacrylate liquid skin protectant (CLSP1) was used during 2022, and a second (CLSP2 during 2023 (January-June).  For Facility 3, data was only collected for years 2022 and 2023.  Poisson regression modeling with vice robust standard error were run to examine the association between the year, HAPI counts and goodness of fit.

Results: All three facilities showed a significant decrease (p< 0.0001) in HAPI counts over the three-year period.  Facility 1 decreased from baseline HAPI counts of 95 in 2021 to 67 in 2022, and 30 in 2023.  Facility 2 decreased from a baseline count of 33 to 29 in 2022 and 25 in 2023.  Facility 3 showed a significant decrease from 2022 with a count of 17 down to a count of 8 in 2023.  Following implementation of the HAPI prevention protocol using CLSP2, the facilities averaged a 95% compliance rate.  In addition, the facilities nursing staff preferred the use of CLSP2 because it could be seen on the skin and stayed in place for seven days.  In addition, CLSP2 was less bulky and more cost effective than foam dressings for longer stay patients.

Discussion: Utilizing CLSP along with standard pressure injury prevention can reduce and prevent HAPIs.