Is Hydrofera Blue (polyurethane foam dressing) effective for treating a sacral pressure ulcer?

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Last updated: June 23, 2025View editorial policy

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From the Guidelines

Hydrofera Blue polyurethane foam dressing is a recommended option for treating sacral pressure ulcers, particularly for reducing wound size, as suggested by the American College of Physicians guideline 1. The use of hydrocolloid or foam dressings, such as Hydrofera Blue, is supported by a weak recommendation based on low-quality evidence, but it is still considered effective in promoting wound healing and reducing wound size 1. When using Hydrofera Blue for sacral pressure ulcers, it is essential to cut the dressing to fit the wound with a 1-2 cm border extending onto intact skin and secure it with appropriate tape or secondary dressing. Key benefits of Hydrofera Blue include:

  • Antimicrobial properties to reduce bacterial burden without cytotoxicity to healthy tissue
  • Ability to absorb exudate while maintaining a moist wound environment, supporting autolytic debridement and promoting granulation tissue formation
  • Potential to manage bioburden without the use of antibiotics However, for deep or necrotic pressure ulcers, additional debridement may be necessary before applying this dressing, and very dry wounds may require the addition of a hydrogel to provide moisture. It is crucial to change the dressing every 1-3 days, depending on exudate levels, but it can remain in place up to 7 days if the wound is not heavily draining, ensuring the dressing is secured well to prevent displacement during patient repositioning 1.

From the Research

Effectiveness of Hydrofera Blue for Sacral Pressure Ulcers

  • There is limited direct evidence on the effectiveness of Hydrofera Blue (polyurethane foam dressing) for treating sacral pressure ulcers 2.
  • A study on dressings and topical agents for treating pressure ulcers found that foam dressings may increase the probability of healing compared to saline gauze, but the evidence is of low certainty 2.
  • Another study on the biomechanical protective effects of treatment dressings on soft tissues surrounding a non-offloaded sacral pressure ulcer found that anisotropic stiffness feature of a dressing is a key design element, but it did not specifically evaluate Hydrofera Blue 3.
  • A review of antibiotics and antiseptics for pressure ulcers found that the relative effects of systemic and topical antimicrobial treatments on pressure ulcers are not clear, and the quality of the evidence ranges from moderate to very low 4.
  • A study on managing sacral pressure ulcers with hydrocolloid dressings found that hydrocolloid dressings can be effective in promoting healing, but it did not evaluate Hydrofera Blue 5.
  • A study on prophylactic sacral dressing for pressure ulcer prevention in high-risk patients found that a prophylactic sacral dressing may help prevent unit-acquired sacral pressure ulcers, but it did not specifically evaluate Hydrofera Blue 6.

Key Findings

  • The evidence on the effectiveness of Hydrofera Blue for treating sacral pressure ulcers is limited and indirect.
  • Foam dressings, including Hydrofera Blue, may be beneficial in promoting healing, but the evidence is of low certainty.
  • The choice of dressing should be based on individual patient needs and wound characteristics, as well as clinical experience and patient preference 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Dressings and topical agents for treating pressure ulcers.

The Cochrane database of systematic reviews, 2017

Research

Antibiotics and antiseptics for pressure ulcers.

The Cochrane database of systematic reviews, 2016

Research

Prophylactic Sacral Dressing for Pressure Ulcer Prevention in High-Risk Patients.

American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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