What cream can help prevent pressure (bed) sores?

From the Guidelines

To help prevent bed sores (pressure ulcers), I recommend using a moisturizing barrier cream, as low-quality evidence showed that a skin cream containing fatty acid and a skin cleanser other than soap decreased risk for pressure ulcers 1. Apply a thin layer to at-risk areas like the tailbone, heels, hips, and elbows 2-3 times daily or during each position change. Before application, gently clean and thoroughly dry the skin. For those at higher risk, specialized products like Mepilex or hydrocolloid dressings may provide additional protection. Beyond creams, prevention requires:

• Frequent position changes (every 2 hours)
• Use of pressure-relieving surfaces like foam mattresses
• Maintaining good nutrition and hydration
• Keeping skin clean and dry These measures work by maintaining skin integrity, reducing friction and shear forces, and protecting against moisture damage. Bed sores develop when prolonged pressure restricts blood flow to tissues, causing cell death and skin breakdown, so a comprehensive approach that includes both topical products and proper positioning is essential for prevention. Key considerations include:
• Identifying high-risk individuals
• Using advanced static mattresses or overlays for those at increased risk
• Avoiding alternating-air mattresses or overlays due to lack of clear benefit and higher costs
• Implementing a multicomponent approach to pressure ulcer prevention, including creams, dressings, repositioning, and nutritional support.

From the FDA Drug Label

Purpose: Skin Protectant Directions: Clean skin gently with mild skin cleanser. Pat dry or allow to air dry. Apply as necessary. If applying to perineal area, apply after each incontinent episode or diaper change to promote comfort and long lasting protection. Active Ingredient: Dimethicone 5% The dimethicone cream can help prevent bed sores by providing a skin protectant barrier 2. To use, clean the skin gently and apply the cream as necessary, especially after incontinent episodes or diaper changes 2. The cream contains 5% Dimethicone as the active ingredient 2.

• Apply the cream to clean and dry skin
• Reapply as necessary
• Use in the perineal area after each incontinent episode or diaper change for long lasting protection

From the Research

Cream to Help Prevent Bed Sores

• There are various studies that have investigated the use of creams and dressings to prevent bed sores, also known as pressure ulcers 3, 4, 5, 6, 7.
• A study published in 2017 found that the use of a hydrocolloid dressing significantly decreased the incidence of facial pressure ulcers caused by noninvasive ventilation 4.
• Another study published in 2017 found that foam dressings may be effective in treating pressure ulcers, but the evidence was of low to very low certainty due to various limitations and biases 5.
• A 2016 study found that the use of a 5-layered soft silicone foam dressing reduced the incidence of hospital-acquired pressure ulcers in critically ill patients 6.
• A 2013 Cochrane review found that dressings applied over bony prominences reduced pressure ulcer incidence, but the evidence was compromised by the low quality of the included trials 7.
• The use of topical agents, such as creams, to prevent pressure ulcers is not supported by strong evidence, and further well-designed trials are needed to determine their effectiveness 3, 7.

Types of Creams and Dressings

• Hydrocolloid dressings: may be effective in preventing pressure ulcers, particularly in high-risk patients 4.
• Foam dressings: may be effective in treating pressure ulcers, but the evidence is of low to very low certainty 5.
• Silicone foam dressings: may be effective in preventing pressure ulcers in critically ill patients 6.
• Topical agents: the evidence for their use in preventing pressure ulcers is limited and inconclusive 3, 7.

Limitations and Future Research

• Many of the studies on creams and dressings for preventing bed sores have limitations and biases, which reduces the certainty of the evidence 3, 4, 5, 6, 7.
• Further well-designed trials are needed to determine the effectiveness of different types of creams and dressings in preventing pressure ulcers 3, 7.
• Research should focus on high-quality, prospective studies that address important clinical, quality of life, and economic outcomes 7.