Sacral Soft Tissue Deformations When Using a Prophylactic Multilayer Dressing and Positioning System

Lea Peko Cohen, Ayelet Levy, Nogah Shabshin, Ziv Neeman, Amit Gefen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


PURPOSE: The sacrum is the most common location of pressure injuries (PIs) in bedridden patients. The purpose of this study was to measure the effect of specifi c pressure preventive devices on sacral skeletal muscle, subcutaneous fat, and skin tissue deformations. SUBJECTS AND SETTING: The sample comprised 3 healthy adults residing in a community setting in Tel Aviv, Israel. DESIGN: Descriptive, comparative design. METHODS: Tissue thickness changes of 3 healthy adults were measured using magnetic resonance imaging (MRI) in weight bearing sacral skin, subcutaneous fat, and muscle. Changes in tissue thickness were compared under the following conditions: (1) lying supine on a rigid surface (unpadded MRI table), (2) lying on a standard foam mattress, (3) lying on a mattress after application of a prophylactic multilayer dressing, and (4) lying on a standard foam mattress with a prophylactic multilayer dressing and a positioning system. One-way analysis of variance and post hoc Tukey-Kramer multiple pairwise comparisons were used to compare outcomes. RESULTS: The mattress, the prophylactic multilayer dressing, and the turning and positioning device when applied together resulted in significantly lower deformation levels of each of the soft tissue layers (ie, skin, subcutaneous fat, and muscle separately) as well as of the total soft tissue bulk, with respect to the rigid MRI table ( P < .05). CONCLUSION: Study findings suggest that a combination of preventive interventions may reduce the risk of developing a sacral PI.

Original languageEnglish
Pages (from-to)432-437
Number of pages6
JournalJournal of Wound, Ostomy and Continence Nursing
Issue number5
StatePublished - 1 Sep 2018


  • MRI
  • Magnetic resonance imaging
  • Pressure injury
  • Pressure ulcer
  • Prevention
  • Prophylactic multilayer dressing
  • Tissue tolerance
  • Turning and positioning system


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