Created by the British Columbia Provincial Nursing Skin and Wound Committee in collaboration with the Wound Clinicians from
/
Skin and Wound Product Information Sheet
Mepilex Border Sacrum for Pressure Ulcer Prevention
Classification
Key Points
Indications
Precautions
Contraindications
Formats & Sizes
Prophylactic Dressing
 Used to enhance, but not replace, routine pressure ulcer prevention strategies for the
prevention of sacral/coccyx pressure ulcers.
 Redistributes shear forces, reduces friction, redistributes pressure and balances microclimate
during wear time.
 Soft and conformable waterproof foam dressing with silicone adhesive layer for atraumatic
dressing removal.
 Presently for use in critically ill patients (Intensive Care Units) for the prevention of sacral/coccyx
pressure ulcers.
 Patient Selection Criteria
 Apply immediately if:
o On bedrest
o Post cardiac arrest this admission
o Shock, Systemic Inflammatory Response Syndrome (SIRS), Multiple Organ Dysfunction
Syndrome (MODS)
o Surgical procedure longer than 8 hours (may be cumulative)
o Anticipated use of vasopressors more than 48 hours
 Apply if five (5) or more of the following are present:
o Age more than 65 years
o History of pressure ulcers
o Diabetes Mellitus
o Edema (weeping or generalized)
o Liver failure
o Malnutrition (pre-albumin less than 200, albumin less than 25, or NPO more than three days)
o Weight greater than 250 pounds
o Anticipated mechanical ventilation more than 48 hours
o Nitric oxide ventilation
o Vascular drivelines (i.e. Left Ventricular Assess Device (LVAD), balloon pump)
o Spinal cord injury
o Sedation or paralytics for more than 48 hours
o Traction
o Restraints
 Does not replace the use of other pressure ulcer prevention strategies (i.e. pressure risk
assessment, regular positioning, appropriate pressure redistribution and support strategies).
 Dressing should not be cut
 Protect against direct sunlight
 Pre-existing sacral or coccyx pressure ulcer, including Stage 1 pressure ulcer
 Trauma or burn to sacrum or coccyx.
 Do not use with skin barriers /skin sealants or cleaning wipes containing dimethicone, emollients
etc. as these reduce the effectiveness of the adhesive properties of the dressing
 Mepilex Border Sacrum
o
23 x 23 cm
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Created by the British Columbia Provincial Nursing Skin and Wound Committee in collaboration with the Wound Clinicians from
/
Skin and Wound Product Information Sheet
Application Directions
Rationale
To Apply
Assess the patient’s anatomy and evaluate if the dressing should
be placed according to Figure A or B based on coverage and/or
potential issues with incontinence.
Product is usually placed inverted so that the wider
portion of the dressing is used to cover the sacral –
coccyx/lower buttock area.
Fig A: Product placement
Fig B. Product placement inverted
Position patient on their side. Cleanse the area with pH-balanced
skin cleanser or chlorhexidine bathing wipe or warm water.
Gently pat the skin dry.
Emollients, dimethicone (and other skin
preparations) can reduce the adhesive properties of
the silicon dressing.
Do not use emollient or dimethicone ointments/barrier wipes or
skin sealants in area where dressing will be applied.
Have a colleague hold the buttocks apart. Remove the dressing’s
center release film and apply dressing into the upper aspect of
gluteal cleft and to sacral area. Gently smooth each side of the
dressing into place and run the side of a hand along the gluteal
cleft to secure placement
It is important that the dressing ‘fits’ into the upper
aspect of the gluteal cleft to ensure that the dressing
is properly secured against incontinence episodes.
On the dressing, print “P” for Preventative/Protective dressing
and add the date that the dressing was applied.
Daily Care
Once a day, peel dressing back and assess the skin. Reapply
existing dressing ensuring the border of the dressing is smooth
with no wrinkles. Document assessment findings.
To communicate with other staff the purpose of the
dressing and when it needs to be changed.
If patient is incontinent and top of dressing is soiled, gently wipe
off.
If dressing does not stay intact for longer than 24 hours due to
incontinence, discontinue the dressing and use barrier cream or
alternative skin management.
Dressing is waterproof and will not allow urine or
feces to soak into the dressing.
If dressing does not stay in place it is not a costeffective prevention strategy.
If a pressure ulcer develops within the area of the dressing,
discontinue the prevention/protection dressing and initiate
appropriate wound management. Inform OT, PT and/or Wound
Clinician of the pressure ulcer occurrence.
To Remove
Gently lift the border and use one hand to stabilize the skin.
Frequency of Dressing Change
Remove every three (3) days or sooner if dressing is soiled or
dislodged. Replace the prevention/protection dressing as long as
patient meets selection criteria above.
Expected Outcome
Pressure ulcer does not develop
Wrinkles in the dressing are to due to sheer forces
being applied to the dressing; if possible, remove
these concerns e.g. lower the head of the bed.
Other pressure ulcer interventions will need to be
considered..
To minimize trauma to skin.
As the patient’s level of pressure ulcer risk improves,
the dressing may no longer be required.
For further information, please contact your Wound Clinician.
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