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Clinical Evidence

Parafricta medical products are designed to address the key nursing goal identified by EPUAP (European Pressure Ulcer Advisory Panel), namely to “protect against the adverse effects of external mechanical forces: pressure, friction and shear on skin”.

Exposure to friction and shear have been shown to be the most important factor from those used in the Braden Scale in explaining of the prevalence of category II ulceration.  Lack of mobility is the most important factor in explaining the prevalence of overall less prevalent category III/IV ulceration, but even in this case friction and shear are a strong secondary factor (Lahmann and Kottner 2011). See References Page

Parafricta medical products offer unique protection against friction and shear, and are compatible with, and complementary to,  all existing methods of mitigating the other main cause of decubitus ulcers i.e. pressure, which contributes to the progression of skin damage to ulceration by restricting blood supply  (e.g. use of pressure reducing mattresses and beds).

A study carried out in a care home setting showed that redness and oedema in heels and sacral areas were greatly reduced over a period of several weeks by the wearing of Parafricta garments.  Hampton, S et al 2009.

There is published clinical data from a 650 eligible patient cohort study carried out on in three wards in a UK general hospital which investigated the effects of routine use of Parafricta in the 359 patients at high or very high risk of developing pressure ulcers according to the Waterlow scoring system.   The number of patients developing pressure ulcers was reduced by 16% (p=0.029) whilst the number of patients who were admitted with pressure ulcers that then improved increased by 21% (p=0.001) in the cohort treated with Parafricta garments.  Smith and Ingram 2010.

 smith-and-ingram-picture

Since Parafricta bootees were introduces into routine use at St Helens and Knowsley Teaching Hospitals NHS Trust in 2012 the incidence of grade 2 heel pressure ulcers has been reduced by 78%  (Gleeson, D 2014 Wounds UK poster presentation)

gleeson-data-summary

References & Websites

Clinical Investigation

Hampton, S et al, “Parafricta material, can it reduce the potential for pressure damage?”  Journal of Community Nursing 23(4) (2009) 28-31

Smith, G and Ingram, A “Clinical and cost effectiveness evaluation of low friction and shear garments” Journal of Wound Care 19(12) (2010) 535-42

Stephen-Haynes, J and Callaghan, R “Clinical outcomes using a low friction garment in the care home setting” Wounds UK 7 (4) (2011)

Gleeson, D “Pressure ulcer reduction using low-friction fabric bootees” British Journal of Nursing (Tissue Viability Supplement) 24 (6) (2015)

The Role of Friction and Shear in Skin Damage

Hampton,S “Reducing shear forces: Parafricta fabric” Nurs Residential Care 9(12) (2007) 580-2

Bree-Aslan, C and Hampton, S “Parafricta and the prevention of shearing forces: heel ulcers” Nurs Residential Care 10(1) (2008) 626-8

Lahmann, N and Kottner, “Relation between pressure, friction and pressure ulcer categories: A secondary data analysis of hospital patients using CHAID methods” International Journal of Nursing Studies 48 (2011) 1487-1494.

Lahmann, N and Kottner, “Friction and shear highly associated with pressure ulcers of residents in long-term care – Classification Tree Analysis (CHAID) of Braden items” Journal of Evaluation in Clinical Practice 17 (2011) 168–173.

Conner L and Clack J “In vivo CT scan comparison of vertical shear in human tissue caused by various support surfaces” Decubitus 6(2) (1993) 20-23, 26-28

L.-C. Gerhardt, N. Mattle, G. U. Schrade, N. D. Spencer and S. Derler, “Study of skin–fabric interactions of relevance to decubitus: friction and contact-pressure measurements”, Skin Research and Technology 2008; 14: 77–88.

L.-C. Gerhardt, A. Lenz, N. D. Spencer, T. Munzer and S. Derler, “Skin–textile friction and skin elasticity in young and aged persons”, Skin Research and Technology 2009, 15, 288–298.

M Snycerski, I Frontczak-Wasiak “A functional woven fabric with controlled friction coefficients preventing bedsores”, AUTEX Research Journal vol. 4, no. 3 September 2004.

Metin Yavuz, Georgeanne Botek, and Brian L. Davis, “Plantar shear stress distributions: Comparing actual and predicted frictional forces at the foot-ground interface”, J Biomech. 2007 ; 40(13): 3045–3049

Cost of Skin Damage

Dealey, C , Posnett, J and Walker A (2012) “The cost of pressure ulcers in the United Kingdom”  Journal of Wound Care 21 (6) 261-266