Intervention: routine care plus dressing
silicone foam
ADHESION
If allocated to the intervention group, participants have a prophylactic sacral dressing applied by a trained research nurse (ResN), following the manufacturer’s instructions. The trial dressing is the Mepilex® Border Sacrum, a foam border silicon dressing available in two sizes to accommodate physical differences of participants. The dressing manufacturer recommends the dressing be changed when the edge begins to roll and/or loses adhesion or becomes soiled. Dressings will also be changed if saturation occurs, if staff accidentally remove the dressing, or if the dressing becomes dislodged.The ResN takes a baseline photograph of the participant’s sacrum and then applies a silicone foam border dressing (Mepilex®). The dressing and sacral skin are visually inspected every day for up to 14 days. The frequency of dressing replacements (with reason, including device deficiencies) will be documented. Participants in the intervention group will continue to receive routine care, as per hospital procedures informed by national standards and international practice guidelines [