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The objective was to evaluate the efficacy of multi-layered silicone foam (intervention) compared with transparent polyurethane film (control) in preventing heel pressure injuries caused by surgical positioning of individuals undergoing elective surgery. It was designed an intra-patient, open, parallel, randomised controlled trial was conducted in a university hospital in southern Brazil, from March 2019 to February 2020, with patients undergoing elective surgeries of cardiac and gastrointestinal specialties. The patients who met the sel