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Evidence summaries

Beds, Mattresses and Cushions for Pressure Sore Prevention

High specification foam mattresses are more effective than standard hospital foam in the prevention of pressure ulcers. Medical grade sheepskins may decrease pressure ulcer development. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 59 RCTs. 31 trials involved participants without pre-existing pressure ulcers. Ten trials included patients with ulcers greater than or equal to grade 1 at baseline; four trials did not specify the grading of the pre-existing ulcers, and one trial only included people with grade 4 pressure ulcers. In 13 trials the baseline skin status of the participants was unclear.

Foam alternatives to standard hospital foam mattresses reduced the incidence of pressure ulcers in people at risk (RR 0.40 95% CI 0.21 to 0.74). One high-quality trial suggested that alternating-pressure mattresses may be more cost effective than alternating-pressure overlays.Pressure-relieving overlays on the operating table reduced postoperative pressure ulcer incidence, although two studies indicated that foam overlays caused adverse skin changes. Meta-analysis of three trials indicated that Australian standard medical sheepskins prevent pressure ulcers (RR 0.56 95% CI 0.32 to 0.97).

References

Primary/Secondary Keywords