Review: specially designed products to prevent or heal pressure sores are more effective than standard mattresses
QUESTION: In patients who are at risk of pressure sores, are pressure relieving beds, mattresses, and cushions (support surfaces) effective for preventing and treating pressure sores?
Randomised controlled trials (RCTs) were identified by searching 19 databases from their inception to 1997, hand searches of 5 wound care journals, conference abstracts, bibliographies of relevant studies and review articles, and contact with experts and manufacturers. Unpublished data were also sought.
Interventions included standard or specialised foam mattresses or overlays; gel, fibre, or water filled mattresses or overlays; alternating pressure mattresses or overlays; air fluidised, bead, or low air loss beds; sheepskins; turning beds or frames; wheelchair cushions; or operating table overlays; and outcomes were incidence or healing rates of sores, cost, comfort, reliability, and acceptability.
Data were extracted on study quality, inclusion and exclusion criteria, baseline characteristics, settings, interventions, follow up, outcomes, acceptability, and reliability.
37 RCTs met the inclusion criteria. Methodological quality was generally poor, many settings and products were studied, and sample size was often small. 29 RCTs studied patients without pre-existing pressure …