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Alternating pressure mattresses were more cost effective than alternating pressure overlays for preventing pressure ulcers

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Q What is the relative cost effectiveness of alternating pressure mattresses and alternating pressure overlays for preventing pressure ulcers in hospital patients with limited mobility?


Embedded ImageDesign:

randomised controlled trial (RCT).

Embedded ImageSetting:

10 hospitals in the UK.

Embedded ImagePatients:

1972 patients ⩾55 years of age (mean age 75 y, 64% women) admitted to vascular, orthopaedic, medical, or elderly care wards in the previous 24 hours, with an expected hospital stay of ⩾7 days and limited activity and mobility (Braden scores of 1 or 2) or existing grade 2 pressure ulcer. Elective surgical patients were included if they were expected to have limited mobility for ⩾3 days postoperatively. Exclusion criteria included ⩾ grade 3 pressure ulcer, planned admission to intensive care ward after surgery, sleeping at night in a chair, and weight <45 kg or >140 kg.

Embedded ImageIntervention:

alternating pressure overlay (n = 990) or alternating pressure mattress (n = 982) for duration of ward stay or until mobility improved to a Braden score of 3 or …

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  • For correspondence: Professor N Cullum, University of York, York, UK. nac2{at}

  • Source of funding: Health Technology Assessment Programme of the UK Department of Health.