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Review: alternative-foam mattresses and some operating-table overlays reduce pressure ulcers more than standard surfaces

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Do pressure-relieving surfaces reduce pressure ulcers more than standard support surfaces? Are some types of pressure-relieving surfaces more effective than others?


Included studies were randomised controlled trials (RCTs) that compared beds, mattresses, mattress overlays, and cushions in patients at risk of pressure ulcers and reported objective outcomes. Outcomes included incidence of new pressure ulcers.


Medline, CINAHL, EMBASE/Excerpta Medica, CINAHL, Cochrane Wounds Group Specialised Register, CENTRAL, and Cochrane Library (all to Feb 2008), and reference lists were searched. Experts and manufacturers were contacted. 52 RCTs were included.


Constant low-pressure (CLP) supports. Of 8 RCTs comparing CLP supports with standard mattresses, 5 showed a benefit for alternative-foam mattresses (pooled risk reduction [RR] 60%, 95% CI 26 to 79). Water beds (1 RCT, RR 65%, CI 21 to 85) and Beaufort bead beds (1 RCT, RR 68%, CI 24 to 86) reduced pressure ulcers, but viscoelastic foam trolley mattresses did not (1 RCT). In 5 RCTs, a benefit for 1 type …

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  • Source of funding: NIHR; NHS Health Technology Assessment Programme, UK; National Institute of Clinical Excellence Guidelines Programme, UK.