Preventing pressure ulcers—are pressure-redistributing support surfaces effective?: a Cochrane systematic review and meta-analysis

McInnes, Elizabeth, Jammali-Blasi, Asmara, Bell-Syer, Sally, Dumville, Jo and Cullum, Nicky (2012) Preventing pressure ulcers—are pressure-redistributing support surfaces effective?: a Cochrane systematic review and meta-analysis. International Journal of Nursing Studies, 49 3: 345-359. doi:10.1016/j.ijnurstu.2011.10.014


Author McInnes, Elizabeth
Jammali-Blasi, Asmara
Bell-Syer, Sally
Dumville, Jo
Cullum, Nicky
Title Preventing pressure ulcers—are pressure-redistributing support surfaces effective?: a Cochrane systematic review and meta-analysis
Journal name International Journal of Nursing Studies   Check publisher's open access policy
ISSN 0020-7489
1873-491X
Publication date 2012-03
Sub-type Article (original research)
DOI 10.1016/j.ijnurstu.2011.10.014
Open Access Status
Volume 49
Issue 3
Start page 345
End page 359
Total pages 15
Place of publication Bromley, United Kingdom
Publisher Elsevier
Language eng
Formatted abstract
Objectives
To undertake a systematic review of the effectiveness of pressure redistributing support surfaces in the prevention of pressure ulcers.

Design
Systematic review and meta-analysis.

Data sources
Cochrane Wound Group Specialised Register, The Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE and EBSCO CINAHL. The reference sections of included trials were searched for further trials.

Review methods
Randomised controlled trials and quasi-randomised trials, published or unpublished, which assessed the effects of support surfaces in preventing pressure ulcers (of any grade), in any patient group, in any setting compared to any other support surface, were sought. Two reviewers extracted and summarised details of eligible trials using a standardised form and assessed the methodological quality of each trial using the Cochrane risk of bias tool.

Results
Fifty-three eligible trials were identified with a total of 16,285 study participants. Overall the risk of bias in the included trials was high. Pooled analysis showed that: (i) foam alternatives to the standard hospital foam mattress reduce the incidence of pressure ulcers in people at risk (RR 0.40, 95% CI 0.21–0.74) and Australian standard medical sheepskins prevent pressure ulcers compared to standard care (RR 0.48, 95% CI 0.31–0.74). Pressure-redistributing overlays on the operating table compared to standard care reduce postoperative pressure ulcer incidence (RR 0.53, 95% CI 0.33–0.85).

Conclusions
While there is good evidence that higher specification foam mattresses, sheepskins, and that some overlays in the operative setting are effective in preventing pressure ulcers, there is insufficient evidence to draw conclusions on the value of seat cushions, limb protectors and various constant low pressure devices. The relative merits of higher-tech constant low pressure and alternating pressure for prevention are unclear. More robust trials are required to address these research gaps.
Keyword Pressure ulcer
Prevention
Review
Hospital equipment
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Thu, 22 May 2014, 09:40:55 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work