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Cullum 20047

Any patient care setting (41 RCTs) 32 of the trials assessed mattresses or overlays in acute or critical care. These RCTs were published between 1982 and 2002. Only 5 studies were published from the year 2000 and forward.

Pressure-relieving cushions, beds, mattress overlays and mattress replacements versus standard support surfaces

One study (McGowan et al. 2000) looked at other interventions in addition to mattresses and is not targeted by this request.

Specialty Mattresses for Prevention of PUs in Acute and Critical Care

Nixon et al. (2006)9 in the PRESSURE trial found no statistically significant difference between alternating pressure mattress replacements and overlays in terms of proportion of patients [10.7% overlay patients, 10.3% mattress replacement patients, a difference of 0.4%, 95% confidence interval (CI) -2.3 to 3.1%, p = 0.75]; but found a delay in time to ulceration of 10.64 days on average 95% CI -24.40 to 3.09) (N=1971)

Three other studies found no differences comparing static versus standard devices. (Feuchtinger et al. 20068; Russel et al. 200313; and, Gunningberg et al. 200017) Two other trials found no differences in the incidence of PUs comparing dynamic 1 (devices with an alternative motion) versus static devices (Vanderwee et al. 2005 and Russell and Lichtenstein et al. 200015) 2 studies were already included in the Reddy report (Russell and L i c h t e n s t e i n e t a l . 2 0 0 0 1 5 ; a n d G u n n i n g b e r g e t a l . 2 0 0 One study (Russell et al. 200213) compared the CONFOR-Med foam mattress and cushion combination to the standard mattress and cushion combination in an elderly acute population, the results were not significant. One study (Keogh & Dealey 200116) found no difference when comparing a profiling bed with a pressure reducing foam mattress/cushion with a flat-based bed with a pressure relieving/redistributing mattress/cushion in patients from a surgical ward and two medical wards over 18 years of age. 0 1 7 ) 11

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