Prevention and treatment of pressure ulcers

Topics: Risk assessment, Randomized controlled trial, Risk Pages: 1 (836 words) Published: July 31, 2015
● An exclusive summary of new NICE

guidance from a member of the
guideline development group

Nursing Practice
Evidence in brief
Tissue viability

and feedback; redesigning documentation
Evidence reviews find little to support particular interventions for pressure ulcers, although bundles of interventions may be effective and reporting processes; and use of risk

Prevention and
treatment of
pressure ulcers


ational Institute for Health and
Care Excellence (2003) guidance on pressure ulcer prevention (currently being updated) recommends that all people at risk of pressure ulcers should, as a minimum provision, be placed on a high-specification foam mattress with pressure-relieving

Further NICE (2005) guidance on the
management of pressure ulcers (also being
updated) notes that there is no conclusive
evidence that any one pressure-relieving
support technology is superior to another.

New evidence

Chou et al (2013) reviewed 67 randomised
controlled trials and cohort studies
looking at the effects of risk assessment
tools and preventive strategies on the incidence and severity of pressure ulcers. The authors concluded that risk assessment tools, such as the Waterlow scale, and most types of support surfaces except

advanced static mattresses, had no effect
on the prevention of pressure ulcers. Likewise, nutritional support, repositioning,

and dressings and pads had no clear beneficial effects. However, two trials reported some reduction in incident pressure ulcers
with cleansers and fatty acid creams.
Smith et al (2013) reviewed 174 studies
of treatment strategies for adults with
pressure ulcers. Support surfaces, nutrition support, local wound applications and adjunctive therapies had no effect
on complete wound healing compared
with standard care, placebo or sham interventions. Some moderate-strength evidence suggested that air-fluidised beds, protein-containing nutritional supplements, electrical...

References: Chou R et al (2013) pressure ulcer risk assessment
and prevention: a systematic comparative
National Institute for Health and Care Excellence
(2005) Pressure Ulcers: the Management Of
(2003) Pressure Ulcer Prevention: Pressure Ulcer
Risk Assessment and Prevention, Including the Use
Smith ME et al (2013) Pressure ulcer treatment
Sullivan N, Schoelles K (2013) Preventing in-facility
pressure ulcers as a patient safety strategy: a
Chou et al (2013) and Smith et al (2013)
will be disappointing for health
that the Chou et al (2013) review found
no evidence in support of pressure ulcer
(2013) treatment review are largely based
on clinically irrelevant comparisons (for
In contrast, the Sullivan and Schoelles
(2013) review concluded that bundling
the single interventions studied by Chou
et al (2013).
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