Pressure sores are relatively common and represent major costs to patients, their carers and to the NHS.
Pressure-relief by manual repositioning of patients, special mattresses, mattress overlays and beds is used to prevent sores in high risk patients, and to treat people with existing sores.
Pressure sore prevalence rates should not be used as a measure of the quality of care; incidence rates may only be used as an indicator of the quality of preventive care if the risk of developing a sore is taken into account.
The evidence on the accuracy of pressure sore risk scales is confusing, and it is not clear that these scales are better than clinical judgement or that they improve outcomes.
The effectiveness of different schedules of manual repositioning has not been adequately studied.
The standard hospital mattress is less effective at preventing sores than some low pressure foam mattresses.
Most of the equipment available for the prevention and treatment of pressure sores has not been reliably evaluated, and no 'best buy' can be recommended.
Patients at raised risk of developing a pressure sore should be provided either with an evaluated low pressure foam mattress or, if at higher risk, with a large-celled alternating pressure mattress or a proven low-air loss or air-fluidised bed. However, there is insufficient research evidence on clinical- or cost-effectiveness to guide equipment choice.
