Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers
Shi, C., Dumville, J. C., Cullum, N., Rhodes, S. and McInnes, E.. (2021). Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers. Cochrane Database of Systematic Reviews. (5), pp. 1-121. https://doi.org/10.1002/14651858.CD013623.pub2
|Authors||Shi, C., Dumville, J. C., Cullum, N., Rhodes, S. and McInnes, E.|
Data collection and analysis
Primary outcome: Pressure ulcer incidence
We did not find analysable data for two comparisons: reactive water surfaces versus foam surfaces, and reactive water surfaces versus reactive fibre surfaces. Reactive gel surfaces used on operating tables followed by foam surfaces applied on hospital beds (14/205 (6.8%)) may increase the proportion of people developing a new pressure ulcer compared with alternating pressure (active) air surfaces applied on both operating tables and hospital beds (3/210 (1.4%) (risk ratio 4.53, 95% confidence interval 1.31 to 15.65; 2 studies, 415 participants; I2 = 0%; low‐certainty evidence). For all other comparisons, it is uncertain whether there is a difference in the proportion of participants developing new pressure ulcers as all data were of very low certainty.
Included studies did not report time to pressure ulcer incidence for any comparison in this review.
Support‐surface‐associated patient comfort: the included studies provide data on this outcome for one comparison. It is uncertain if there is a difference in patient comfort between alternating pressure (active) air surfaces and reactive fibre surfaces (one study with 187 participants; very low‐certainty evidence).
All reported adverse events: there is evidence on this outcome for one comparison. It is uncertain if there is a difference in adverse events between reactive gel surfaces followed by foam surfaces and alternating pressure (active) air surfaces applied on both operating tables and hospital beds (one study with 198 participants; very low‐certainty evidence).
We did not find any health‐related quality of life or cost‐effectiveness evidence for any comparison in this review.
Future research in this area should consider evaluation of the most important support surfaces from the perspective of decision‐makers. Time‐to‐event outcomes, careful assessment of adverse events and trial‐level cost‐effectiveness evaluation should be considered in future studies. Trials should be designed to minimise the risk of detection bias; for example, by using digital photography and adjudicators of the photographs being blinded to group allocation. Further review using network meta‐analysis will add to the findings reported here.
|Journal||Cochrane Database of Systematic Reviews|
|Journal citation||(5), pp. 1-121|
|Publisher||John Wiley & Sons|
|Digital Object Identifier (DOI)||https://doi.org/10.1002/14651858.CD013623.pub2|
|Open access||Published as ‘gold’ (paid) open access|
|Research or scholarly||Research|
File Access Level
|Online||06 May 2021|
|Publication process dates|
|Deposited||29 Jul 2021|
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