Support surfaces for treating pressure injury: a Cochrane systematic review

Objectives: To examine the effects on healing of pressure relieving support surfaces in the treatment of pressure injury.Design: Systematic review.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sections of included trials were searched for further trials.Review methods: Randomised controlled trials, published or unpublished, assessing the effect of support surfaces in treating all pressure injuries were sought. All included studies had to have reported objective measures of pressure injury healing. Where possible, findings from individual trials were calculated using risk ratio estimates or mean difference with 95% confidence intervals.Results: Eighteen eligible trials involving 1309 participants were identified. There was no statistically significant effect on pressure injury size with low air loss devices compared with foam alternatives. One small trial at high risk of bias found that sheepskin positioned under the legs significantly reduced redness and a very small subgroup analysis favoured a profiling bed when compared with a standard bed in terms of the healing of grade 1 pressure injuries.Conclusions: Overall, there was an absence of good evidence to support the superiority of any pressure relieving device in the treatment of pressure injuries. This review highlights that the current evidence base requires improving by undertaking robust trials to ascertain which support surfaces are most effective for the treatment of pressure injuries. (C) 2012 Elsevier Ltd. All rights reserved