Pressure ulcers, commonly referred to as decubitus ulcers or informally as bed sores, are localized injuries to the skin and underlying tissue caused by sustained pressure or rubbing at the weight-bearing, bony parts of the body of immobilized individuals, such as the hips, elbows and heels. Pressure sores can develop as a result of pressure alone, or pressure combined with forces of friction and shear, and they can progress across different levels of severity based on depth of damage from mild tissue damage to necrosis.
Skin and tissue damage occurs most frequently among individuals who cannot reposition themselves, among the elderly, those who are acutely ill or malnourished, or among persons with neurological deficits, such as those with spinal cord injury. The elderly population is particularly at risk given that the risk of skin tears grows with increasing age as the skin becomes less dense and less vascular. The prevalence of pressure ulcers in Canada ranges between 25.1% in acute care hospitals and 29.9% in long-term care facilities. Pressure ulcers can have a negative impact on the quality of life of the affected individuals, and pose a significant financial burden on the healthcare system.
A number of interventions are currently being used to prevent the development of pressure ulcers in patients at risk of skin ulceration. Pressure ulcer prevention is achieved most commonly by reducing or redistributing pressure at anatomical sites most susceptible for skin and tissue damage; preventive strategies may include the use of special support surfaces (including special beds, mattresses and overlays) designed to redistribute pressure, heel supports, patient repositioning techniques, wheelchair cushions, nutritional supplementation, among others. Despite these established preventive strategies, new and emerging interventions may also be available for efficient pressure ulcer prevention. The purpose of this report is to examine the clinical effectiveness, cost-effectiveness, and evidence-based guidelines regarding the preventive use of emerging technologies in adult patients at risk of developing pressure ulcers in acute care settings.
Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that the Canadian Agency for Drugs and Technologies in Health (CADTH) could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.
