Norwegian studies imply that between 7 and 15 per cent of inpatients develop pressure ulcers. They develop more often in specific groups of patients, like patients with spinal cord injury, hip fracture and patients in intensive care.

Pressure ulcers are areas of localized damage to the skin and underlying tissue, believed to be caused by pressure, shear force or friction. Pressure ulcers occur fast, and have been documented to develop within one hour. Age, immobility, inadequate nutrition, sensory deficiency, multiple comorbidities, reduced activity, circulatory abnormalities, and dehydration have been identified as some of the risk factors.

We included seven systematic reviews on prevention of pressure ulcers published in the Cochrane Database of Systematic Reviews in 2010 or later.

• Nutritional supplements consisting of both energy and protein probably make little or no difference in the reduction of the development of pressure ulcers in patients with poor nutritional status.
• Some mattresses probably reduce the development of pressure ulcers compared to standard foam hospital mattresses. Standard foam hospital mattresses are seldom described. The documen­ta­tion identified is not sufficient for guiding a choice between various foam mattresses. There is a need for an overview of mattresses and pillows that could help the health services to make wise choices in the procurement process.
• Dressings applied over bony prominences may reduce the development of pressure ulcers.
• For several interventions there is uncertainty if they have effect, due to few studies. These interventions comprise repositioning, frequency of repositioning, other types of surfaces compared to alternating pressure, various risk assessment tools, and topical agents applied on bony prominences.

Many interventions were evaluated in just one study. To obtain a more trustworthy result, it is necessary that the studies are repeated.