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Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial [with consumer summary]
Nixon J, Cranny G, Iglesias C, Nelson EA, Hawkins K, Phillips A, Torgerson D, Mason S, Cullum N
BMJ 2006 Jun 17;332(7555):1413-1415
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To compare whether differences exist between alternating pressure overlays and alternating pressure mattresses in the development of new pressure ulcers, healing of existing pressure ulcers, and patient acceptability. DESIGN: Pragmatic, open, multicentre, randomised controlled trial. SETTING: 11 hospitals in six NHS trusts. PARTICIPANTS: 1,972 people admitted to hospital as acute or elective patients. INTERVENTIONS: Participants were randomised to an alternating pressure mattress (n = 982) or an alternating pressure overlay (n = 990). MAIN OUTCOME MEASURES: The proportion of participants developing a new pressure ulcer of grade 2 or worse; time to development of new pressure ulcers; proportions of participants developing a new ulcer within 30 days; healing of existing pressure ulcers; and patient acceptability. RESULTS: Intention to treat analysis found no difference in the proportions of participants developing a new pressure ulcer of grade 2 or worse (10.7% overlay patients, 10.3% mattress patients; difference 0.4%, 95% confidence interval 2.3% to 3.1%, p = 0.75). More overlay patients requested change owing to dissatisfaction (23.3%) than mattress patients (18.9%, p = 0.02). CONCLUSION: No difference was found between alternating pressure mattresses and alternating pressure overlays in the proportion of people who develop a pressure ulcer. TRIAL REGISTRATION: ISRCTN78646179.
Reproduced with permission from the BMJ Publishing Group.

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