OBJECTIVE: To estimate the effectiveness of a new high-performance Australian medical sheepskin (meeting Australian Standard 4480.1-1998) in preventing pressure ulcers in a general hospital population at low to moderate risk of these ulcers. DESIGN: Open-label randomised controlled clinical trial. SETTING: A large metropolitan teaching hospital in Melbourne, Victoria, in 2000. PARTICIPANTS: 441 patients aged over 18 years admitted between 12 June and 30 November 2000, with expected length of stay over 2 days and assessed as at low to moderate risk of developing pressure ulcers. INTERVENTION: Patients were randomly allocated to receive a sheepskin mattress overlay for the duration of their hospital stay (218 patients) or usual treatment, as determined by ward staff (referent group, 223 patients). MAIN OUTCOME MEASURES: Incidence rate and cumulative incidence of pressure ulcers, assessed daily throughout hospital stay. RESULTS: 58 patients developed pressure ulcers (sheepskin group, 21; referent group, 37). Cumulative incidence risk was 9.6% in the sheepskin group (95% CI 6.1% to 14.3%) versus 16.6% in the referent group (95% CI 12.0% to 22.1%). Patients in the sheepskin group developed new pressure ulcers at a rate less than half that of referent patients (rate ratio 0.42; 95% CI 0.26 to 0.67). CONCLUSIONS: The Australian Medical Sheepskin is effective in reducing the incidence of pressure ulcers in general hospital inpatients at low to moderate risk of these ulcers.

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