Limited Evidence on Best Approaches for Pressure Ulcer Treatment and Prevention, AHRQ Reviews Find
Limited evidence is available to draw firm conclusions about the best approaches for treating pressure ulcers, a finding consistent with other recent reviews, according to a new research review from AHRQ’s Effective Health Care Program. Given the serious impact pressure ulcers have on health status, costs, and patient quality of life, treatments are needed to promote and shorten healing and minimize the risk of complications. Some evidence suggests wound improvement (reduction in ulcer size) was better on air-fluidized beds compared to other support surfaces, including standard hospital beds. Nutritional supplementation also resulted in wound improvement when used with other measures for treating pressure ulcers. Advancing pressure ulcer care will take more rigorous studies to solidify the evidence base on widely used treatments. These findings can be found in the full review, Pressure Ulcer Treatment Strategies: Comparative Effectiveness. A related research report found that commonly used instruments to assess patients’ risk of pressure ulcers can identify patients at increased risk for ulcers when compared with clinical judgment. Frequently used instruments include the Braden, Norton, and Waterlow scales. In higher risk populations, studies consistently found advanced static support mattresses and overlays were associated with lower risk of pressure ulcers compared with standard mattresses, with no clear differences between different advanced static support surfaces. More research is needed to understand the effectiveness of other preventive interventions in relation to standard care, and the comparative effectiveness of preventive interventions. These findings can be found in the full review, Pressure Ulcer Risk Assessment and Prevention: Comparative Effectiveness.