Preventing Pressure Ulcers: A Systematic Review

作者：Madhuri Reddy, Sudeep S. Gill, Paula A. Rochon · 发表于：JAMA · 年份：2006 · DOI：10.1001/jama.296.8.974 · 被引用次数：820 · 研究领域：Pressure Ulcer Prevention and Management、Wound Healing and Treatments、Surgical site infection prevention

CONTEXT: Pressure ulcers are common in a variety of patient settings and are associated with adverse health outcomes and high treatment costs. OBJECTIVE: To systematically review the evidence examining interventions to prevent pressure ulcers. DATA SOURCES AND STUDY SELECTION: MEDLINE, EMBASE, and CINAHL (from inception through June 2006) and Cochrane databases (through issue 1, 2006) were searched to identify relevant randomized controlled trials (RCTs). UMI Proquest Digital Dissertations, ISI Web of Science, and Cambridge Scientific Abstracts were also searched. All searches used the terms pressure ulcer, pressure sore, decubitus, bedsore, prevention, prophylactic, reduction, randomized, and clinical trials. Bibliographies of identified articles were further reviewed. DATA SYNTHESIS: Fifty-nine RCTs were selected. Interventions assessed in these studies were grouped into 3 categories, ie, those addressing impairments in mobility, nutrition, or skin health. Methodological quality for the RCTs was variable and generally suboptimal. Effective strategies that addressed impaired mobility included the use of support surfaces, mattress overlays on operating tables, and specialized foam and specialized sheepskin overlays. While repositioning is a mainstay in most pressure ulcer prevention protocols, there is insufficient evidence to recommend specific turning regimens for patients with impaired mobility. In patients with nutritional impairments, dietary supplements may be beneficia...