[Prevention of pressure ulcers--review of the evidence]

Pressure ulcers continue to constitute a health problem for people who are physically limited or bedridden, particularly among the elderly and victims of spinal cord injuries. The problem exists across the entire health framework, including hospitals, clinics, long-term care facilities and homes. The prevention of pressure ulcers is of prime importance, as most of them are preventable by means of a high level of awareness and by implementing preventive measures. These measures must be taken from the moment of admission or immobilization. Such preventive measures can save much suffering and expense to the family and the medical establishment alike. A pressure ulcer may develop in a matter of hours, whereas the cure takes many months, if at all. The complications of pressure ulcers are protean: they may serve as a conduit of pathogens, to prolong hospitalization, and to increase the risk of death. The diminution of the quality of life of the affected patient results from pain, discomfort, unpleasant odors from discharges, isolation and resultant depression. The prevention of pressure ulcers requires the involvement of a number of interventions, most of which have not undergone rigorous prospective randomized controlled studies. Recently, a systematic review has been undertaken to evaluate just such interventions. The preventive interventions that were reviewed include devices to relieve pressure, repositioning, exercise to assist bladder control, nutritional supplementation and moisturizing skin. The resultant recommendations appear in this review article.