Pressure Ulcers: The Benefits and Costs of New Therapies

Abstract

To the Editor. —Ferrell et al1are to be congratulated for a well-designed study that has added to the body of literature concerning the treatment of pressure ulcers. In developing a clinical practice guideline on pressure ulcers in adults,2the Agency for Health Care Policy and Research reviewed 13 clinical studies examining the effects of pressure-reducing devices on the incidence of pressure ulcers, only three of which were randomized controlled trials. They concluded that although there is evidence pressure-reducing devices can decrease the incidence of pressure ulcers, there is no evidence to suggest that one type of device is more effective than another. One problem with the present study is that it compares newer, high-cost, low-air-loss bed technology with a basic foam mattress. Other available devices include gel-foam mattresses, full-gel mattresses, and alternating air support mattresses. There are also important roles for aggressive risk assessment, education, and skin