Prevention and treatment of pressure sores--a neglected research subject? An overview of clinically controlled studies in the period 1987-91

Abstract

Pressure sores are frequently seen in elderly hospitalized patients and leads to prolonged hospitalization and increased morbidity and mortality. The object of this paper was to retrieve the last five years literature regarding prevention and treatment of pressure sores. During the period 1987-1991, 751 papers on this topic were published and indexed in Medline. Only 9 of these papers represented controlled clinical trials. Three of them dealt with prevention, and the remaining 6 with treatment. Although 4 of 9 studies showed statistically significant differences between the actively treated group and the placebo group, none of the studies showed convincing clinical differences. Serious methodological flaws with respect to design, blinding, randomisation, sample size and statistical analysis were found in 8 of 9 studies. None of the clinical controlled studies on prevention of pressure sores showed any statistically significant differences between the control group and treatment with, respectively Prevasore lotion, Foam cushion and Silicore mattress. In the 6 trials on treatment of pressure sores, respectively mucopolysaccharide polysulphate creme, ketanserin creme and air-fluidized beds showed statistically better results than control treatment. We conclude that well-designed controlled clinical trials are needed to establish rational routines for prevention and treatment of pressure sores.