Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb 12;2014(2):CD005485.
doi: 10.1002/14651858.CD005485.pub3.

Pressure-relieving devices for treating heel pressure ulcers

Elizabeth McGinnis  1 , Nikki Stubbs
Affiliations

Pressure-relieving devices for treating heel pressure ulcers

Elizabeth McGinnis et al. Cochrane Database Syst Rev. .

Abstract

Background: Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure or shear. Pressure redistribution devices are used as part of the treatment to reduce the pressure on the ulcer. The anatomy of the heel and the susceptibility of the foot to vascular disease mean that pressure ulcers located there require a particular approach to pressure relief.

Objectives: To determine the effects of pressure-relieving interventions for treating pressure ulcers on the heel.

Search methods: In May 2013, for this first update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid EMBASE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); and EBSCO CINAHL. No language or publication date restrictions were applied.

Selection criteria: We included randomised controlled trials (RCTs) that compared the effects of pressure-relieving devices on the healing of pressure ulcers of the heel. Participants were treated in any care setting. Interventions were any pressure-relieving devices including mattresses and specific heel devices.

Data collection and analysis: Both review authors independently reviewed titles and abstracts and selected studies for inclusion. Both review authors independently extracted data and assessed studies for risk of bias.

Main results: In our original review, only one study met the inclusion criteria. This study (141 participants) compared two mattress systems; however, losses to follow up were too great to permit reliable conclusions. We did not find any further relevant studies during this first update.

Authors' conclusions: This review identified one small study at moderate to high risk of bias which provided no evidence to inform practice. More research is needed.

PubMed Disclaimer

Conflict of interest statement

Nikki Stubbs receives funding from the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP‐PG‐0407‐10428). The views expressed in this review are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.

Nikki Stubbs has received funding from Pharmaceutical companies to support training and education events in the service and payments have been received by the author for non product related educational sessions. These have been unrelated to the subject matter of this systematic review and have never been in support or in pursuit of the promotion of products.

Elizabeth McGinnes has been supported in her academic studies by the following charitable organisations: Leeds Teaching Hospitals NHS Trust Charitable Trustees and the Smith & Nephew Foundation/ Multiple Sclerosis Society. The systematic review was part of her thesis.

Figures

1
1
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
2
2
Flow chart for patients with heel ulcers recruited by Russell (2000) in the study
1.1
1.1. Analysis
Comparison 1 Nimbus system compared with Cairwave system, Outcome 1 Heel ulcer healed.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Russell 2000 {published and unpublished data}
    1. Russell L, Reynolds TM. Randomised controlled trial of two pressure‐relieving systems. Journal of Wound Care 2000;9(2):52‐5. - PubMed

References to studies excluded from this review

Allman 1987a {published data only}
    1. Allman RM, Keruly JC, Smith CR. Cost effectiveness of air‐fluidized beds versus conventional therapy for pressure sores. Clinical Research 1987;35(3):A728. - PubMed
Allman 1987b {published data only}
    1. Allman RM, Walker JM, Hart MK, Laprade CA, Noel LB, Smith CR. Air‐fluidized beds or conventional therapy for pressure sores. A randomized trial. Annals of Internal Medicine 1987;107(5):641‐8. - PubMed
Andrews 1989 {published data only}
    1. Andrews J, Balai R. The prevention and treatment of pressure sores by use of pressure distributing mattresses. Care Science and Practice 1989;7(3):72‐6. - PubMed
Bates Jenson 1998 {published data only}
    1. Bates Jenson BM. A quantitative analysis of wound characteristics as early predictors of healing in pressure sores. Dissertation. University of California, LosAngeles 1998.
Bell 1993 {published data only}
    1. Bell JC, Matthew SD. Results of a clinical investigation of four pressure reduction replacement mattresses. Journal of ET Nursing 1993;20(5):204‐10. - PubMed
Benbow 1995 {published data only}
    1. Benbow M. Easing the pressure. Nursing Times 1995;91(47):64,68,70. - PubMed
Bennett 1998 {published data only}
    1. Bennett RG, Baran PJ, DeVone LV, Bacetti H, Kristo B, Tayback M, et al. Low air loss hydrotherapy versus standard care for incontinent hospitalized participants. Journal of American Geriatric Society 1998;46(5):569‐76. - PubMed
Blanco Blanco 2002 {published data only (unpublished sought but not used)}
    1. Blanco Blanco J, Ballester Torralba J, Rueda Lopez J, Torra i Bou JE. Comparative study of the use of a heel protecting bandage and a special hydrocellular dressing in the prevention of pressure ulcers in elderly participants. 12th Conference of the EWMA, Granada, Spain, May 23‐25. 2002:114.
Bliss 1966 {published data only}
    1. Bliss MR, McLaren R, Exton Smith AN. Mattresses for preventing pressure sores in geriatric participants. Monthly Bulletin of the Ministry of Health and Public Health Laboratory Service 1966;25:238‐68. - PubMed
Bliss 1967 {published data only}
    1. Bliss MR, McLaren R, Exton Smith AN. Preventing pressure sores in hospital: controlled trial of a large‐celled ripple mattress. British Medical Journal 1967;67(1):394‐7. - PMC - PubMed
Bliss 1995 {published data only}
    1. Bliss MR. Preventing pressure sores in elderly participants: a comparison of seven mattress overlays. Age and Aging 1995;24(4):297‐302. - PubMed
Braniff‐Matthews 1997 {published data only (unpublished sought but not used)}
    1. Braniff‐Matthews C, Rhodes J. Prevention versus treatment: long‐term management of care. European Wound Management Association Conference; 1997, 27‐29 April; Milan, Italy. 1997:6.
Branom 1999 {published data only (unpublished sought but not used)}
    1. Branom R, Knox L. Low air loss vs non powered/dynamic surfaces in wound management. 31st Annual Wound, Ostomy and Continence Conference: Minneapolis, MN, USA. 1999:483.
Branom 2001 {published data only}
    1. Branom R, Rappl LM. 'Constant force technology' versus low air loss therapy in the treatment of pressure ulcers. Ostomy/Wound Management 2001;47(9):38‐46. - PubMed
Bridel‐Nixon 1997 {published data only}
    1. Bridel‐Nixon J, McElvenny D, Brown J, Mason S. A randomized controlled trial using a double‐triangular sequential design: methodology and management issues. European Wound Management Association Conference; 1997, 27‐29 April; Milan, Italy. 1997:65‐66.
Brown 2001 {published data only}
    1. Brown SJ. Bed surfaces and pressure sore prevention: an abridged report. Orthopaedic Nursing 2001;20(4):38‐40. - PubMed
Caley 1994 {unpublished data only}
    1. Caley L, Jones S, Freer J, Muller JS. Two types of low air loss therapy. Personal Communication 1994:378‐380.
Chaloner 2000 {published data only}
    1. Chaloner D. A prospective controlled comparison between two dynamic alternating mattress replacement systems within a community setting. 9th European Conference on Advances in Wound Management: Harrogate, UK, November 9‐11 1999. 2000:9‐11.
Cheneworth 1994 {published data only (unpublished sought but not used)}
    1. Cheneworth CC, Hagglund KH, Valmassoi B, Brannon C. Portrait of practice: healing of heel ulcers. Advances in Wound Care 1994;7(2):44‐8. - PubMed
Clark 2002 {published data only}
    1. Clark M, Benbow M, Butcher M, Gebhardt K, Teasley G, Zoller J. Collecting pressure ulcer prevention and management outcomes: 1. British Journal of Nursing 2002;11(4):230, 232, 234. - PubMed
Collins 2002 {published data only}
    1. Collins AS, Todd R, McCoy A, Deitz G, Pruitt D, Garner M, et al. Stride right. Nursing Management 2002;33(9):33‐6. - PubMed
Conine 1990a {published data only}
    1. Conine TA, Daechsel D, Lau MS. The role of alternating air and Silicore overlays in preventing decubitus ulcers. International Journal of Rehabilitation Research 1990;13(1):57‐65. - PubMed
Conine 1990b {published data only}
    1. Conine TA, Daechse lD, Choi AK, Lau MS. Costs and acceptability of two special overlays for the prevention of pressure sores. Rehabilitation Nursing 1990;15(3):133‐7. - PubMed
Crook 1998 {published data only (unpublished sought but not used)}
    1. Crook H. Using a low‐pressure inflatable support system in the prevention of pressure sores in orthopaedic participants. European Wound Management Association Conference; 1998 November; Harrogate, UK. 1998:24.
Cullum 2001 {published data only}
    1. Cullum N, Nelson EA, Flemming K, Sheldon T. Systematic reviews of wound care management: (5) beds; (6) compression; (7) laser therapy, therapeutic ultrasound, electrotherapy and electromagnetic therapy. Health Technology Assessment 2001; Vol. 5, issue 9:1‐221. - PubMed
Day 1990 {published data only}
    1. Day AL, Leonard FE, Racz TM. Developing a research approach for the treatment of pressure ulcers. Ostomy/Wound Management 1990 Nov‐Dec;31:30‐6. - PubMed
Day 1993 {published data only (unpublished sought but not used)}
    1. Day A, Leonard F. Seeking quality care for participants with pressure ulcers. Decubitus 1993;6(1):32‐43. - PubMed
De Keyser 1994 {published data only}
    1. Keyser G, Dejaeger E, DeMeyst H, Eders GC. Pressure‐reducing effects of heel protectors. Advanced Wound Care 1994;7(4):30‐2, 34. - PubMed
Devine 1995a {published data only (unpublished sought but not used)}
    1. Devine B. Alternating pressure air mattresses in the management of established pressure sores. Journal of Tissue Viability 1995;5(3):94‐8.
Devine 1995b {published data only}
    1. Devine BL. Alternating pressure air mattresses in the management of established pressure sores. Proceedings of the 5th European Conference on Advances in Wound Management: Harrogate, UK, November 21‐24. 1995:19‐20.
Ernst 2009 {published data only}
    1. Ernst AA. Review: little evidence exists for type of dressing or support surface or for nutritional supplements for pressure ulcers. ACP Journal Club 2009; Vol. 151, issue 1. - PubMed
Evans 2000 {published data only (unpublished sought but not used)}
    1. Evans D, Land L, Geary A. A clinical evaluation of the Nimbus 3 alternating pressure mattress replacement system. Journal of Wound Care 2000;9(4):181‐6. - PubMed
Ewing 1964 {published data only}
    1. Ewing MR, Garrow C, Pressley TA, Ashley C, Kinsella NM. Further experiences in the use of sheepskins as an aid to nursing. Medical Journal of Australia 1964;2:139‐41. - PubMed
Ferrell 1993 {published data only}
    1. Ferrell B, Keeler E, Siu A, Ahn S, Osterweil D. Cost‐effectivness of low‐air‐loss beds for treatment of pressure ulcers. Journal of Gerontology 1995;50A(3):M141‐6. - PubMed
    1. Ferrell BA, Osterweil D, Christenson P. A randomised trial of low air loss beds for treatment of pressure ulcers. JAMA 1993;269(4):494‐7. - PubMed
Fleischer 1997 {published data only}
    1. Fleischer I, Bryant D. Evaluating replacement mattresses. Nursing Management 1997;28(8):38‐42. - PubMed
Goldstone 1982 {published data only}
    1. Goldstone LA, Norris M, O'Reilly M, White J. A clinical trial of a bead bed system for the prevention of pressure sores in elderly orthopaedic participants. Journal of Advanced Nursing 1982;7(6):545‐8. - PubMed
Gray 1998 {published data only (unpublished sought but not used)}
    1. Gray D, Smith M. A randomized controlled trial of two pressure‐reducing foam mattresses. European Wound Management Association Conference; 1998 November; Harrogate, UK. 1998:4.
Greer 1988 {published data only}
    1. Greer DM, Morris J, Walsh NE, Glenn AM, Keppler J. Cost‐effectiveness and efficacy of air‐fluidized therapy in the treatment of pressure ulcers. Journal of Enterostomal Therapy 1988;15(6):247‐51. - PubMed
Groen 1999 {published data only}
    1. Groen HW, Groenier KH, Schuling J. Comparative study of a foam mattress and a water mattress. Journal of Wound Care 1999;8(7):333‐5. - PubMed
Hardin 2000 {published data only}
    1. Hardin JB, Cronin SN, Cahill K. Comparison of the effectiveness of two pressure‐relieving surfaces: low‐air‐loss versus static fluid. Ostomy/Wound Management 2000;49(9):50‐6. - PubMed
Henn 2004 {published data only (unpublished sought but not used)}
    1. Henn G, Russell L, Towns A, Taylor H. A Two‐centre prospective study to determine the utility of a dynamic mattress and mattress overlay. 2nd World Union of Wound Healing Societies Meeting; 2004 July 8‐13; Paris, France. 2004:54.
Johnson 1991 {published data only (unpublished sought but not used)}
    1. Johnson G, Daily C, Francisus V. A clinical study of hospital replacement mattresses. Journal of ET Nursing 1991;18(5):153‐7. - PubMed
Knight 1999 {published data only (unpublished sought but not used)}
    1. Knight M, Simpson J, Fear‐Price M. An evaluation of pressure‐reducing overlay mattresses in the community situation. 9th European Conference on Advances in Wound Management; November 9‐11; Harrogate, UK. 1999:25.
Knowles 1999 {published data only}
    1. Knowles C, Horsey I. Clinical evaluation of an electronic pressure‐relieving mattress. British Journal of Nursing 1999;8(20):1392‐5. - PubMed
Land 2000 {published data only (unpublished sought but not used)}
    1. Land L, Evans D, Geary A, Taylor C. A clinical evaluation of an alternating‐pressure mattress replacement system in hospital and residential care settings. Journal of Tissue Viability 2000;10(1):6‐11. - PubMed
Laurent 1997 {published data only}
    1. Laurent S. Effectiveness of pressure decreasing mattresses in cardiovascular surgery participants: a controlled clinical trial. 3rd European Conference for Nurse Managers; 1997 Oct; Brussels, Belgium. 1997.
Lazzara 1991 {published data only}
    1. Lazzara DJ, Buschmann MT. Prevention of pressure ulcers in elderly nursing home residents: are special support surfaces the answer?. Decubitus 1991;4(4):42‐6. - PubMed
Marchand 1993 {published data only}
    1. Marchand AC, Lidowski H. Reassessment of the use of genuine sheepskin for pressure ulcer prevention and treatment. Decubitus 1993;6(1):44‐7. - PubMed
Melland 1998 {published data only}
    1. Melland HI, Langemo D, Hanson D, Olson B, Hunter S. Clinical trial of the Freedom bed. Prairie Rose 1998;67(2):11a‐12a. - PubMed
Moody 1993 {published data only (unpublished sought but not used)}
    1. Moody M. The role of a pressure relief dressing in the prevention and treatment of pressure sores. 3rd European Conference on Advances in Wound Management; October 19‐22, 1993; Harrogate, UK. 1994:174.
Mulder 1994 {published data only}
    1. Mulder GD, Taro N, Seeley J, Andrews K. A study of pressure ulcer response to low air loss beds vs. conventional treatment. Journal of Geriatric Dermatology 1994;2(3):87‐91.
Munro 1989 {published data only (unpublished sought but not used)}
    1. Munro BH, Brown L, Heitman BB. Pressure ulcers: one bed or another?. Geriatric Nursing 1989;10(4):190‐2. - PubMed
Osterbrink 2005 {published data only (unpublished sought but not used)}
    1. Osterbrink J, Mayer H, Schroder G. Clinical evaluation of the effectiveness of a multimodal static pressure relieving device. European Wound Management Association Conference; 2005, 15‐17 September; Stuttgart, Germany. 2005; Vol. Thur 14:00‐15:30; V26‐6:73.
Phillips 2000 {published data only (unpublished sought but not used)}
    1. Phillips L. Cost‐effective strategy for managing pressure ulcers in critical care: a prospective, non‐randomised, cohort study. Journal of Tissue Viability 2000;10(Suppl 3):2‐6. - PubMed
Price 1999 {published data only}
    1. Price P, Bale S, Newcombe R, Harding K. Challenging the pressure sore paradigm. Journal of Wound Care 1999;8(4):187‐90. - PubMed
Regan 2009 {published data only}
    1. Regan MA, Teasell RW, Wolfe DL, Keast D, Mortenson WB, Aubut JL. A systematic review of therapeutic interventions for pressure ulcers after spinal cord injury. Archives of Physical Medicine and Rehabilitation 2009;90(2):213‐31. - PMC - PubMed
Russell 1998 {published data only (unpublished sought but not used)}
    1. Russell L. Randomized comparative clinical trial of the Pegasus Cairwave mattress and Proactive seating cushion and the Huntleigh Nimbus III mattress and Alpha Transcell seating cushion. European Wound Management Association and Journal of Wound Care Autumn Conference; November 9‐11; Harrogate, UK. 1998:4.
Russell 2000a {published data only}
    1. Russell L, Reynolds T, Carr J, Evans A, Holmes M. A comparison of healing rates on two pressure‐relieving systems. British Journal of Nursing 2000;9(22):2270‐80. - PubMed
    1. Russell L, Reynolds T, Carr J, Evans A, Holmes M. Randomised controlled trial of two pressure‐relieving systems. Journal of Wound Care 2000;9(2):52‐5. - PubMed
Russell 2003 {published data only (unpublished sought but not used)}
    1. Russell L, Reynolds TM, Towns A, Worth W, Greenman A, Turner R. Product evaluation. Randomized comparison trial of the RIK and the Nimbus 3 mattresses. British Journal of Nursing 2003;12(4):256‐9. - PubMed
Scott 1995 {published data only}
    1. Scott F. Easing the pressure for hip fracture participants. Nursing Times 1995;91(29):20‐31. - PubMed
Sharp 2007 {published data only (unpublished sought but not used)}
    1. Sharp A. Pilot study to compare the incidence of pressure ulceration on two therapeutic support surfaces in elderly care. 17th Conference of the European Wound Managment Association; May 2‐4, 2007; Glasgow, Scotland. 2007:Oral presentation 114, 73.
Smith 1995 {published data only}
    1. Smith DM. Pressure ulcers in the nursing home. Annals of Internal Medicine 1995;123(6):433‐42. - PubMed
Soppi 2004 {published data only (unpublished sought but not used)}
    1. Soppi E, Takala J. Novel carital speciality mattress in the management of pressure sores. 2nd World Union of Wound Healing Societies Meeting:Paris, France, July 8‐13. 2004:X023.
Strauss 1991 {published data only}
    1. Strauss MJ, Gong J, Gary BD, Kalsbeek WD, Spear S. The cost of home air‐fluidized therapy for pressure sores: a randomized controlled trial. Journal of Family Practice 1991;33(1):52‐9. - PubMed
Taylor 1999 {published data only}
    1. Taylor L. Evaluating the Pegasus Trinova: a data hierarchy approach. British Journal of Nursing 1999;8(12):771‐4, 776‐8. - PubMed
Tewes 1993 {published data only}
    1. Tewes M. Prevention and treatment of pressure sores ‐ a neglected research subject. An overview of clinically controlled studies in the period 1987‐91. Vård i Norden 1993;13(2):4‐7. - PubMed
Thomas 2001a {published data only}
    1. Thomas D. Prevention and management of pressure ulcers. Reviews in Clinical Gerontology 2001;11:115‐30.
Thomas 2001b {published data only}
    1. Thomas DR. Prevention and treatment of pressure ulcers: what works? what doesn't?. Cleveland Clinic Journal of Medicine 2001;68:704‐7, 710‐4, 717‐2. - PubMed
Thomas 2006 {published data only}
    1. Thomas DR. Prevention and treatment of pressure ulcers. Journal of the American Medical Directors Association 2006;7(1):46‐59. - PubMed
Thomas 2007 {published data only}
    1. Thomas DR. The prevention and management of pressure ulcers. Reviews in Clinical Gerontology 2007;17(4):241‐57.
Whittingham 1999 {published data only}
    1. Whittingham K. Randomized control trial of six pressure‐redistributing foam mattresses. Journal of Tissue Viability 1999;9:104.
Yang 2007 {published data only}
    1. Yang R, Feng L, Chen D‐Z. Clinical evidence on nursing care for participants with pressure sore. Chinese Journal of Evidence‐Based Medicine 2007;7(9):694‐6.
Young 1992 {published data only}
    1. Young JB, Dobrzanski S. Pressure sores: epidemiology and current management concepts. Drugs and Aging 1992;2(1):42‐57. - PubMed

Additional references

Allman 1997
    1. Allman RM. Pressure ulcer prevalence, incidence, risk factor and impact. Geriatric Medicine 1997;13(3):421‐36. - PubMed
Briggs 2003
    1. Briggs M. The prevalence, characteristics and treatment of pain in chronic venous leg ulcers. PhD Thesis, University of Leeds 2003.
Ciocon 1993
    1. Ciocon JO, Fernandez BB, Ciocon DG. Leg edema: clinical clues to the differential diagnosis. Geriatrics 1993;48(5):34‐40, 45. - PubMed
Clark 1994
    1. Clark M, Watts S. The incidence of pressure sores within a National Health Service Trust hospital during 1991. Journal of Advanced Nursing 1994;20(1):33‐6. - PubMed
Dealey 1991
    1. Dealey C. Are your participants sitting comfortably?. Journal of Tissue Viability 1991;1(2):36‐9.
Dealey 1991a
    1. Dealey C. The size of the pressure ulcer problem in a teaching hospital. Journal of Advanced Nursing 1991;16(6):633‐70. - PubMed
Essex 2009
    1. Essex HN, Clark M, Sims J, Warriner A, Cullum N. Health‐related quality of life in hospital inpatients with pressure ulceration:assessment using generic health‐related quality of life measures. Wound Repair and Regeneration 2009;17(6):797‐805. - PubMed
Gray 1994
    1. Gray DG, Campbell MK. Randomised clinical trial of two foam mattresses. Journal of Tissue Viability 1994;4(4):128‐32.
Higgins 2003
    1. Higgins JTP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analysis. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, on behalf of the Cochrane Statistical Methods Group and the Cochrane Bias Methods Group (Editors). Chapter 8. Assessing risk of bias in included studies. In: Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org..
Kaltenthaler 2001
    1. Kaltenthaler E, Whitfield MD, Walter SJ, Akehurst RL, Paisley S. UK, USA and Canada: how do their pressure ulcer prevalence and incidence data compare?. Journal of Wound Care 2001;10(1):530‐5. - PubMed
Kannell 1973
    1. Kannell WB, Shurtleff D. The Framingham Study. Cigarettes and the development of intermitted claudication. Geriatrics 1973;28(2):61‐8. - PubMed
Kosiak 1959
    1. Kosiak M. Etiology and pathology of ischemic ulcers. Archives of Physical Medicine and Rehabilitation 1959;40(2):62‐9. - PubMed
Langer 2003
    1. Langer G, Schloemer G, Knerr A, Kuss O, Behrens J. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD003216] - DOI - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J, on behalf of the Cochrane Information Retrieval Methods Group. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
McInnes 2011
    1. McInnes E, Cullum NA, Bell‐Syer SEM, Dumville JC, Jammali‐Blasi A. Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews 2011, Issue 4. [DOI: 10.1002/14651858.CD001735.pub4] - DOI - PubMed
McNeeley 1995
    1. McNeeley MJ, Boyko EJ, Ahroni JH, Stensel VL, Reiber GE, Smith DG, et al. The independent contributions of diabetic neuropathy and vasculopathy in foot ulceration. How great are the risks?. Diabetes Care 1995;18(2):216‐9. - PubMed
Neale 1981
    1. Lorimer DL, French G, O'Donnell M, Burman JG (editors). Neale's disorders of the foot: diagnosis and management. Churchill Livingston, 1981.
Nixon 2005
    1. Nixon J, Thorpe H, Barrow H, Phillips A, Nelson EA, Mason SA, et al. Reliability of pressure ulcer classification and diagnosis. Journal of Advanced Nursing 2005;50(6):613‐23. - PubMed
Raney 1989
    1. Raney JP. A comparison of the prevalence of pressure sores in hospitalised ALS and MS participants. Decubitus 1989;2(2):4‐51. - PubMed
RCN 2005
    1. RCN. The Management of Pressure Ulcers in Primary & Secondary Care: A Clinical Practice Guideline. http://www.rcn.org.uk/__data/assets/pdf_file/0017/65015/management_press... 2005. - PubMed
Reswick 1976
    1. Reswick JB, Rogers J. Experiences at Ranchos Los Amigos hospital with devices and techniques to prevent pressure ulcers. In: Kenedi RM, Cowden JM, Scales JT editor(s). Bedsore biomechanics. London: Macmillan Press, 1976:301‐13.
Ryan 1969
    1. Ryan TJ. The epidermis and its blood supply in venous disorders of the leg. Transcriptions of the St John's Hospital Dermatological Society 1969; Vol. 55:51‐7. - PubMed
SIGN 2010
    1. Scottish Intercollegiate Guidelines Network (SIGN). Search filters. http://www.sign.ac.uk/methodology/filters.html#random (accessed 27 September 2010).
Spencer 2000
    1. Spencer S. Pressure relieving interventions for preventing and treating diabetic foot ulcers. Cochrane Database of Systematic Reviews 2000, Issue 3. [DOI: 10.1002/14651858.CD002302] - DOI - PubMed
Thoolen 2000
    1. Thoolen M, Ryan TJ, Bristow I. A study of the skin of the sole of the foot using high‐frequency ultrasonography and histology. The Foot 2000;10:14‐7.
Tortora 1996
    1. Tortora GJ, Grabowski SR. Principles of Anatomy and Physiology. 8th Edition. USA: Harper Collins, 1996.
Valk 2010
    1. Dorresteijn JAN, Kriegsman DMW, Assendelft WJJ, Valk GD. Patient education for preventing diabetic foot ulceration. Cochrane Database of Systematic Reviews 2012, Issue 10. [DOI: 10.1002/14651858.CD001488.pub4] - DOI - PubMed
Vogt 1992
    1. Vogt MT, Wolfson SK, Kuller LH. Lower extremity arterial disease and the aging process: a review. Journal of Clinical Epidemiology 1992;45(5):529‐42. - PubMed

Publication types

LinkOut - more resources