Summary of findings 4. Other dressing versus control for preventing pressure ulcers.
| Other dressing versus control for preventing pressure ulcers | ||||||
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Patient or population: individuals at risk of pressure ulcer development
Settings: intensive care, coronary care and medical clinic (2 trials); spinal surgery (1 trial); geriatric hospital (1 trial)
Intervention: other dressing Comparison: control | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (trials) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Other dressing | |||||
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Pressure ulcer incidence: polyurethane film vs hydrocolloid dressing Assessed with observation Follow‐up: 30 days |
Study population | RR 0.58 (0.24 to 1.41) | 160 (1 RCT) | ⊕⊝⊝⊝ Very low1 | There was no clear difference in pressure ulcer incidence (polyurethane film 7/80 (9%); hydrocolloid 12/80 (15%), very low‐certainty evidence) | |
| 150 per 1000 | 87 per 1000 (36 to 211) | |||||
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Pressure ulcer incidence: Kang’ huier vs routine care Assessed with observation Follow‐up: 3 days |
Study population | RR 0.42 (0.08 to 2.05) | 100 (1 RCT) | ⊕⊝⊝⊝ Very low2 | There was no clear difference in pressure ulcer incidence (Kang’ huier 2/49 (4%); routine care 5/51 (10%), very low‐certainty evidence) | |
| 98 per 1000 | 41 per 1000 (8 to 201) | |||||
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Pressure ulcer incidence: PPD vs no dressing Assessed with observation Follow‐up: 3 weeks |
Study population | RR 0.18 (0.04 to 0.76) | 74 (1 RCT) | ⊕⊝⊝⊝ Very low3 | There was no clear difference in pressure ulcer incidence (PPD 2/37 (5%); no dressing 11/37 (29%), very low‐certainty evidence) | |
| 297 per 1000 | 54 per 1000 (12 to 226) | |||||
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Pressure ulcer incidence: thin polyurethane foam vs no dressing Assessed with observation Follow‐up: mean 14.5 hours |
Study population | RR 1.31 (0.83 to 2.07) | 74 (1 RCT) | ⊕⊕⊝⊝ Low4 | There was no clear difference in pressure ulcer incidence (thin polyurethane 20/35 (57%); no dressing 17/39 (44%), low‐certainty evidence) | |
| 436 per 1000 | 571 per 1000 (362 to 902) | |||||
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Pressure ulcer incidence: adhesive foam dressing vs no dressing Assessed with observation Follow‐up: mean 14.5 hours |
Study population | RR 1.65 (1.10 to 2.48) | 78 (1 RCT) | ⊕⊝⊝⊝ Very low5 | There was no clear difference in pressure ulcer incidence (adhesive foam 28/39 (72%); no dressing 17/39 (44%), low‐certainty evidence) | |
| 436 per 1000 | 719 per 1000 (479 to 1000) | |||||
| Adverse events | None reported | |||||
| *The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; PPD: pressure ulcer preventive dressing; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Downgraded once due to high risk of performance bias, and downgraded twice for serious imprecision due to small number of events and wide confidence interval. 2Downgraded twice for risk of bias due to high risk of performance and detection bias, and downgraded twice for serious imprecision due to small number of events and wide confidence interval. 3 Downgraded twice for risk of bias due to high risk of performance, detection and other bias, and downgraded twice for serious imprecision due to small number of events and wide confidence interval. 4 Downgraded twice for risk of bias due to high risk of performance and attrition bias, and downgraded once for imprecision due to a wide confidence interval.
5 Downgraded twice for risk of bias due to high risk of performance and attrition bias, and downgraded once for imprecision due to a wide confidence interval.