Mistiaen 2009.

Methods	RCT with 30‐day follow‐up.
Participants	Patients recruited from aged care facility (predominantly rehabilitation department) and rehabilitation centre. Grade 1 pressure ulcers included in the sample.
Interventions	1. Australian medical sheepskin within 48 h of admission on the patient's bed. Application in wheelchair recommended and under heels permitted. (Hi‐temp, urine resistant, size XXL mattress) (n = 271). 2. Usual care (n = 272). Cointerventions: usual intervention for prevention of pressure ulcers in study settings.
Outcomes	Number and grade of pressure ulcers developed. 1. Grade 1 = 18, Grade 2 = 6, Grade 3 = 0, Grade 4 = 0. 2. Grade 1 = 32, Grade 2 = 6, Grade 3 = 2, Grade 4 = 0.
Notes	ITT analyses performed. Sample size calculation performed, however, not included in this paper (included in published protocol). 33% of intervention group believed the sheepskin to be too warm, and thus the trial was stopped early in these patients.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Truly random methods of randomisation used.
Allocation concealment (selection bias)	Low risk	Adequate methods of allocation concealment used.
Blinding (performance bias and detection bias) Pressure ulcer incidence	High risk	No blinding on patients, clinicians, outcome assessors. Unclear/unstated blinding of data analysts.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Not reported.
Selective reporting (reporting bias)	Unclear risk	Not reported.
Free of other bias ‐ were groups similar at baseline regarding the most important prognostic indicators?	Low risk	Groups were well matched.
Free of other bias ‐ was the timing of the outcome assessment similar in all groups?	Low risk	No other concerns.