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. 2021 May 6;2021(5):CD013621. doi: 10.1002/14651858.CD013621.pub2

2. Pressure ulcer incidence results reported in studies that compared different types of foam surfaces.

Study ID Results Comment
Comparison: foam surfaces compared with other types of foam surfaces
Bueno de Camargo 2018 Viscoelastic mattress (foam density of 40 and 60)

  • Proportion of participants developing a new pressure ulcer: 10/31 (32.3%)

  • Time to pressure ulcer incidence: median time to develop an ulcer 8.5 days (interquartile range (IQR) 5.0–14.0)

 Standard mattress with pyramidal overlay (foam with a density of 33)

  • Proportion of participants developing a new pressure ulcer: 25/31 (80.6%)

  • Time to pressure ulcer incidence: median time to develop an ulcer 6.0 days (IQR 3.0–8.0)

  • Proportion of participants developing a new pressure ulcer: RR 0.40 (95% CI 0.23 to 0.69)

  • Time to pressure ulcer incidence: Mann‐Whitney test P value = 0.088; HR 0.33 (95% CI 0.17 to 0.64), estimated by the review authors using the methods described in Tierney 2007
Collier 1996 Multiple types of foam mattresses, each served as an arm in Collier 1996

  • Omnifoam (HNE Healthcare)

  • Softform (Medical Support System)

  • Transfoam (Karomed)


These could be defined as 'high specification foam surfaces'

  • Proportion of participants developing a new pressure ulcer: 0/33 (0%)

 Multiple arms, each served as an arm in Collier 1996; and the NHS standard foam mattress appeared to be the control in Collier 1996

  • Clinifloat (SSI Medical Services Ltd)

  • STM5 (Servies to Medicine)

  • Therarest (KCI Medical Ltd)

  • Vapourlux (Parkhouse)

  • NHS standard contract 130 mm foam mattress (Reylon Ltd)


  • Proportion of participants developing a new pressure ulcer: 0/57 (0%)

  • Proportion of participants developing a new pressure ulcer: summary estimate not estimable
Gray 2000 Transfoamwave

  • Proportion of participants developing a new pressure ulcer: 2/50 (4.0%)

 Transfoam

  • Proportion of participants developing a new pressure ulcer: 2/50 (4.0%)

  • Proportion of participants developing a new pressure ulcer: RR 1.00 (95% CI 0.15 to 6.82)
Kemp 1993 Convoluted foam mattress overlay (foam surfaces 3‐inch or 4‐inch, density 22.7 kg/m3)

  • Proportion of participants developing a new pressure ulcer: 21/45 (46.7%)

  • Time to pressure ulcer incidence: see comments

 Solid foam mattress overlay (foam surfaces 4‐inch density 21.3 kg/m3)

  • Proportion of participants developing a new pressure ulcer: 12/39 (30.8%)

  • Time to pressure ulcer incidence: see comments

  • Proportion of participants developing a new pressure ulcer: RR 1.52 (95% CI 0.86 to 2.67)

  • Time to pressure ulcer incidence: hazard ratio for convoluted foam vs solid foam of exp(0.906) = 2.47 and P = 0.018 (HR 2.47, 95% CI 1.25 to 4.90) in a Cox regression model adjusted for mobility score (solid foam as reference). The risk of developing a pressure ulcer was greater for patients nursed on convoluted foam than for patients nursed on solid foam when the averaged mobility score was also taken into account.
Ozyurek 2015 Multi‐layered, viscoelastic polyurethane, 8 cm of high‐flexibility foam

  • Proportion of participants developing a new pressure ulcer: 22/178 (12.4%)

 Multi‐layered, viscoelastic foam

  • Proportion of participants developing a new pressure ulcer: 23/179 (12.8%)

  • Proportion of participants developing a new pressure ulcer: RR 0.96 (95% CI 0.56 to 1.66)
Vyhlidal 1997 MAXIFLOAT (29 lb indentation force load deflection (IFD), polyurethane foam)

  • Proportion of participants developing a new pressure ulcer: 5/20 (25.0%)

 Iris 3000 (4‐inch, density of 28.8 kg/m3) foam)

  • Proportion of participants developing a new pressure ulcer: 12/20 (60.0%)

  • Proportion of participants developing a new pressure ulcer: RR 0.42 (95% CI 0.18 to 0.96)