New Research Findings and What They Mean for Pressure Area Care.

Pressure ulcers continue to be a major challenge for the NHS, with high human and financial costs. However, in recent years, new research has shed light on both the causes of pressure injuries and the most effective ways to prevent them. These findings are beginning to shape how clinicians in the UK approach pressure area care, offering opportunities to improve outcomes for patients and reduce costs for the health system.

Understanding Risk

Recent studies have moved beyond traditional risk assessment tools, such as the Waterlow or Braden scales, by highlighting the importance of personalised risk profiles with PURPOSE T, recommended by the national wound care strategy programme as the risk assessment of choice, taking into account factors like frailty, nutrition, cognitive impairment, and immobility, which contribute significantly to pressure ulcer development

Additionally, the use of aSSKINg is widely used as a tool to incorporate other factors in pressure area management beyond assessment.

With the number of people in the UK with dementia rising(6) studies on patients with advanced dementia suggest prevalence rates can be as high as 40%(2), reinforcing the need for targeted interventions in this group.

Biomechanical research has also given us a better understanding of how tissue deformation, rather than just pressure alone, leads to damage.(3) This has changed the conversation from simply reducing pressure to thinking about shear, microclimate, and patient movement patterns.

Advances in Technology

Recent clinical trials have provided stronger evidence for the effectiveness of pressure redistribution technologies. A large multicentre RCT from Beeckman and colleagues(1) (2020) showed that reactive air mattresses were as effective as alternating pressure systems in preventing pressure ulcers in nursing home residents, while being more cost-efficient. This kind of evidence is important in shaping NHS procurement decisions, particularly given financial pressures.

Emerging research is also pointing towards the value of repositioning devices. Automated systems, for example, are being used in the UK and internationally to support single-handed care and reduce the physical burden on staff. Findings suggest that not only can these devices improve patient comfort and outcomes(7) but they may also reduce injuries among staff, further adding to their value.

Cost-Effectiveness

Health economics research continues to build the case for prevention. AHRQ(4) data from the US demonstrate that investing in prevention saves money. With the cost to manage an unhealed pressure ulcer quoted as being 2.4 x more than a healed one(8). This evidence is strengthening the case for ensuring equipment provision and training are adequately funded within Integrated Care Systems & and Integrated Care Boards

Implications for UK Clinical Practice

For frontline clinicians, the implications are clear. Pressure area care is no longer just about turning patients every two hours. It is about:

• Using evidence-based equipment appropriate to each patient’s risk profile.

• Recognising the importance of tissue deformation and shear, not just pressure.

• Ensuring nutrition, hydration, and skin care are part of holistic prevention.

• Leveraging technology to make prevention sustainable in the face of workforce pressures.

Looking Ahead

If new research findings are consistently translated into practice, patients will experience fewer pressure ulcers, healthcare will save costs, and staff will be supported in delivering safer, more effective care. The challenge now is ensuring that these insights don’t remain confined to academic journals but are embedded in everyday clinical practice.

References

1. Beeckman, D., Serraes, B., et al. (2020).

A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents. International Journal of Nursing Studies, 106, 103564.

https://doi.org/10.1016/j.ijnurstu.2020.103564

2. Mitchell, S.L., Kiely, D.K., & Hamel, M.B. (2004).

Dying with advanced dementia in the nursing home. Archives of Internal Medicine, 164(3), 321–326.

https://doi.org/10.1001/archinte.164.3.321

3. Gefen, A. (2020).

The future of pressure ulcer prevention is here: detecting and targeting early tissue damage through innovations in bioengineering. Healthcare (Basel), 8(3), 199.

https://doi.org/10.3390/healthcare8030199

4. Agency for Healthcare Research and Quality (AHRQ) (2020).

Pressure Injury Prevention in Hospitals. Evidence-based Practice Center Report. Rockville, MD: AHRQ.

Available at: https://www.ahrq.gov

5. NHS Improvement (2018).

Stop the Pressure: National Pressure Ulcer Improvement Programme. NHS Improvement, London.

6. Alzheimer’s Research UK. (2023).

New estimates suggest dementia cases are set to rise – are they reliable? [online] Available at: https://www.alzheimersresearchuk.org/news/new-estimates-suggest-dementia-cases-are-set-to-rise-are-they-reliable/ [Accessed 12 Sep. 2025].

7. Moris, R. (2025). Turning Made Easy [Poster presentation]. ARN Rehabilitation Nursing Conference, Phoenix, AZ, 31 July–2 August. Available at: https://rehabnurse.org/conference/2025-conference/overview

8. Guest, J.F., Fuller, G.W., Vowden, P. and Vowden, K.R. (2018) Cohort study evaluating pressure ulcer management in clinical practice in the UK following initial presentation in the community: costs and outcomes. BMJ Open, 8(7), e021769. Available at: https://bmjopen.bmj.com/content/8/7/e021769