Key Message
Reactive air surfaces, alternating-pressure (active) air surfaces, and reactive gel surfaces may be more effective at preventing pressure injuries compared to foam surfaces. The clinical effectiveness of therapeutic support surfaces to prevent pressure injuries may be influenced by the care setting (e.g., long-term care, acute care, intensive care units) as well as follow-up time.
An overview of reviews with a network meta-analysis did not find any significant differences between different types of support surfaces on time to pressure injury. However, limited evidence suggests there may be a difference between foam surfaces, compared to other types of foam surfaces.
Specialized skin protection cushions may also help to prevent pressure injuries compared to standard foam cushions, though there may be no difference between different types of air cushions.
It was unclear if there are significant differences between support surfaces for the treatment of pressure injuries. Authors of an overview of reviews stated that reactive air surfaces may be more effective than foam surfaces, but this was not statistically significant.
Limited evidence was identified regarding adverse events and health-related quality of life, as well as for pediatric patients.
Limited evidence was identified for support surfaces other than mattresses, beds, and overlays (e.g., cushions), as well as therapeutic small devices for prevention of pressure injuries. No studies were identified for therapeutic small devices for treatment.