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Int J Nurs Stud. 2005 Jan;42(1):37-46.

The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers.

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  • 1Nursing Science, Ghent University, Belgium.



Turning is considered to be an effective way of preventing pressure ulcers, however almost no research has been undertaken on this method.


The aim of the study was to investigate the effect of four different preventative regimes involving either frequent turning (2, 3 hourly) or the use of a pressure-reducing mattress in combination with less frequent turning (4, 6 hourly).


838 geriatric nursing home patients participated in the study.


During 28 days, four different turning schemes were used: turning every 2 h on a standard institutional (SI) mattress (n = 65), turning every 3 h on a SI mattress (n = 65), turning every 4 h on a viscoelastic foam (VE) mattress (n = 67), and turning every 6h on a VE mattress (n = 65). The remaining patients (n = 576) received standard preventive care.


The incidence of non-blanchable erythema (34.8-38.1%) was not different between the groups. The incidence of grade II and higher pressure ulcers in the 4h interval group was 3.0%, compared with incidence figures in the other groups varying between 14.3% and 24.1%.


Turning every 4 h on a VE mattress resulted in a significant reduction in the number of pressure ulcer lesions and makes turning a feasible preventive method in terms of effort and cost.

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