based on the Cochran Database of Systemic Review of 53 randomized controlled trials. Iglesias [18] showed that
alternative pressure mattresses were associated with lower overall costs due to a shortened length of stay in hospital
and a delayed time to ulceration. DeFloor et al. [19] reportedthat applying various combinations of turning and pressure-r educing devices to at-risk patients decreased the incidence of grade II and higher pressure ulcers by fivefold. de Laat et al. found in a prospective cohort study that implementing a hospital-wide pressure ulcer guideline reduced the incidence
from 43% to 28%. Baldelli and Paciella [21] also reported an overall reduction in incidence (7%) and prevalence (15%) after implementing a prevention strategy in an intensive care unit (ICU) setting. These strateg ies have been embodied in clini-cal guidelines such as Prevention and Treatment of Pressure Ulcers [22] developed by the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP), and Pressure Ulcers in Adults [23] by the Ag ency for Health Care Policy and Research (AHCPR). These well-known preventive care measures should be applied to appropriately selected patients at the right time.