Logo image
Back
Repositioning for pressure injury prevention in adults
Journal article   Peer reviewed

Repositioning for pressure injury prevention in adults

Sharon L Latimer, Wendy P Chaboyer, Sebastian Probst, Lukman Thalib, Dinesh Palipana, Samuel Lapkin, Elizabeth McInnes, Martin J Downes and Brigid M Gillespie
Cochrane database of systematic reviews, (6), pp.1-51
04/06/2026
DOI: https://doi.org/10.1002/14651858.CD009958.pub4
PMID: 42240176
Appears in  Recent Faculty of Health Publications

Metrics

1 Record Views

Abstract

Rationale: Pressure injuries (or pressure ulcers) are localised damage to skin or tissue (or both) occurring over bony prominences, resulting from prolonged pressure or shear forces (or both). Adults receiving care in any healthcare setting can develop pressure injuries. Immobility, malnutrition, and reduced sensation are some known risk factors. Regular repositioning is a theoretically sound prevention strategy that is part of standard patient care. This is the second update of a review published in 2014 and updated in 2020. Objectives: To evaluate the benefits and harms, and cost-effectiveness, of repositioning regimens (i.e. repositioning frequencies, position, micromovement) for pressure injury prevention in adults in acute, long-term, or aged healthcare settings, compared to standard care or another repositioning regimen. Search Methods: To identify studies for inclusion in the review, we searched the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Embase, EBSCO CINAHL Plus, and trial registries on 7 May 2025. We also scanned the reference lists of included studies, reviews, meta-analyses, and health technology reports. Eligibility criteria: We included randomised controlled trials that assessed the effects of any repositioning regimen and measured pressure injury incidence in adults (at least 18 years of age) without an existing pressure injury, in any acute, long-term, or aged healthcare setting. Outcomes: The primary outcome was the cumulative incidence of pressure injuries (any category/stage). Secondary outcomes were health-related quality of life, procedural pain, patient satisfaction, pressure injury prevention and treatment costs, and incremental costs per pressure injury avoided. Risk of bias: We assessed the risk of bias in the evidence using the Cochrane RoB 2 tool. We evaluated the certainty of the evidence using GRADE methodology and GRADEpro software. Synthesis methods: Seven review authors were involved in independently undertaking study selection, data extraction, and RoB and GRADE assessment. All outcomes were binary and reported as risk ratios (RR) with 95% confidence intervals (CI). We pooled data using the fixed-effect or random-effects model, depending on clinical and methodology heterogeneity. Included studies: We found three new trials. This 2026 update of the review therefore includes 11 trials, which were conducted in acute and aged healthcare settings, and involved 4462 participants aged 18 to 90 years. No new economic substudies were identified, so our cost analysis is based on the two economic evaluations that were included in the previous version of the review.

Details

Logo image