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Lastly, the ease of recruitment and time frame of this study are also positives. This study provides answers in the need for further well-designed RCTs looking at cost-effectiveness of different surfaces.

  However, because the surfaces were visible, researchers were not blinded to the different options. The possibility of differences in the care received from the nursing staff regarding positioning and hygiene cannot be discarded. Although a reminder placed at the bedside of each subject required a signature by staff members following a position change every 2 hours, it is impossible to control the length of time spent sitting up in a chair versus lying in bed. Compliance with regard to positioning was also an issue. Some confused subjects were not following commands and even refused positioning from time to time. This in itself underscores the importance of having surfaces to prevent pressure ulcers.

  The cost analysis is limited to the rental or the purchasing of surfaces, restricting comparisons because they were only performed on mattresses currently rented at the hospital where the study was conducted.

  Further work is needed to determine whether the effect demonstrated in this study regarding pressure ulcer incidence results in a significant difference between prevention and wound healing. Due to the limited number of patients, the authors must be cautious when generalizing these findings. A larger sample might have given a broader sense of statistical differences.

Conclusion

  This study helped improve knowledge regarding pressure ulcer prevention as it pertains to cost effectiveness. With budget cuts and restrictions, managers must be informed of more economic prevention choices.

  Results of this study may give others the incentive to examine the curative properties of this cost-efficient surface with patients living with existing pressure ulcers. The challenge of finding a cost-effective curative approach for treating pressure ulcers is a valuable asset for the health care system. The fact that the inflated surface can be used as a single-patient use surface might help in providing valuable information with regard to infection prevention. Ease of use of the equipment and patient transfer also are important factors to consider and would be worthy aspects to explore in a future study.

Acknowledgments

  The authors thank the directors, nursing staff, occupational therapists, and physiotherapists at the hospital for their collaboration in this project. The authors also thank Christine Dzurovka, Katherine Wadas, and Tarik Alam for their comments and revision of this article.

References

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