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June 2, 1993

Pressure Ulcers: The Benefits and Costs of New Therapies-Reply

Author Affiliations

Sepulveda (Calif) Veterans Affairs Medical Center

JAMA. 1993;269(21):2735-2736. doi:10.1001/jama.1993.03500210035020

In Reply.  —The letters by Breite and Pane and Chevalier illustrate several important issues that health care providers and policymakers face when confronted with the problem of pressure ulcer management. Pane and Chevalier appropriately suggest that future comparisons should include other support surfaces less expensive but potentially as effective as low-air-loss systems. There are at least 115 different patient support surfaces available for the prevention and management of pressure ulcers.1 Keeping the goals of care in mind (prevention vs cure), medical and economic policies should support the use of technology in settings where data exist to prove effectiveness for appropriate indications. Unfortunately, few support surfaces are tested in randomized clinical trials for either prevention or healing of pressure ulcers in nursing homes.Pane and Chevalier are also correct about the importance of skin care, ulcer prevention, and early assessment. Our study was not designed to address these issues. However,