Preventing pressure ulcers with the Australian Medical Sheepskin: an open-label randomised controlled trial

Damien J Jolley, Robyn Wright, Sunita McGowan, Mark B Hickey, Kenneth C Montgomery, Don A Campbell and Rodney D Sinclair
Med J Aust 2004; 180 (7): 324-327.


Objective: To estimate the effectiveness of a new high-performance Australian medical sheepskin (meeting Australian Standard 4480.1-1998) in preventing pressure ulcers in a general hospital population at low to moderate risk of these ulcers.

Design: Open-label randomised controlled clinical trial.

Setting: A large metropolitan teaching hospital in Melbourne, Victoria, in 2000.

Participants: 441 patients aged over 18 years admitted between 12 June and 30 November 2000, with expected length of stay over 2 days and assessed as at low to moderate risk of developing pressure ulcers.

Intervention: Patients were randomly allocated to receive a sheepskin mattress overlay for the duration of their hospital stay (218 patients) or usual treatment, as determined by ward staff (referent group, 223 patients).

Main outcome measures: Incidence rate and cumulative incidence of pressure ulcers, assessed daily throughout hospital stay.

Results: 58 patients developed pressure ulcers (sheepskin group, 21; referent group, 37). Cumulative incidence risk was 9.6% in the sheepskin group (95% CI, 6.1%–14.3%) versus 16.6% in the referent group (95% CI, 12.0%–22.1%). Patients in the sheepskin group developed new pressure ulcers at a rate less than half that of referent patients (rate ratio, 0.42; 95% CI, 0.26–0.67).

Conclusions: The Australian Medical Sheepskin is effective in reducing the incidence of pressure ulcers in general hospital inpatients at low to moderate risk of these ulcers.

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  • Damien J Jolley1
  • Robyn Wright2
  • Sunita McGowan3
  • Mark B Hickey4
  • Kenneth C Montgomery5
  • Don A Campbell6
  • Rodney D Sinclair7

  • 1 School of Health Sciences, Deakin University, Melbourne, VIC.
  • 2 School of Nursing, University of Melbourne, Melbourne, VIC.
  • 3 Fremantle Hospital and Health Service, Fremantle, WA.
  • 4 CSIRO Leather Research Centre, Melbourne, VIC.
  • 5 Clinical Epidemiology Unit, Royal Melbourne Hospital, Melbourne, VIC.
  • 6 University of Melbourne (St Vincent’s Hospital), Melbourne, VIC.



We wish to thank Donna McVean, Carole Meijs, Adriana Tiziani, Rachael Duncan, Margot Yeomans (Royal Melbourne Hospital), Jacinta Wassenberg (CSIRO), Carl Gibbons (Deakin University), and Clare Murphy and Trang Vu (Victorian Public Health Trainee Scheme).

Funding for this study was provided by a project grant from the National Health and Medical Research Council of Australia, and by the CSIRO Textile and Fibre Technology, Leather Research Centre.

Competing interests:

KCM and MBH are employees of CSIRO Textile and Fibre Technology, Leather Research Centre, which coordinated the development of the Australian Standard 4480.1-1998 for the Australian Medical Sheepskin.

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