Incidence of pressure ulcers due to prone position in patients admitted to the ICU for Covid-19.

It was retrospective, so care may have been under-recorded in the charts. The four hospitals used different computer programmes, which may have caused inconsistent coding and assessment, and some variables were discarded. No sample size calculation was performed; all eligible patients were included. There was no single pressure ulcer prevention protocol, so differences between hospitals may reflect practice variation rather than patient risk. The study could not analyse the efficacy of individual prevention treatments, because the same patient could receive different care to risk areas. Only variables related to nursing care and prevention were considered; other causes such as treatment, poor peripheral perfusion and vasoactive drugs were not analysed.

The study received no specific grant from public, commercial or not-for-profit funding agencies, and the authors declared no conflicts of interest.

Do not read this as proof that prone positioning, repositioning, or nutrition caused pressure ulcers. It was a retrospective observational study, and patients received several prevention measures together, including air mattresses, hyperoxygenated fatty acids, almond oil, hydrocolloid or silicone dressings, heel pads, pillows and foams, and postural changes, so the contribution of any single component cannot be separated.