Prevention and Care of Pressure Ulcers in Long-Term Bedridden Adult and Older Adult Patients in the Community: A Systematic Review

Liuren Meng,1,2 Samoraphop Banharak,1 Chakkarin Sommana,1 Khanisorn Ransinyo,1 Wuttipong Cheumnok,3 Junhong Tian4 1Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Meaung, Khon Kaen, Thailand; 2Basic Teaching and Research Section of Nursing, School of Nursing, Youjiang Medical University for Nationalities, Baise, Guangxi, People’s Republic of China; 3Department of Adult and Geriatric Nursing, Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy, Lak Si, Bangkok, Thailand; 4Outpatient Department, Chinese Community Health Service Center of Yunyan District of Guiyang, Guiyang, Guizhou, People’s Republic of ChinaCorrespondence: Samoraphop Banharak, Email [email protected]: Pressure injuries remain a significant and costly complication among long-term bedridden adult and older adult patients, leading to increased morbidity, complications, and a diminished quality of life. This review aimed to summarize interventions for the prevention and care of pressure ulcers among long-term bedridden adult and older adult patients in the community. Fourteen databases were searched from March 2013 to March 2024, yielding 16 studies for final analysis. Two interconnected core elements were identified: 1) multidimensional intervention pathways and 2) three targeted preventive measures. The pathways include face-to-face education/training, home visits, digital tools (WeChat/smartphone apps), multidisciplinary collaboration, and remote follow-up. The targeted measures—position management with pressure-relief techniques, skin integrity maintenance, and nutritional/fluid support—were associated with improvements in PU-related outcomes: combined repositioning and pressure-relief devices were associated with lower PU incidence, temperature-controlled skin care with zinc oxide was associated with reduced skin redness, high-protein diets and omega-3 supplements were associated with improved skin resilience and barrier function, and integrated protocols (Braden-stratified repositioning/app monitoring) may improve care efficiency. Limitations included heterogeneity in study designs and outcome measures, incomplete reporting of implementation details, and limited geographical representation, as most were conducted in China (14/16), with only one study each from Finland and India. The certainty of evidence ranged from very low to moderate across outcomes; therefore, the findings should be interpreted cautiously. This review highlights potentially adaptable strategies for community-based PU prevention and care. It underscores the need for standardized, long-term studies to enhance the generalizability and sustainability of intervention strategies.Prospero Registration Number: CRD42024524789.Keywords: pressure ulcers, bedridden patients, long-term care, community health services, home care service, aged, systematic review