A common clinical strategy for relief of pressure sores is theuse of pressure redistributing beds, mattresses and overlays. Alarge-scale mattress replacement was scheduled for 1998 andthis led to a multi-professional review of the pressure-relievingproperties of a range of foam mattresses. Mattresses weresubjected to 48 h indentor testing. Attention was paid to theabsolute peak pressures and the percentage change relative tothe initial readings. Having achieved a high ranking in indentortesting, selected mattresses were placed in the clinical settingfor a one-week period. A purchasing decision was made basedupon indentor testing, clinical evaluation and by examining price.For confirmation, a number of other major users were consulted.The 13 mattresses provided variable pressure relievingproperties. A process of exclusion was adopted in order to finda subset suitable for clinical evaluation. The standard NHSmattress performed poorly. One type was dual-function wherebythe mattress was intended to be matched for patient weight,having a "heavy" and a "light" side (deemed to be impractical).Some generated high initial pressures and were removed. Wediscarded mattresses that produced an increase in pressure overthe 24 h loading or that responded poorly after the rest period.The remaining mattresses were deemed suitable, on an equalbasis, for further testing. Three mattresses were placed on clinicaltrial for a one-week period, all performing satisfactorily. Pricewas examined in the context of manufacturers' guarantee usedas an indication of mattress life. On the basis of these findings,the team of nurses and engineers were able to make a purchasingrecommendation. We are confident that this will lead to fewerpressure sores, improved care and better patient outcome.