Evaluating the effectiveness of care bundles on the development of pressure ulcers in surgical patients: a systematic review

To explore the effectiveness of care bundles in reducing the development of pressure ulcers (PUs) in surgical patients. A systematic review was conducted following the Joanna Briggs Institute (JBI) guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Eligible studies included original research using a prospective design, involving adult patients (>18 years) in the perioperative period. The search was initially conducted in October 2024 and subsequently updated in January 2026, using SCOPUS, Web of Science, SciELO via Web of Science, MEDLINE via PubMed, Embase, CINAHL, Cochrane Library, BVS and LILACS via BVS databases. A narrative synthesis of the results was performed. Four studies were included. Despite variation in bundle composition, most studies reported reduced PU incidence following bundle implementation. The most frequently applied interventions across perioperative phases were PU risk assessment scales, skin assessment, use of support surfaces, prophylactic dressings, interprofessional communication, and scheduled patient repositioning. Across the included studies, bundles that combined multiple interventions such as risk and skin assessment, support surfaces, prophylactic dressings, interprofessional communication and repositioning were associated with reduced PU incidence perioperatively. However, methodological limitations in the included studies lower the certainty and generalisability of the evidence. • Care bundles can reduce pressure ulcer incidence in surgical populations. • Bundles differ widely in both intervention type and number. • Risk assessment tools are the most commonly used preventive measures.