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Pressure ulcers are a com­mon skin issue that causes health­care, eco­nomic, and social bur­dens. The ulcers can appear any­where on the body, but because they are more com­mon in immo­bi­lized patients, par­tic­u­larly the elderly, they are more fre­quently seen on the sacrum, hips and heels.

A pres­sure ulcer is a skin lesion, a wound that is pro­duced sec­ondary to inad­e­quate blood sup­ply to the area. The pres­sure accu­mu­lates when the soft tis­sue is com­pressed between two planes — for exam­ple, the hos­pi­tal bed, the soft tis­sue, and the weight of the patient’s hip bone. The ulcers can lead to necro­sis (death of body tis­sue) and there­fore can also affect the joints, bones, and greatly impact qual­ity of life.

Strategies to pre­vent pres­sure ulcers include the assess­ment of risk fac­tors, the use of sup­port sur­faces, repo­si­tion­ing the patient, main­tain­ing opti­mal nutri­tional sta­tus, hydra­tion and skin care. The phar­ma­ceu­ti­cal indus­try has launched skin care prod­ucts that con­tain oils derived from hyper­ox­y­genated fatty acids (HOFA) to treat pres­sure ulcers.

Although there are stud­ies show­ing the effec­tive­ness of HOFA skin care prod­ucts, there is a high cost, par­tic­u­larly when ongo­ing treat­ment is required. In a study, pub­lished in PLOS ONE, Lupiañez-Perez and Colleagues sort to deter­mine whether the use of olive oil could achieve sim­i­lar ben­e­fi­cial out­comes for immo­bi­lized patients.

The authors report that, ​“Olive oil has between 330 to 500 mg of polyphe­nolsperk­ilo­gram of fat, and under 20mEq of per­ox­ide perk­ilo­gram of fat. It is com­pat­i­ble with human tis­sues what con­verts it in an ideal prod­uct for topic use.” Not to men­tion, oleic acid, nat­ural antiox­i­dants such as hydrox­y­ty­rosol and tyrosol and high resis­tance to oxida­tive processes, all of which inspired the hypoth­e­sis that olive oil could be a more cost-effec­tive treat­ment for pres­sure ulcers with sim­i­lar ben­e­fits to HOFA skin care prod­ucts.

According to the authors, the sub­jects selected for the 16-week fol­low-up trial were sim­i­lar to ​“the sub­jects exam­ined in HOFA effi­cacy tri­als.” In the 16 week fol­low up trial, the inci­dence of stage 2 pres­sure ulcers was mea­sured as the main out­come in 915 patients (aver­age age of patients 80.56 years) who were ran­dom­ized to either, HOFA appli­ca­tion or ​“two appli­ca­tions daily of the olive- oil-based for­mula, to the skin areas of the sacrum, hips and heels” in the form of 0.33 ml in each spray­ing. The liq­uid spray con­tained 97 per­cent extra vir­gin olive oil and 3 per­cent hyper­icum per­fo­ra­tum and pep­per­mint.

The authors con­clude that the ​“results obtained con­firm the non-infe­ri­or­ity of the olive oil treat­ment; there were no dif­fer­ences exceed­ing the lower limit of the con­fi­dence inter­val and thus olive oil ther­apy achieves an effec­tive pre­ven­tion of pres­sure ulcers in these cir­cum­stances.”

For exam­ple, the spe­cific val­ues for the sacrum with 8 sub­jects in either group were 2.55 per­cent for olive oil and 3.08 per­cent for HOFA. It is also impor­tant to note that pre­vi­ous stud­ies on HOFA have never been con­ducted beyond one month. Therefore, the length of this study pro­vides clin­i­cal sig­nif­i­cance for the effec­tive­ness of olive oil as a top­i­cal agent.

As the authors sug­gest, ​“The lower cost of the prod­uct makes it more acces­si­ble to the pop­u­la­tion in gen­eral and to the health­care sys­tem, and offers a viable alter­na­tive to stan­dard HOFA treat­ment promis­ing a sig­nif­i­cant reduc­tion in phar­ma­ceu­ti­cal expen­di­ture and alle­vi­at­ing the bur­dens placed on health care per­son­nel and care­givers, by reduc­ing the inci­dence of pres­sure ulcers.”

• PLOS ONE:Topical Olive Oil Is Not Inferior to Hyperoxygenated Fatty Aids to Prevent Pressure Ulcers in High-Risk Immobilised Patients in Home Care