The 4 randomised controlled trials (Aloweni et al. 2017, Kalowes et al. 2016, Santamaria et al. 2015a and Walker et al. 2017) compared Mepilex Border Sacrum with standard care in adults at risk of developing pressure ulcers in intensive care units in Singapore, the US and Australia. The external assessment centre (EAC) considered these studies to have acceptable internal and external validity and to provide relevant evidence for the use of Mepilex Border Sacrum. Pooled treatment effect estimates from the fixed-effect meta-analysis of the 3 studies that reported pressure ulcer incidence rates as the number of patients with a pressure ulcer showed a non-significant relative risk (RR) in favour of Mepilex Border Sacrum (RR 0.51, 95% confidence interval [CI] 0.22 to 1.18; p=0.12). Based on the assumption of 1 pressure ulcer per patient in Santamaria (2015a), pooled treatment effect estimates from a fixed-effect meta-analysis of the 4 studies showed a significant relative risk in favour of Mepilex Border Sacrum (RR 0.42, 95% CI 0.20 to 0.86; p=0.02). However, a random-effects meta-analysis of the 4 studies showed a non- significant relative risk with Mepilex Border Sacrum (RR 0.45, 95% CI 0.20 to 1.04; p=0.06).