An initial audit took place to examine current systems and practices involving alternating mattresses as part of the SSKIN pressure ulcer prevention programme. Following this, the Trust introduced 125 Dyna-Form Mercury Advance mattresses (Direct Health Services) to six inpatient wards. The wards included particularly complex patients, all of whom historically had been a very high risk of Trust-acquired pressure ulcers, despite positive changes in culture towards zero tolerance of pressure ulcer.