This study evaluated the change in existing pressure ulcers and incidence of new pressure ulcers in surgical ICU patients using a new low-air-loss, weight-based, microclimate management (LAL-MCM) system compared to the standard SICU bed with an integrated, powered air pressure redistribution (IP-AR) surface. Incidence of supine pressure ulcers was 0% in the LAL-MCM group and 18% in the IP-AR group (P=0.046), despite more comorbidities in the patients in the LAL-MCM group.