A consensus conference was held to fill the void in clinical literature as to the appropriate surface technology to prevent or treat pressure ulcers. Although the literature is clear that technology may help, no specific guidance yet exists on which surfaces are appropriate for th right patient and the right time. This article lays the foundation for how the expert consensus panel researched, deliberated and created an algorithm for support surface selection. It provides the first known consenses based algorithm for pressure ulcer prevention and treatment in press.