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News 9th Open Meeting of the European Pressure Ulcer Advisory Panel	Enjoy the summer and see you in Berlin. We are now entering that quiet time of the year when everyone goes on holiday, the volume of e-mail dries up and those still at work can have a peaceful time catching up on filing and all the other things that don't happen when we are busy. However for some the next few weeks will be hectic for at the end of August the EPUAP will host its 9th annual meeting in Berlin. I hope that many readers of this newsletter will be there from August 31st to September 2nd to share in what is the key pressure ulcer event of the year. One of the highlights will be the unveiling of the new EPUAP pressure ulcer classification tool PUCLAS 2. If you have used PUCLAS 1 as a guide to helping you classify pressure ulcers then you will already know how useful this CD can be and if you haven't yet used it check it out on-line at www.epuap.org. PUCLAS 2 will be even more helpful with a much wider range of pressure ulcer photographs to explore. Get your copy of PUCLAS 2 at Berlin or contact the EPUAP in the autumn to strengthen your ability to identify pressure ulcers from moisture lesions and then classify true pressure ulcers correctly. The Berlin conference will also feature scientific sessions dedicated to shear and the search for quantitative methods for assessing pressure ulcer risk and the impact of interventions. One initiative to be launched at the Berlin meeting will be the development of a joint guideline on pressure ulcer prevention with the EPUAP and NPUAP coming together to create a new international evidence-based guideline. There will be more on this initiative in the next newsletter which will come 'live' from the Berlin conference. So look on the Wounds UK web-site at the end of August for breaking news from Berlin on the new guideline and other EPUAP activities. As for future news on this newsletter I often receive copies of new PhD Theses from students in mainland Europe. Would you like to see reports of these in this newsletter so that you can keep up to date with the very latest research? Let me know through the Wounds UK website or e-mail me at mailto:clarkm@whru.co.uk Looking forward to seeing you in Berlin as we approach the pressure ulcer highlight of the year - the annual meeting of the European Pressure Ulcer Advisory Panel Michael Clark Editor	References Recent publications

News 9th Open Meeting of the European Pressure Ulcer Advisory Panel, Berlin August 31st - September 2nd 2006. Here is the current programme for the EPUAP conference to be held in Berlin in a few weeks time. The programme is complete apart from the free paper and poster presentations and of course is subject to change as the meeting date draws closer. Hopefully you will have already booked your delegate place at this event? If you have not yet booked why not contact the EPUAP at EPUAP@aol.org to find out more about booking your seat at this event. Flights to Berlin from the UK are relatively inexpensive and hotels have reduced their rates for the August period - for example have a look at the hotel rooms available through www.expedia.co.uk to se the bargains that are on offer. PROGRAMME Thursday August 31st 8.00 am Registration 10:30 am Sponsored symposia Room: BO5-BO6, KCI   21st Century Wound Care - Holistic approach to pressure ulcer management   10:30 am Chair and Introduction, George Cherry, UK 10:50 am Patient evaluation of the benefit of outpatient and inpatient vacuum therapy. Multicentre study with patient-relevant end-points Matthias Augustine, Germany 11.10 am Improving home help quality outcomes with negative pressure wound therapy Christine Lang, USA 11.30 am Cost-effective outcomes Paul Trueman, UK 11.50 am General Discussion Room: BO9, Gaymor   Deep tissue injury in pressure ulcer development   12.00 LUNCH 1.00pm MAIN MEETING PRESSURE ULCERS PUTTING KNOWLEDGE INTO PRACTICE Room: Upstairs main theatre Chairs: Tom Defloor, Peter Diesing   1.00pm Welcoming address 1.10pm Technological advances in pressure ulcer prevention - how close are we to produce an objective clinical monitoring system? Dan Bader 1.35pm Management and treatment of infection in pressure ulcers:polybacterial infection - the role of anaerobic bacteria Joe Selkon, UK 2.00 PM Quality of Life EPUAP Phenomenology group Alison HopkinsWelcoming address 2.25 PM Electrical stimulation for wound Healing: The Technology,Evidence and Protocol Luther Kloth 2.50 PM Implementation Tom Defloor 3.15 PM Keynote address 4.00 PM Welcome to Oxford in 2007 10th Anniversary Meeting George Cherry Tea 4.15 PM Sponsored symposia Room: B 09, Nutricia Chair Michael Clark The role of specialist nutritional intervention in pressure ulcer healing Welcome & Introduction Michael Clark   Nutrition for Effective Pressure Ulcer Treatment Dr. Rebecca Stratton   The role of specific nutrients in wound healing Dr. Ralf-Joachim Schulz   Cubitan and pressure ulcers; putting evidence into practice Prof Jos MGA Schols   Question and answer, summary and close Dr. Michael Clark Room: B05-B06, Smith & Nephew, Chair Professor KeithHarding Evolution or revolution? Adapting to complexity in wound management Why we need more than one approach in pressure ulcer management Professor Keith Harding   The evolution of ALLEVYN and its clinical relevance Theresa Hurd   Considerations in appropriate dressing design Professor Keith Harding   Working with complexity in pressure ulcer management John Timmons   Conclusion and Question Session Professor Keith Harding 6.00 pm Welcome reception in exhibition area   Friday September 1st 8.00 am Poster viewing with discussion and continental breakfast 9.00 am FREE PAPERS Session 1 FREE PAPERS Session 2 10:15 am Coffee Break Room B 05-B06   Chair: Martin Ferguson-Pell 10.45 From the laboratory: Research activities within leading pressure ulcer centres 10.45 Overview to UCL-ACDS Pressure Ulcer Research Strategy Martin Ferguson-Pell 11:00 Quince assessment of mattress degradation Duncan Bain   Tissue Reflectance spectroscopy: - for risk assessment Martin Ferguson-Pell - for early pressure ulcer detection Duncan Bain - related to seating and posture Graham Nicholson Development of test methods for support surface characterisation Duncan Bain and Graham Nicholson Wrapup Martin Ferguson-Pell Room B-09   Chair: Sue Bale Focussed session - Education and pressure ulcers   10.45 Welcome 10.50 PUCLAS 2 Tom Defloor 11.15 Pressure Ulcer education in Portugal Katia Furtado 11.25 Working with EWMA Zena Moore 11.50 Questions and Discussion   12.00 noon LUNCH POSTERS and EXHIBITION VIEWING   Sponsored symposium 12.30 pm Room B-09 Gerromed Chair Luther Kloth Electrical stimulation: a power tool for wound healing - new clinical evidence Pulsatile galvanic stimulation (PGS) associated with surgical treatment of decubitus lesions Dr. Argentina Vidrascu Antibacterial activity of positive and negative polarity high voltage pulsed current (HVPC) on six typical Gram-positive and gram-negative bacterial pathogens of chronic wounds Prof. Dr. Axel Kramer Clinical experience with a new topical device "wound ELŽ" used in geriatric patients with chronic wounds Dr. Ralf-Joachim Schulz Electrical stimulation in treatment of chronic wounds - a prospective study using"wound ELŽ" Prof.Dr. Eike Debus 2.00 pm Room: B-05-B 06, Chair Denis Colin Pressure Ulcer Measurement 2.00 pm Room:Room:B 09, Chair Jacqui Fletcher Shear forces: relevance, measurements and interpretation Speakers: Dr. Denis Colin - the Shear Force Initiative. Progress to date Professor T Ohura, Japan - we have his abstract so title should be available Dr Richard Goosens, The Netherlands need to ask him for abstract Followed by general debate on the relevance of shear force (Participants Bader, Ces Oomens, Alastair McLeod, Goossens, Ohura, Colin) 3.45 pm TEA 4.15 PM FREE PAPERS Session 3 FREE PAPERS Session 4 5.30pm End   7.30-11.00pm Drinks Reception at the Park Inn Berlin, Alexanderplatz followed by dinner and poster prize presentation with entertainment   Saturday September 2nd 9.30am Room: B-05-B06, Chair Tom Defloor Focussed session: classification Room: B-09, Chair Ruud Halfens Some results of the yearly prevalence measurements in Germany and the Netherlands   Introduction to the theme Th.eo Dassen Ruud Halfens   Impact of different nominators and denominators on calculated pressure ulcer prevalence rates N. Lahman, Theo Dassen Ruud Halfens   Variations in pressure ulcer prevalence rates between the Netherlands and Germany - possible explanation A. Tannen, Theo Dassen, Ruud Halfens   Pressure ulcer prevention: Protocols and Prevalence De Wilborn, RJG Halfens, T Dassen   The use of preventive measurements during the years H Bielitz, F Hertel, E Mertens, T Dassen, RJG Halfens   Risk of Pressure ulcers and Care dependency K Balzer, E Mertens, T Dassen and R Halfens   11:00 Tea Room:B 05-B 06 11.30 am AGM and working group reports   Shear Force Initiative Group   When: Sunday September 3rd Where: in Berlin at the Dorint Novotel Berlin Mitte (minutes away from congress area). Room to be notified later Time: 9:00 - 16:00 lunch included Keep reading for: References Download this newsletter in PDF format References This month's references compile MEDLINE and EMBASE listed publications that describe or discuss the relevance of shear forces in pressure ulcer development. All references come from 1997 to 2006 and are listed in descending date order with the latest references first. Barbut F, Parzybut B, Boelle PY, Neyme D, Farid R, Kosmann MJ, et al.[Pressure sores in a university hospital].[see comment]. Presse Medicale 2006;35(5 Pt 1):769-78. Olyaee Manesh A, Flemming K, Cullum NA, Ravaghi H. Electromagnetic therapy for treating pressure ulcers.[update of Cochrane Database Syst Rev. 2001;(1):CD002930; PMID: 11279778]. Cochrane Database of Systematic Reviews 2006(2):CD002930. Thomas DR. Prevention and treatment of pressure ulcers. Journal of the American Medical Directors Association 2006;7(1):46-59. Schoonhoven L, Grobbee DE, Donders AR, Algra A, Grypdonck MH, Bousema MT, et al. Prediction of pressure ulcer development in hospitalized patients: a tool for risk assessment. Quality & Safety in Health Care 2006;15(1):65-70. Park HS, Park KY, Yu SM. [Factors influencing the development of pressure ulcers in surgical patients]. Daehan Ganho Haghoeji 2005;35(1):125-34. Bansal C, Scott R, Stewart D, Cockerell CJ. Decubitus ulcers: a review of the literature. International Journal of Dermatology 2005;44(10):805-10. Ohura N, Ichioka S, Nakatsuka T, Shibata M. Evaluating dressing materials for the prevention of shear force in the treatment of pressure ulcers. Journal of Wound Care 2005;14(9):401-4. Gefen A, Gefen N, Linder-Ganz E, Margulies SS. In vivo muscle stiffening under bone compression promotes deep pressure sores. Journal of Biomechanical Engineering 2005;127(3):512-24. Lindgren M, Unosson M, Krantz AM, Ek AC. Pressure ulcer risk factors in patients undergoing surgery. Journal of Advanced Nursing 2005;50(6):605-12. Mackey D. Support surfaces: beds, mattresses, overlays-oh my! Nursing Clinics of North America 2005;40(2):251-65. Maklebust J. Choosing the right support surface. Advances in Skin & Wound Care 2005;18(3):158-61. Brienza DM, Geyer MJ. Using support surfaces to manage tissue integrity. Advances in Skin & Wound Care 2005;18(3):151-7. Thompson D. A critical review of the literature on pressure ulcer aetiology. Journal of Wound Care 2005;14(2):87-90. Lachenbruch C. Skin cooling surfaces: estimating the importance of limiting skin temperature. Ostomy Wound Management 2005;51(2):70-9. Schoonhoven L, Grobbee DE, Bousema MT, Buskens E, pre Psg. Predicting pressure ulcers: cases missed using a new clinical prediction rule. Journal of Advanced Nursing 2005;49(1):16-22. Feuchtinger J, Halfens RJG, Dassen T. Pressure ulcer risk factors in cardiac surgery: A review of the research literature. Heart & Lung: Journal of Acute & Critical Care. Vol. 34(6)(pp 375-385), 2005. Kikuchi M, Kai Y, Nakai N, Inoue C, Yano K. Control of depressurization and seating are effective for a case of ischial pressure ulcer. [Japanese]. Skin Research. Vol. 4(5)(pp 448-452), 2005. Sharp CA, McLaws ML. A discourse on pressure ulcer physiology: The implications of repositioning and staging. World Wide Wounds. Vol. 2005(pp 9p), 2005. Norton L, Sibbald RG. Is bed rest an effective treatment modality for pressure ulcers? Ostomy Wound Management 2004;50(10):40-2. Fisher AR, Wells G, Harrison MB. Factors associated with pressure ulcers in adults in acute care hospitals. Holistic Nursing Practice 2004;18(5):242-53. Gordon MD, Gottschlich MM, Helvig EI, Marvin JA, Richard RL. Review of evidenced-based practice for the prevention of pressure sores in burn patients. Journal of Burn Care & Rehabilitation 2004;25(5):388-410. Cullum N, McInnes E, Bell-Syer SE, Legood R. Support surfaces for pressure ulcer prevention.[see comment][update of Cochrane Database Syst Rev. 2000;(2):CD001735; PMID: 10796662]. Cochrane Database of Systematic Reviews 2004(3):CD001735. Lindgren M, Unosson M, Fredrikson M, Ek AC. Immobility--a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study. Scandinavian Journal of Caring Sciences 2004;18(1):57-64. Norman D. Measuring interface pressure: validity and reliability problems. Journal of Wound Care 2004;13(2):78-80. Jun Seongsook RN, Jeong Ihnsook RN, Lee Younghee RN. Validity of pressure ulcer risk assessment scales; Cubbin and Jackson, Braden, and Douglas scale. International Journal of Nursing Studies 2004;41(2):199-204. Edlich RF, Winters KL, Woodard CR, Buschbacher RM, Long WB, Gebhart JH, et al. Pressure ulcer prevention. Journal of Long-Term Effects of Medical Implants. Vol. 14(4)(pp 285-304), 2004. Mess SA, Kim S, Davison S, Heckler F. Implantable baclofen pump as an adjuvant in treatment of pressure sores. Annals of Plastic Surgery 2003;51(5):465-7. Bours GJ, Halfens RJ, Berger MP, Huijer Abu-Saad H, Grol RT. Development of a model for case-mix adjustment of pressure ulcer prevalence rates.[see comment]. Medical Care 2003;41(1):45-55. Oura T. New concepts for understanding pressure ulcers. [Japanese]. Japanese Journal of Plastic & Reconstructive Surgery. Vol. 46(4)(pp 343-352), 2003.Date of Publication: 01 APR 2003. Lyder CH. Pressure ulcer prevention and management. Journal of the American Medical Association. Vol. 289(2)(pp 223-226), 2003.Date of Publication: 08 JAN 2003. Jastremski CA. Pressure relief bedding to prevent pressure ulcer development in critical care. Journal of Critical Care 2002;17(2):122-5. Collins F. Vicair Academy Mattress in the prevention of pressure damage. British Journal of Nursing 2002;11(10):715-8. Ragan R, Kernozek TW, Bidar M, Matheson JW. Seat-interface pressures on various thicknesses of foam wheelchair cushions: a finite modeling approach. Archives of Physical Medicine & Rehabilitation 2002;83(6):872-5. Perneger TV, Rae AC, Gaspoz JM, Borst F, Vitek O, Heliot C. Screening for pressure ulcer risk in an acute care hospital: development of a brief bedside scale.[see comment]. Journal of Clinical Epidemiology 2002;55(5):498-504. Read S. Treatment of a heel blister caused by pressure and friction. British Journal of Nursing 2001;10(1):10-12, 16-19. Williams C. 3M Cavilon Durable Barrier Cream in skin problem management. British Journal of Nursing 2001;10(7):469-70. Hampton S, Collins F. SuperSkin: the management of skin susceptible to breakdown. British Journal of Nursing 2001;10(11):742-6. Hughes C. Obstetric care. Is there risk of pressure damage after epidural anaesthesia? Journal of Tissue Viability 2001;11(2):56-8. Bergquist S. Subscales, subscores, or summative score: evaluating the contribution of Braden Scale items for predicting pressure ulcer risk in older adults receiving home health care. Journal of Wound, Ostomy, & Continence Nursing 2001;28(6):279-89. Gunningberg L, Lindholm C, Carlsson M, Sjoden PO. Risk, prevention and treatment of pressure ulcers--nursing staff knowledge and documentation. Scandinavian Journal of Caring Sciences 2001;15(3):257-63. Thomas DR. Prevention and treatment of pressure ulcers: what works? what doesn't? Cleveland Clinic Journal of Medicine 2001;68(8):704-7, 717-22. Reichert B, Krapohl BD, Plotz W, Mailander P. Modified dorsalis pedis flap for coverage of a pretibial pressure sore after hip rotationplasty. British Journal of Plastic Surgery 2001;54(3):262-4. Rubayi S, Kiyono Y. Flap surgery to cover olecranon pressure ulcers in spinal cord injury patients. Plastic & Reconstructive Surgery. Vol. 107(6)(pp 1473-1481), 2001. Graff MK, Bryant J, Beinlich N. Preventing heel breakdown.[see comment]. Orthopaedic Nursing 2000;19(5):63-9. Halfens RJ, Van Achterberg T, Bal RM. Validity and reliability of the braden scale and the influence of other risk factors: a multi-centre prospective study. International Journal of Nursing Studies 2000;37(4):313-9. Kolnaar BGM, Chel VGM. Summary of the guideline 'Decubitus' [pressure ulcer] of the Dutch College of General Practitioners. [Dutch]. Nederlands Tijdschrift voor Geneeskunde. Vol. 144(14)(pp 646-649), 2000.Date of Publication: 01 APR 2000. Sanders JE, Goldstein BS, Leotta DF, Richards KA. Image processing techniques for quantitative analysis of skin structures. Computer Methods & Programs in Biomedicine 1999;59(3):167-80. Mon Hsia L, Grimm DR, Teodorescu V, Kronowitz SJ, Bauman WA. Transcutaneous oxygen tension in subjects with tetraplegia with and without pressure ulcers: A preliminary report. Journal of Rehabilitation Research & Development. Vol. 36(3)(pp 202-206), 1999. Fontaine R, Risley S, Castellino R. A quantitative analysis of pressure and shear in the effectiveness of support surfaces. Journal of Wound, Ostomy, & Continence Nursing 1998;25(5):233-9. Zulkowski K. Construct validity of Minimum Data Set items within the context of the Braden Conceptual Schema. Ostomy Wound Management 1998;44(10):36-40, 46-7. Goldstein B, Sanders J. Skin response to repetitive mechanical stress: a new experimental model in pig. Archives of Physical Medicine & Rehabilitation 1998;79(3):265-72. Schue RM, Langemo DK. Pressure ulcer prevalence and incidence and a modification of the Braden Scale for a rehabilitation unit. Journal of Wound, Ostomy, & Continence Nursing 1998;25(1):36-43. Klitzman B, Kalinowski C, Glasofer SL, Rugani L. Pressure ulcers and pressure relief surfaces. Clinics in Plastic Surgery. Vol. 25(3)(pp 443-450), 1998. Tourtual DM, Riesenberg LA, Korutz CJ, Semo AH, Asef A, Talati K, et al. Predictors of hospital acquired heel pressure ulcers. Ostomy Wound Management 1997;43(9):24-8, 32-4 passim. James H. Pressure sore prevention in acutely ill patients. Professional Nurse 1997;12(6 Suppl):S8-10. Sorensen JL, Lassen MK, Alsbjorn BF, Gottrup F. [Pressure sores. Background and therapeutic strategy]. Ugeskrift for Laeger 1997;159(3):275-9.   Download this newsletter in PDF format