Click here for the Wounds UK Home Page February 2007

News report February 2007	What is the true cost of wound Care Education? Recently I had the pleasure of being invited to speak at a pressure ulcer symposium sponsored by a well-established medical device manufacturer. For a day and a half over 100 tissue viability nurses enjoyed a series of well-delivered presentations along with excellent hospitality. Such events remain relatively common although perhaps diminished in frequency and scale since the heady days of the 1990's. However do we stop to consider the cost of such events? In the early days of tissue viability many of the commercially supported events were in truth little more than opportunities to place marketing messages, sales staff and potential customers in the same room. As time passed the programme of these meetings slowly improved until today where few (if any) company-specific messages are delivered. So the educational value of these events is probably similar to many non-commercial conferences and symposia. That being said there has been a growing trend for major conferences to provide opportunities for manufacturers to host symposia that largely present new products and the scientific and clinical evaluations that have been undertaken to support the new intervention. The tissue viability community has to be vigilant regarding the insertion of these symposia within conferences for there could be a time where the non-commercial presentations become squeezed into unsocial time slots to allow as many commercial symposia as the market desires and the conference day allows! Probably the real costs of commercially sponsored events lie in our time and negative perceptions of the tissue viability community. What is the cost to the health service for 100 plus senior nursing colleagues to attend a symposium, in the case of my recent event that would be 150 TVN-days, which in any currency equates to quite a lot of money and perhaps more importantly the opportunity costs of the strategic and local wound care decisions that could have been made if everyone had been at work rather than at a conference. As for perceptions enough has been said around the close relationships between the commercial sector and the tissue viability community to make further comment redundant. How do we justify the time and minimise the perhaps unfair views that the relationship between manufacturers and tissue viability practitioners is unhealthy? Perhaps one solution would be to demonstrate that the educational event had merit equivalent to attending a non-commercial event? This could be achieved through the accreditation of company symposia and by extrapolation all commercial sourced educational tools. Who would provide such accreditation - perhaps this could best be undertaken within the trade associations to which our manufacturers belong probably with the trade association working with established educational providers to assess and quality-mark proposed commercial conferences? Through such routes we may be able to demonstrate to local management that an event is both worthwhile and does not reflect an overfriendly relationship with one or more suppliers. What do you think of such an approach to safeguarding the value of commercial symposia especially in a climate where health service educational budgets are increasingly squeezed dry? Michael Clark Editor	References

News report February 2007 Pressure ulcer conferences The 2007 pressure ulcer conference season has begun with the 10th meeting of the US National Pressure Ulcer Advisory Panel in San Antonio, Texas over the 9th and 10th of February. This event marked the 20th anniversary of the founding of the NPUAP (Editor's note - it doesn't seem like 20 years have passed since the early discussions regarding forming NPUAP and the first meetings of the new initiative). The conference titled 'Charting the Course for Pressure Ulcer Prevention and Treatment' aimed at providing three key outcomes; Definitions of pressure ulcer grading that accommodate the concept of deep tissue injury Definitions of the performance of support surfaces Clinical, legal and regulatory perspectives around current best practice for pressure ulcer prevention and treatment Next month's news report will seek to address what happened at this event and what the 'take home' messages for the UK tissue viability community were! New pressure ulcer Phd thesis. It is a pleasure to note that another PhD student has completed their thesis on pressure ulcers. Debby Gawlitta studied Biomedical Engineering at the Eindhoven University of Technology followed by a traineeship at the Georgia Institute of Technology. The project was focussed on fibrin and collagen as scaffold materials in tissue engineered small diameter blood vessels. She obtained her masters degree in 2002 on a project involving the development of a device to study cellular and collagen responses to mechanical conditioning in tissue engineered aortic valve constructs. Now she has recently completed her PhD thesis working on markers for mechanically induced damage of tissue engineered skeletal muscle tissue. The reference to her PhD thesis exploring aspects of pressure ulcer aetiology is listed below. D. Gawlitta, Compression induced factors influencing the damage of engineered skeletal muscle, PhD. Thesis, 2007, Eindhoven University of Technology Download this newsletter in PDF format References This month's pressure ulcer references are drawn from new references to be added to MEDLINE and highlight the growing importance of pressure ulcer research in mainland Europe. Hedman, T.L., Chapman, T.T., Dewey, W.S., Quick, C.D., Wolf, S.E., and Holcomb, J.B., Two simple leg net devices designed to protect lower-extremity skin grafts and donor sites and prevent decubitus ulcer. Journal of Burn Care & Research, 2007. 28(1): p. 115-9. Kottner, J., Mertens, E., and Dassen, T., [Pressure ulcer prevalence in Germany: results of a cross-sectional study in 2006]. Pflege Zeitschrift, 2007. 60(1): p. 28-31. Vanderwee, K., Grypdonck, M., and Defloor, T., Non-blanchable erythema as an indicator for the need for pressure ulcer prevention: a randomized-controlled trial. Journal of Clinical Nursing, 2007. 16(2): p. 325-35. Vanderwee, K., Grypdonck, M.H., De Bacquer, D., and Defloor, T., Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesions. Journal of Advanced Nursing, 2007. 57(1): p. 59-68. Rastinehad, D., Pressure ulcer pain. Journal of Wound, Ostomy, & Continence Nursing, 2006. 33(3): p. 252-7. Gunningberg, L., EPUAP Pressure Ulcer Prevalence Survey in Sweden: A Two-Year Follow-Up of Quality Indicators. Journal of Wound, Ostomy, & Continence Nursing, 2006. 33(3): p. 258-66. Hopkins, A., Dealey, C., Bale, S., Defloor, T., and Worboys, F., Patient stories of living with a pressure ulcer. Journal of Advanced Nursing, 2006. 56(4): p. 345-53. Wilborn, D., Halfens, R., and Dassen, T., Pressure Ulcer: Prevention protocols and prevalence. Journal of Evaluation in Clinical Practice, 2006. 12(6): p. 630-8. de Sousa, C.A., Dos Santos, I., and da Silva, L.D., [Applying recommendations of the Braden's scale and preventing pressure ulcers--evidences for nursing care]. Revista Brasileira de Enfermagem, 2006. 59(3): p. 279-84. Zulkowski, K. and Ratliff, C., Perineal dermatitis or pressure ulcer: how can you tell? Nursing, 2006. 36(12 Pt.1): p. 22-3. Dini, V., Bertone, M., and Romanelli, M., Prevention and management of pressure ulcers. Dermatologic Therapy, 2006. 19(6): p. 356-64. Vollman, K.M., Ventilator-associated pneumonia and pressure ulcer prevention as targets for quality improvement in the ICU. Critical Care Nursing Clinics of North America, 2006. 18(4): p. 453-67. Noonan, C., Quigley, S., and Curley, M.A., Skin integrity in hospitalized infants and children a prevalence survey. Journal of Pediatric Nursing, 2006. 21(6): p. 445-53. Quintavalle, P.R., Lyder, C.H., Mertz, P.J., Phillips-Jones, C., and Dyson, M., Use of high-resolution, high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development. Advances in Skin & Wound Care, 2006. 19(9): p. 498-505. Mahan, P., Agency for Healthcare Research and, Q., and Agency for Health Care Policy and, R., Pressure ulcer prevention and treatment part II--treatment. Journal of Practical Nursing, 2006. 56(3): p. 6-18; quiz 18-20. Kim, T.Y. and Lang, N.M., Predictive modeling for the prevention of hospital-acquired pressure ulcers. AMIA, 2006. Annual Symposium Proceedings/AMIA Symposium.: p. 434-8. Sharp, C.A. and McLaws, M.L., Estimating the risk of pressure ulcer development: is it truly evidence based? International Wound Journal, 2006. 3(4): p. 344-53. Abel, R.L., Warren, K., Bean, G., Gabbard, B., Lyder, C.H., Bing, M., and McCauley, C., Quality improvement in nursing homes in Texas: results from a pressure ulcer prevention project. Journal of the American Medical Directors Association, 2005. 6(3): p. 181-8. Thomas, D.R. and Osterweil, D., Is a pressure ulcer a marker for quality of care? Journal of the American Medical Directors Association, 2005. 6(3): p. 228-30. Acaroglu, R. and Sendir, M., Pressure ulcer prevention and management strategies in Turkey. Journal of Wound, Ostomy, & Continence Nursing, 2005. 32(4): p. 230-7. Dosa, D., Should I hospitalize my resident with nursing home-acquired pneumonia? Journal of the American Medical Directors Association, 2005. 6(5): p. 327-33. Li, Z., E, C.T., M, C.K., A, T.M., S, L.L., and M, P.L., Effect of prolonged pressure on flowmotion: An Investigation Using an in vivo Rat Model. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine & Biology Society, 2005. 1: p. 597-600. Yang, Y. and Wang, J., A design of bioimpedance spectrometer for early detection of pressure ulcer. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine & Biology Society, 2005. 6: p. 6602-4. Factora, R., Year in review: National Pressure Ulcer Long-Term Care Study (NPULS). Journal of the American Medical Directors Association, 2004. 5(5): p. 356-7. Lee, Y.H., Jeong, I.S., and Jeon, S.S., [A comparative study on the predictive validity among pressure ulcer risk assessment scales]. Daehan Ganho Haghoeji, 2003. 33(2): p. 162-9. Thomas, D.R., Are all pressure ulcers avoidable? Journal of the American Medical Directors Association, 2001. 2(6): p. 297-301. Dimant, J. and Amda, Implementing pressure ulcer prevention and treatment programs: using AMDA Clinical Practice Guidelines. Journal of the American Medical Directors Association, 2001. 2(6): p. 315-25. Benati, G., Delvecchio, S., Cilla, D., and Pedone, V., Impact on pressure ulcer healing of an arginine-enriched nutritional solution in patients with severe cognitive impairment. Archives of Gerontology & Geriatrics - Supplement, 2001. 7: p. 43-7. Rogers, A.A., Burnett, S., Moore, J.C., and Shakespeare, P.G., Involvement of proteolytic enzymes-plasminogen activators and matrix metalloproteinases-in the pathophysiology of pressure ulcers. Wound Repair & Regeneration, 1995. 3(3): p. 273-83. Starer, P., Cystometric evaluation of elderly nursing home patients with indwelling urinary catheters. Archives of Gerontology & Geriatrics, 1992. 15(1): p. 79-86.