Click here for the Wounds UK Home Page July 2005

Get involved with the European Pressure Ulcer Advisory Panel's incidence project! Have you got a copy of Bedsore Biomechanics? Join the campaign for a reprint What have been the most influential publications in pressure ulcer prevention and treatment? Informal readers' poll	Does your neighbour know about pressure ulcers? Over the past few months new words have begun to creep into everyday English - terms like MRSA and infection control appear regularly on news and current affairs programmes and on the front pages of our newspapers. In a short space of time the cleanliness of health care facilities and the presumed link between cleanliness and infections have become newsworthy and are seen by the public and our elected representatives as being important and even vote-catching. This is a positive development serving to raise the awareness of one aspect of health care but why stop at nosocomial infections? Why shouldn't pressure ulcers be equally important? The costs and consequences of pressure ulcers are equally dramatic but how many of the public would be aware of this? Probably the answer is relatively few. While this remains the case then how can we expect pressure ulcers to be seen as a health care priority? The European Pressure Ulcer Advisory Panel sent a letter to all UK Members of Parliament in 2004 setting out the scale of the problem of pressure ulcers and their consequences for the Health Service. From these letters sent to our elected representatives how many responses did EPUAP receive? One hundred? Fifty? Twenty? No, only 5 MP's responded with none seeking further details upon pressure ulcers. How do we press pressure ulcers higher upon the political and public agenda? This is a thorny issue - should the public be made aware of the appearance of severe pressure ulcers through advertising campaigns? Might such shock tactics backfire by suggesting that the health care professionals who work to prevent and treat such wounds have in some way failed to protect the vulnerable patients in their care? Can we raise awareness of pressure ulcers without the use of striking clinical images? But how then to get the impact of a severe pressure ulcer across to the general public who may have no perception of the effect of such wounds upon the quality and quantity of life experienced by people with large pressure ulcers? These are key questions that must be answered if any campaign to enhance the public awareness of pressure ulcers has any chance of achieving its goals. If we cannot engage the public and our politicians in this debate then it is unlikely that our neighbours will ever understand the importance of pressure ulcers while other issues will continue to dominate the health care debate. Michael Clark Editor	Keeping up to date with pressure area care What's New So Far in 2005?

Get involved with the European Pressure Ulcer Advisory Panel's incidence project! The European Pressure Ulcer Advisory Panel (EPUAP) are going to undertake a pilot study to investigate the robustness of their proposals for measuring pressure ulcer incidence and you can get involved in this exciting project. The EPUAP seeks participants working within acute care who would be willing to undertake the following; a pressure ulcer prevalence survey conducted using the EPUAP methodology. This can be performed across an entire hospital or within selected medical specialities. The prevalence survey will then be followed up with a four to eight week period of daily incidence recording within the ward with the greatest perceived pressure ulcer problem as identified during the prevalence survey. These surveys will be conducted in early 2006 with the overall project report presented during the next Open Meeting of the EPUAP to be held in Berlin over the 31st August to 2nd September 2006. The EPUAP do not have funds available to support individual participants within the incidence project but each participating site will receive training in pressure ulcer classification and incidence monitoring. If you would like to receive further details regarding participation in this project or be kept informed of the project's progress then contact the EPUAP Incidence Working Group through clarkm@whru.co.uk. Keep reading for: Have you got a copy of Bedsore Biomechanics? What have been the most influential publications in pressure ulcer prevention and treatment? Keeping up to date with pressure area care Download this newsletter in PDF format Have you got a copy of Bedsore Biomechanics? Thirty years ago the first UK meeting on pressure ulcers was held in Glasgow and the proceedings of this meeting were published in 1976 as a book 'Bedsore Biomechanics' edited by Kenedi, Cowden and Scales. Published by Macmillan Press the book quickly disappeared from print and remains hard to obtain today. The individual presentations were divided into six sessions - pressure ulcers the problem, tissue biomechanics, state of the art in prevention, cure and cost effectiveness, patient monitoring, body support characteristics and reports from working groups. Perhaps the greatest indictment of our progress over the past thirty years is that much of the content of Bedsore Biomechanics remains as relevant today as it did back in 1975. While relevant, not many of us have access to a full copy of this valuable book and perhaps it is now time for an enterprising publisher to seek to re-print this essential companion to understanding the causes and management of pressure ulcers? Maybe the first step in achieving a reissue of Bedsore Biomechanics is to provide evidence that the tissue viability community really wants to be able to obtain a copy? To this end this newsletter seeks to start an avalanche leading to the eventual publication of Bedsore Biomechanics for today's tissue viability practitioners and researchers. E-mail us at Wounds UK and register your support for Bedsore Biomechanics to be made available. With evidence of support for the title we can then petition the copyright holders that a re-print would be commercially viable. I would also encourage all the UK tissue viability and wound care organisations to get involved and lend their support for Bedsore Biomechanics to once again grace our bookshelves! Keep reading for: What have been the most influential publications in pressure ulcer prevention and treatment? Keeping up to date with pressure area care Download this newsletter in PDF format What have been the most influential publications in pressure ulcer prevention and treatment? Over the years a vast amount of research studies, clinical guidelines, books, journals and reports have been issued upon the topics of pressure ulcer prevention and treatment, but of these which have had the greatest impact upon practice and practitioners in the United Kingdom? Indeed have any led to significant improvements in the care of people vulnerable to, or with pressure ulcers? This e-newsletter would like to know your views on what have been the five most significant publications on pressure ulcers since the start of the 'modern' era of pressure ulcer activity in 1960. Let us know by e-mail to Wounds UK and tell us why you think these are the key reports to have changed practice. Over the summer and early autumn we will report month-by-month with a summary of the opinions of the readers of this newsletter on what has influenced us most, and why. Take part in this informal poll of readers and let's find out which publication has had the greatest impact on pressure area care. Keep reading for: Keeping up to date with pressure area care Download this newsletter in PDF format Pressure Ulcer References: What's New So Far in 2005? With six months of the year gone a quick search through MEDLINE for new pressure ulcer publications has identified 77 new papers in print since the beginning of the year. Have you read all of these? There is a real challenge for all of us - how do we keep up to date with the ever growing torrent of new ideas and evidence for our practices? This e-newsletter sets out a group of interesting new publications to help keep you up-to-date with what's happening in pressure ulcers. Sharp C, Burr G, Broadbent M, Cummins M, Casey H, Merriman A. Clinical variance in assessing risk of pressure ulcer development. British Journal of Nursing 2005;14(6):S4-12. Clark M. Changing pressure-redistributing mattress stocks: costs and outcomes. British Journal of Nursing 2005;14(6):S30-2. Dorr DA, Horn SD, Smout RJ. Cost analysis of nursing home registered nurse staffing times. Journal of the American Geriatrics Society 2005;53(5):840-5. Sae-Sia W, Wipke-Tevis DD, Williams DA. Elevated sacral skin temperature (T(s)): a risk factor for pressure ulcer development in hospitalized neurologically impaired Thai patients. Applied Nursing Research 2005;18(1):29-35. Salas Campos L, Pastor Amoros T, Martin Campos R, Martinez de la Chica A, De Haro Barrios A. [Therapeutic uses for Asian yellow-flowered crowfoot, genus Ranunculus: the case of Blastoestimulina]. Revista de Enfermeria 2005;28(1):59-62. Gonzalez Jimenez F, Pareja Illeras M, Jimenez Lopez P, Carmona Sanchez M. [How to evaluate nursing procedures for bedsores, or decubitus ulcers by means of a codified and computerized record-keeping system]. Revista de Enfermeria 2005;28(1):23-6. Dittes P. The princess and the pea-sized wound. Home Healthcare Nurse 2005;23(3):150-1. 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. Wedge C, Gosney M. Pressure-relieving equipment: promoting its correct use amongst nurses via differing modes of educational delivery. Journal of Clinical Nursing 2005;14(4):473-8. de Laat EH, Scholte op Reimer WJ, van Achterberg T. Pressure ulcers: diagnostics and interventions aimed at wound-related complaints: a review of the literature. Journal of Clinical Nursing 2005;14(4):464-72. Fleurence RL. Measuring quality of life in patients with pressure ulcers to include in economic evaluations. Journal of Wound Care 2005;14(3):129-31. Torra i Bou JE, Segovia Gomez T, Verdu Soriano J, Nolasco Bonmati A, Rueda Lopez J, Arboix i Perejamo M. The effectiveness of a hyperoxygenated fatty acid compound in preventing pressure ulcers. Journal of Wound Care 2005;14(3):117-21. Crawford SA, Strain B, Gregg B, Walsh DM, Porter-Armstrong AP. An investigation of the impact of the Force Sensing Array pressure mapping system on the clinical judgement of occupational therapists. Clinical Rehabilitation 2005;19(2):224-31. Gunningberg L. Are patients with or at risk of pressure ulcers allocated appropriate prevention measures? International Journal of Nursing Practice 2005;11(2):58-67. Willock J, Harris C, Harrison J, Poole C. Identifying the characteristics of children with pressure ulcers. Nursing Times 2005;101(11):40-3. Gardner SE, Frantz RA, Bergquist S, Shin CD. A prospective study of the pressure ulcer scale for healing (PUSH). Journals of Gerontology Series A-Biological Sciences & Medical Sciences 2005;60(1):93-7. Lachenbruch C. Skin cooling surfaces: estimating the importance of limiting skin temperature. Ostomy Wound Management 2005;51(2):70-9. Ankrom MA, Bennett RG, Sprigle S, Langemo D, Black JM, Berlowitz DR, et al. Pressure-related deep tissue injury under intact skin and the current pressure ulcer staging systems. Advances in Skin & Wound Care 2005;18(1):35-42. Defloor T, Grypdonck MF. Pressure ulcers: validation of two risk assessment scales. Journal of Clinical Nursing 2005;14(3):373-82.   Download this newsletter in PDF format