Click here for the Wounds UK Home Page November 2006

Forthcoming conference on pressure ulcers	This month's editorial must focus upon the forthcoming Harrogate conference over November 13th to 15th 2006. National wound conferences have been taking place in Harrogate since at least 1990 when the Tissue Viability Society hosted an event in the autumn of 1990 in a Harrogate hotel. However for many 'Harrogate' started with the second European Wound Management Association event held in October 1992. Looking back at the programme of this event there was a single session of free papers dedicated to pressure ulcers with seven presentations. The topics of the presentations covered three studies on risk assessment, two on pressure-redistributing surfaces with single presentations upon epidemiology and aetiology. Fourteen years later there are now two sessions in this year's Harrogate programme dedicated to pressure ulcers. The first explores the aetiology and management of heel pressure ulcers while the second revisits arguments for and against risk assessment. No doubt the free paper presentations and posters will provide additional pressure ulcer dedicated material. The extra session pressure ulcers have gathered over 14 years of almost annual Harrogate conferences is encouraging but have we made so little progress over this span of time that we still debate risk assessment with no clearer decisions on the utility of this activity than we had back in 1992? Perhaps when the EPUAP host their 10th annual conference in 2007 that meeting will be able to highlight where (and if) significant advances in our understanding of pressure ulcers have occurred? So many conferences and apparently so little progress? Is that the reality in pressure area care or are we looking in the wrong places for this progress to be found? We still have to turn away from the really big question - are there fewer people with pressure ulcers in 2006 than when the first Harrogate pressure ulcer session occurred back in 1992? That we can't answer this question is a cause for real concern for without strong baseline data we will never convince anyone that our future actions bear fruit with improved health outcomes for people vulnerable to developing pressure ulcers. However it is not all doom and gloom recent advances in imaging technology now allow detailed examination of the skin and soft tissue under clinically relevant loading conditions - this work coupled with studies of the biomechanical responses of cells and tissues will hopefully lead to greater insight into the mechanical causes of pressure damage. So we get part of the jigsaw right but overlook the fundamental issue - has the passage of time since the first Harrogate conference really seen a reduced burden of pressure ulcers through improved preventive care and more effective treatments? Michael Clark Editor	References

Forthcoming conference on pressure ulcers. The start of the 2007 wound care conference season starts as early as January 9th 2007 with a one day meeting to provide practical advice on implementing the Essence of Care Benchmark for Pressure Ulcers. This meeting will take place in Manchester. The conference promotional material notes that 'pressure ulcers have been identified by patients and carers as being one of nine aspects of care that are critical to their experience of healthcare and things that really matter to them. Chaired by John Badham, Professional Nurse Advisor, National Clinical Governance Support Team, this conference provides practical guidance on delivering on the Essence of Care Benchmark for Pressure Ulcers and improving the patient experience'. Further details of this event can be found at www.healthcare-events.co.uk Download this newsletter in PDF format References This month's references highlight recent publications on pressure ulcer prevalence so highlighting that we have a long way to go before we have common definitions and uniform ways to record pressure ulcer occurrence! Srisupan V. Senaratana W. Picheansatian W. Chittreecheur J. Watanakool M. Chaisri P. Singhakumfu L. Tribuddharat C. Danchaivijitr S. Reduction of the incidence of pressure sores by an education program on nursing care. Journal of the Medical Association of Thailand. 2005, 88 Suppl 10:S166-70. Dellefield ME. Organizational correlates of the risk-adjusted pressure ulcer prevalence and subsequent survey deficiency citation in California nursing homes. Research in Nursing & Health. 2006, 29(4):345-58. Hart S. Bergquist S. Gajewski B. Dunton N. Reliability testing of the National Database of Nursing Quality Indicators pressure ulcer indicator. Journal of Nursing Care Quality. 2006, 21(3):256-65. de Laat EH. Schoonhoven L. Pickkers P. Verbeek AL. van Achterberg T. Epidemiology, risk and prevention of pressure ulcers in critically ill patients: a literature review. 2006, Journal of Wound Care. 15(6):269-75. Langemo DK. Brown G. Skin fails too: acute, chronic, and end-stage skin failure. Advances in Skin & Wound Care. 2006, 19(4):206-11. Barbut F. Parzybut B. Boelle PY. Neyme D. Farid R. Kosmann MJ. Luquel L. [Pressure sores in a university hospital. Presse Medicale. 2006, 35(5 Pt 1):769-78. Rosen J. Mittal V. Degenholtz H. Castle N. Mulsant BH. Hulland S. Nace D. Rubin F. Ability, incentives, and management feedback: organizational change to reduce pressure ulcers in a nursing home. Journal of the American Medical Directors Association. 2006, 7(3):141-6. Edwards JL. Pandit H. Popat MT. Perioperative analgesia: a factor in the development of heel pressure ulcers?. British Journal of Nursing. 2006, 15(6):S20-5. Hiser B. Rochette J. Philbin S. Lowerhouse N. Terburgh C. Pietsch C. Implementing a pressure ulcer prevention program and enhancing the role of the CWOCN: impact on outcomes. Ostomy Wound Management. 2006, 52(2):48-59. Lahmann NA. Halfens RJ. Dassen T. Pressure ulcers in German nursing homes and acute care hospitals: prevalence, frequency, and ulcer characteristics. Ostomy Wound Management. 2006, 52(2):20-33.  Scott JR. Gibran NS. Engrav LH. Mack CD. Rivara FP. Incidence and characteristics of hospitalized patients with pressure ulcers: State of Washington, 1987 to 2000. Plastic & Reconstructive Surgery. 2006, 117(2):630-4. Schwien T. Gilbert J. Lang C. Pressure ulcer prevalence and the role of negative pressure wound therapy in home health quality outcomes. Ostomy Wound Management. 2005, 51(9):47-60. Stausberg J. Kroger K. Maier I. Niebel W. Schneider H. [Frequency of decubitus ulcer in patients of a university medical center. Combination of routine documentation and cross-sectional study]. Deutsche Medizinische Wochenschrift. 2005, 130(41):2311-5.