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Wounds 2019 Mar 15. Epub 2019 Mar 15.

Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH.

Introduction: Chronic wounds are physically debilitating and painful and are responsible for the addition of more than $25 billion annually in health care costs in the United States. Extracellular matrix (ECM) replacements have been demonstrated to aid in wound healing by providing an optimal environment to facilitate the healing process.

Objective: This study examines the healing rates of stage 4 pressure ulcers using combination of a commercially available porcine-based wound matrix dressing alongside negative pressure wound therapy (NPWT) versus using NPWT alone. Read More

J Wound Care 2019 Apr;28(Sup4):S23-S30

Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China.

Objective: To verify the feasibility of treating pressure ulcers (PUs) with autologous platelet-rich fibrin-based (PRF) bioactive membrane, both in vitro and in vivo.

Method: An animal model using adult male Sprague-Dawley rats was used. Pressure was periodically exerted on the skin to induce localised ischaemia by using an external magnet and transplanted metal disc. Read More

J Wound Care 2019 Apr;28(Sup4):S18-S22

Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Objective: Ultrasonography is suitable for assessing pressure ulcers, and several features of ultrasonographic images that indicate abnormalities have been reported. However, no study has compared ultrasonographic images between normal and pressure-loaded skin and subcutaneous tissue from the same patients. This study aimed to assess lateral thoracic tissue using ultrasonography for both pre- and postoperative conditions and investigate changes in the tissue caused by loading. Read More

J Wound Care 2019 Apr;28(Sup4):S4-S11

Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Objective: This article compares the results from a recent pressure ulcer (PU) prevalence audit at the Sheikh Khalifa Medical City (SKMC) hospital in Abu Dhabi to identify the impact of new prevention initiatives introduced around 2013 and establish the effectiveness of PU prevention strategies, judged quality of nursing care, and costs associated with patients developing a hospital-acquired pressure ulcer (HAPU).

Method: The methods used were based on a previous point prevalence study involving 441 acute care patients, who were assessed using the International Pressure Ulcer Prevalence (IPUP) Survey. Following pre-selection of a 24-hour period for data capture, hospital staff collected PU data. Read More

Foot (Edinb) 2019 Feb 2;39:37-44. Epub 2019 Feb 2.

Department of Plastic and Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States.

Forefoot ulcerations in patients with diabetes are quite common. Underlying mechanical deformities of the foot in combination with neuropathy are the most important risk factors for ulcer development and adequate offloading is the mainstay of management. Most ulcers heal with local wound care, adequate blood supply, and pressure relief. Read More

Adv Skin Wound Care 2019 Apr 2. Epub 2019 Apr 2.

At the Rehabilitation Engineering and Applied Research Lab, Georgia Institute of Technology, in Atlanta, Georgia, Stephen Sprigle, PhD, PT, is a Professor; and Sharon Sonenblum, PhD, is a Senior Research Scientist.

Objective: To visually assess and report the influence of supine positioning and sacrum and coccyx anatomy on tissue deformation.

Methods: A convenience sample of three participants was scanned using MRI. All participants were scanned in a supine position with a rig oriented in a flat or horizontal position and with the torso portion of the rig elevated to 30° to simulate head-of-bed elevation. Read More

Adv Skin Wound Care 2019 Apr 2. Epub 2019 Apr 2.

At the Guilan University of Medical Sciences, in Rasht, Iran, Mostafa Soodmand, MSc, is a medical-surgical nursing student, School of Nursing and Midwifery; Mohammad Taghi Moghadamnia, PhD, is Assistant Professor of Health in Disasters and Emergencies, Department of Medical-Surgical Nursing, School of Nursing and Midwifery; Iraj Aghaei, PhD, is Assistant Professor of Neurosciences, Social Determinants of Health Research Center; Golshan Ghasemzadeh, BSN, is a researcher, Healthy Heart Research Center, Heshmat Hospital; Ehsan Kazemnejad Lili, PhD, is Associate Professor of Biostatistics, School of Nursing and Midwifery; and Enayatollah Homaie Rad, PhD, is Assistant Professor of Health Economics, Social Determinants of Health Research Center.

Objective: To investigate the roles of hemodynamic factors and oxygenation on the incidence of pressure ulcers in patients in the ICU on mechanical ventilation.

Methods: This prospective analytical cross-sectional study was performed in several ICUs for a period of 8 months in Iran. Researchers checked patients for pressure ulcers on a daily basis. Read More

J Tissue Viability 2019 Mar 27. Epub 2019 Mar 27.

Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; School of Health Sciences, Örebro University, Sweden. Electronic address:

Background: Pressure ulcers have a high impact on patients and their families. Profound and up-to-date knowledge among nurses is important given the effect on attitudes and preventative behaviour. To gain insight into educational needs and priorities, regular knowledge assessments are needed. Read More

Wounds 2019 Apr;31(4 Suppl):S19-S27

Ali Anaim, DPM PC, Philadelphia, PA; Temple University Hospital, Philadelphia, PA; Episcopal Hospital, Philadelphia, PA; Nazareth Hospital, Philadelphia, PA; Phoenixville Hospital, Phoenixville, PA; Pennsylvania Surgery and Laser Center, Philadelphia, PA.

Introduction: Over time, acute and chronic, nonhealing wounds impose heavy financial and quality-of-life burdens on patients. The introduction of new therapies for wounds is essential in benefiting the patient, and in this report, the clinical experience of various wound care providers treating wounds with dehydrated amnion/chorion membrane (dACM) is presented.

Objective: This retrospective clinical experience evaluated the effects of dACM in the treatment of 50 acute and chronic wounds of various etiologies. Read More

Wounds 2019 Apr;31(4):97-102

Osiris Therapeutics, Inc, Columbia, MD.

Introduction: Cryopreserved placental membrane containing viable cells (vCPM) in conjunction with standard of care (SOC) has shown clinical effectiveness in several studies for the management of acute and chronic wounds. Recently, a new lyophilization technique has been developed that allows viable tissues to be stored at room temperature as a structural and functional equivalent to vCPM.

Objective: This case series evaluates the clinical outcomes of a lyopreserved placental membrane containing viable cells (vLPM) for the management of chronic wounds of various etiologies. Read More

Wounds 2019 Apr;31(4):114-116

Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

Chronic ulcers greatly add to the clinical, economic, and patient burden on health care, increasing visits that challenge patients and strain overworked clinical centers. Telemedicine (TM) facilitates interprofessional collaboration and patient education and enables specialist bedside consults for clients without adding to their transfer and travel risks. Evidence supports improved postoperative monitoring, access to experts, and cost savings for TM-managed patients with acute or chronic wounds in a variety of settings. Read More

Adv Skin Wound Care 2019 Apr;32(4):149

R. Gary Sibbald, MD, MEd, DSc (Hons), FRCPC (Med Derm), FAAD, MAPWCA, JM, is the co-Editor-in-Chief of Advances in Skin & Wound Care; Professor, Medicine and Public Health, University of Toronto, Toronto, Ontario, Canada; Director, International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care), Dalla Lana Faculty of Public Health, University of Toronto; Investigator, Institute for Better Health, Trillium Health Partners; Project Lead, ECHO Ontario, Skin & Wound Care; and President (2008-2012), World Union of Wound Healing Societies. Elizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAAN is the co-Editor-in-Chief of Advances in Skin & Wound Care; Faculty, Excelsior College School of Nursing, Albany, New York; Founder and co-Course Director, WoundPedia Manila; President, World Council of Enterostomal Therapists; President, Ayello Harris & Associates, Inc, Copake, New York; and President (1999), National Pressure Ulcer Advisory Panel.

Z Evid Fortbild Qual Gesundhwes 2019 Mar 12. Epub 2019 Mar 12.

PMV forschungsgruppe an der Medizinischen Fakultät und Uniklinik Köln, Universität zu Köln, Herderstraße 52, 50931 Köln, Deutschland.

Objective: There are still few epidemiological data on patients with chronic wounds (leg ulcers, diabetic foot ulcers and pressure ulcers). Statutory health insurance (SHI) data is increasingly being used for questions relating to healthcare science. When using this data, which is primarily collected for billing purposes, the methodological procedure for defining cases must be presented transparently. Read More

Expert Opin Drug Discov 2019 May 14;14(5):485-497. Epub 2019 Mar 14.

a Department of Medical Cell Biology , Uppsala University , Uppsala , Sweden.

Introduction: Chronic, nonhealing skin wounds claim >3% of the health-care budget in industrialized countries, and the incidence is rising. Currently, two parallel trends influence innovations within the field of wound healing: the need to reduce spread of antibiotic resistance and the emerging use of health economy and value-based models. Areas covered: This review focuses on the discovery of drug candidates and development of treatments aiming to enhance wound healing in the heterogeneous group of patients with nonhealing wounds. Read More

Int Wound J 2019 Apr 12;16(2):550-555. Epub 2019 Mar 12.

Department of Medicine, Division of Dermatology, McGill University Health Centre, Montreal, Quebec, Canada.

Pressure ulcers (PUs) are a serious health care problem for nursing home residents and a key quality metric for regulators. Three initiatives were introduced at a 128-bed facility to improve PU prevention. First, a Quality Assurance and Performance Improvement project and a Root Cause Analysis were conducted to improve the facility's wound care programme. Read More

Plast Reconstr Surg Glob Open 2019 Jan 15;7(1):e2047. Epub 2019 Jan 15.

Department of Surgery, Northwell Health, Lake Success, N.Y.

Background: Chronic wounds represent a significant financial burden to the healthcare system and a quality-of-life burden to patients. Many chronic wounds have elevated bioburden in the form of biofilm, which has been associated with delayed wound healing. This study examined the use of a native type I collagen matrix with the antimicrobial polyhexamethylene biguanide (PCMP) in the management of bioburden and treatment of chronic, nonhealing wounds over 12 weeks. Read More

J Wound Ostomy Continence Nurs 2019 Mar/Apr;46(2):98-105

Cynthia A. Walker, MSN, RN, APRN-CNS, CWON, Interprofessional Practice & Patient Safety, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. Alphonsa Rahman, DNP, APRN-CNS, CCRN, Interprofessional Practice & Patient Safety, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. Trina L. Gipson-Jones, PhD, Hampton University, School of Nursing, Hampton, Virginia. Ché Matthew Harris, MD, MS, FACP, Department of General Internal Medicine, Johns Hopkins School of Medicine, Joint Appointment Johns Hopkins School of Nursing, Division of Hospital Medicine, Collaborative Inpatient Medicine Service, Baltimore, Maryland.

The purpose of this quality improvement project was to determine hospitalists' knowledge, practices, and perspectives related to management of pressure injuries and neuropathic/diabetic foot complications (having a foot ulcer or subsequent development of a foot infection because of a foot ulcer). We also sought to identify resources for and knowledge-based barriers to management of these wounds. This quality improvement effort targeted an interdisciplinary group of 55 hospitalists in internal medicine that consisted of 8 nurse practitioners, 10 physician assistants, and 38 physicians. Read More

Int Wound J 2019 Mar 5. Epub 2019 Mar 5.

Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.

Non-invasive ventilation (NIV) masks are commonly used for respiratory support where intubation or a surgical procedure can be avoided. However, prolonged use of NIV masks involves risk to facial tissues, which are subjected to sustained deformations caused by tightening of the mask and microclimate conditions. The risk of developing such medical device-related pressure ulcers can be reduced by providing additional cushioning at the mask-face interface. Read More

Int Wound J 2019 Feb 28. Epub 2019 Feb 28.

NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.

Healing of non-traumatic skin ulcers is often suboptimal. Prognostic tools that identify people at high risk of delayed healing within the context of routine ulcer assessments may improve this, but robust evidence on which factors to include is lacking. Therefore, we scoped the literature to identify which potentially prognostic factors may warrant future systematic reviews and meta-analyses. Read More

Int Wound J 2019 Feb 27. Epub 2019 Feb 27.

Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel.

The emergency department (ED) is at the front line of hospital pressure injury (PI) prevention, yet ED clinicians must balance many competing clinical priorities in the care of seriously ill patients. This paper presents the current biomechanical and clinical evidence and management considerations to assist EDs to continue to develop and implement evidence-based PI prevention protocols for the high-risk emergency/trauma patient. The prevention of hospital-acquired pressure injuries has received significant focus internationally over many years because of the additional burden that these injuries place on the patient, the additional costs and impact to the efficiency of the hospital, and the potential for litigation. Read More

J Wound Ostomy Continence Nurs 2019 Mar/Apr;46(2):106-112

Paul Fulbrook, PhD, MSc, RN, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Brisbane, Australia; Research and Practice Development, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Brisbane, Australia; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and World Federation of Critical Care Nurses, Dayboro, Queensland, Australia. Petra Lawrence, PhD, RN, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia. Sandra Miles, PhD, MN (Ch & Adol), RN, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Brisbane, Australia; and Nursing Research and Practice Development Centre, The Prince Charles Hospital, Brisbane, Australia.

Purpose: The aim of this study was to assess nurses' knowledge of pressure injuries in order to gather benchmark data, identify knowledge gaps, and based on results, implement educational strategies to improve practice.

Design: Cross-sectional survey.

Subjects And Setting: The study setting was a large Australian tertiary general hospital employing approximately 2500 nurses in both full-time and part-time roles. Read More

Adv Skin Wound Care 2019 Mar;32(3):E1

Adv Skin Wound Care 2019 Mar;32(3):131-138

Barbara Delmore, PhD, RN, CWCN, MAPWCA, IIWCC-NYU, is Senior Nurse Scientist, Center for Innovations in the Advancement of Care, and Clinical Assistant Professor, Hansjörg Wyss, Department of Plastic Surgery, NYU Langone Health, New York. Elizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAAN, is the co-Editor-in-Chief of Advances in Skin & Wound Care; Faculty, Excelsior College School of Nursing, Albany, New York; President, World Council of Enterostomal Therapists; and President, Ayello Harris & Associates, Inc, Copake, New York. Hiske Smart, MA Nursing Science (PU for CHE), Hons B Soc Sc Nursing Science (UFS), RN, IIWCC-CAN, is Clinical Nurse Specialist, Wound Care and Hyperbaric Oxygen Therapy Unit, King Hamad University Hospital, Bahrain. Gulnaz Tariq, BSc, MS, IIWCC-CAN, is Wound & Skin Care Manager, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates (UAE). R. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med Derm), FAAD, MAPWCA, JM, is the co-Editor-in-Chief of Advances in Skin & Wound Care; Professor of Medicine and Public Health and Director, International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care), Dalla Lana Faculty of Public Health, University of Toronto, Ontario, Canada. Acknowledgments: The authors thank Salvacion Cruz and her team for assistance in data collection in the UAE; Gary Kwok for his efforts; and Evan X. Accardi for his tremendous help with inputting, organizing, and analyzing the data. As of January 2017, Dr Delmore is currently serving a 3-year term as a National Pressure Ulcer Advisory Panel (NPUAP) board member. Dr Ayello is a past NPUAP president and board member. The authors have disclosed no financial relationships related to this article. Submitted April 28, 2018; accepted in revised form July 23, 2018.

Pressure injuries/ulcers are a global health issue, and there is a need for clinicians from many countries and continents to express their opinions on the terminology change (pressure ulcer to injury) and revised staging definitions. A convenience, opinion survey sample of clinicians from the Western Asia Gulf Region enrolled in a yearlong wound care course participated by expressing their opinion about these changes. Results reveal support for the pressure injury terminology and the revised staging definitions. Read More

Adv Skin Wound Care 2019 Mar;32(3):122-130

Linda J. Cowan, PhD, ARNP, CWOC, is Associate Chief of Nursing Service/Research, Center of Innovation for Disability and Rehabilitation Outcomes Research Section, James A. Haley Veterans Hospital, Tampa, Florida. Hyochol Ahn, PhD, MSN, APRN, ANP-BC, is Director, Brain Stimulation and Imaging Laboratory, Jane and Robert Cizik School of Nursing, University of Texas Health Science Center, Houston, Texas. Micah Flores, PhD, is Operations Support Manager, BioMonde, Gainsville, Florida. Joshua Yarrow, PhD, MS, is Research Health Scientist, North Florida/South Georgia Veterans Health System, Malcom Randall VA Medical Center, Gainesville, Florida. Lee Barks, PhD, ARNP, is a Nurse Researcher, Veterans Administration Research and Education Foundation, Tampa, Florida. At the University of Florida College of Nursing in Gainesville, Florida, Cyndi Garvan, PhD, is Research Associate Professor; Michael T. Weaver, PhD, RN, FAAN, is Professor and Associate Dean for Research; and Joyce Stechmiller, PhD, ACNP-BC, FAAN, is Associate Professor. Acknowledgments: This work was supported by resources provided by the Department of Veterans Affairs, Veterans Health Administration, North Florida/South Georgia Veterans Health System, Gainesville, Florida, as well as the University of Florida College of Nursing. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the University of Florida College of Nursing. The authors have disclosed no other financial relationships related to this article. Submitted July 12, 2018; accepted in revised form September 6, 2018.

Objective: Scientific literature suggests pressure ulcer (PU) risk increases as immobility increases, indicating that more extensive paralysis confers a greater risk of PU. Yet the specific level of paralysis (ie, hemiplegia vs paraplegia vs quadriplegia), apart from neurodegenerative diagnoses, has never been examined in the long-term care (LTC) population. This study examined the prevalence of PU among LTC residents with different paralysis levels. Read More

Adv Skin Wound Care 2019 Mar;32(3):109-121

Elizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAAN • Faculty • Excelsior College School of Nursing • Albany, New York • President • Ayello Harris & Associates, Inc • Copake, New York • President • World Council of Enterostomal Therapists • Co-Editor-in-Chief • Advances in Skin & Wound Care • Philadelphia, Pennsylvania Jeffrey M. Levine, MD, AGSF, CMD • Associate Clinical Professor of Geriatrics and Palliative Care • Icahn School of Medicine at Mount Sinai • New York, New York Diane Langemo, PhD, RN, FAAN • President • Langemo & Associates • Professor Emeritus and Adjunct Professor • University of North Dakota College of Nursing • Grand Forks, North Dakota Karen Lou Kennedy-Evans, RN, FNP, APRN-BC • Wound Consultant • Foothills Rehabilitation Center • Tucson, Arizona Mary R. Brennan, MBA, RN, CWON • Assistant Director for Wound and Ostomy Care • North Shore University Hospital • Manhasset, New York R. Gary Sibbald, MD, DSc (Hons), MEd, FRCPC (Med Derm), ABIM, FAAD, MAPWCA • Professor • Medicine and Public Health • University of Toronto • Toronto, Ontario, Canada • Director • International Interprofessional Wound Care Course and Masters of Science in Community Health (Prevention and Wound Care) • Dalla Lana School of Public Health • University of Toronto • Project Lead • ECHO Ontario, Wound & Skin Care • Previous President • World Union of Wound Healing Societies • co-Editor-in-Chief • Advances in Skin and Wound Care • Philadelphia, Pennsylvania.

General Purpose: To synthesize the literature regarding skin injuries that are found in patients at the end of life and to clarify the terms used to describe these conditions.

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After completing this continuing education activity, you should be better able to:1. Read More

Adv Skin Wound Care 2019 Mar;32(3):101

Elizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAAN, is the co-Editor-in-Chief of Advances in Skin & Wound Care; Faculty, Excelsior College School of Nursing, Albany, New York; President, World Council of Enterostomal Therapists; President, Ayello Harris & Associates, Inc, Copake, New York; and President (1999), National Pressure Ulcer Advisory Panel. R. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med Derm), FAAD, MAPWCA, JM, is the co-Editor-in-Chief of Advances in Skin & Wound Care; Professor, Medicine and Public Health, University of Toronto, Toronto, Ontario, Canada; Director, International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care), Dalla Lana Faculty of Public Health, University of Toronto; and President (2008-2012), World Union of Wound Healing Societies.

J Tissue Viability 2019 Feb 8. Epub 2019 Feb 8.

Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan; Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Japan. Electronic address:

The prevention of progression of Category I pressure ulcers (PUs) to Category II or higher is important, as Category II or higher PUs are open wounds and have a higher infection risk. Prognosis prediction of Category I PUs is necessary to provide successful intensive care for PUs with impaired healing. We focused on skin blotting using plasminogen activator inhibitor 1 (PAI1), interleukin-1α (IL-1α), vascular endothelial growth factor C (VEGF-C), and heat shock protein 90α (HSP90α). Read More

Zhonghua Shao Shang Za Zhi 2019 Feb;35(2):148-152

Nurse Department, the First Affiliated Hospital, Air Force Military Medical University, Xi'an 710032, China.

To explore the influence of cluster nursing intervention on inadequate drainage in vacuum sealing drainage (VSD) for inpatients in burn unit. From October to December 2016, 60 patients, aged (43.6±2. Read More

Int Wound J 2019 Mar;16 Suppl 1:51-61

Academic Division, Korean Association of Wound Ostomy Continence Nurses (KAWOCN), Seoul, Republic of Korea.

The incidence rate of patients developing pressure ulcers associated with medical device use is underreported in Korea. This study aims to determine clinical nurses' perceived importance and performance towards medical device-related pressure injury prevention. A total of 620 nurses from seven hospitals attending continuing education programmes in Korea responded to self-administered questionnaires. Read More

Int Wound J 2019 Mar;16 Suppl 1:43-50

Department of Nursing, Korea University Ansan Hospital, Ansan, Republic of Korea.

Pressure ulcers result in financial losses, including the cost of unnecessary medical expenses because of extended hospital stays, treatment, and examination. This was a retrospective, observational, methodological study to develop quality indicators related to pressure ulcer development and validate risk adjustment factors for pressure ulcer development. We performed a literature review to develop risk adjustment factors, and an expert group performed a content validity test. Read More

Int Wound J 2019 Mar;16 Suppl 1:29-35

Department of Nursing, Severance Hospital, Seoul, South Korea.

This study aimed to investigate Korean nurses' level of knowledge, attitude, and performance of pressure ulcer prevention in long-term care facilities. A descriptive study was performed. Convenience sampling was used, and registered nurses were recruited from the attendees of a continuing education programme for nurses in long-term care facilities. Read More

Int Wound J 2019 Feb 19. Epub 2019 Feb 19.

Reading Hospital, Tower Health System, West Reading, Pennsylvania.

Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an automated system used to deliver, dwell, and remove topical solutions from the wound bed. Recently, a reticulated open cell foam dressing with through holes (ROCF-CC) was developed, which assists with wound cleansing by removing thick exudate and infectious materials. We present our experience using NPWTi-d with ROCF-CC on complex wounds when complete surgical debridement was inappropriate because of medical instability, recurrent non-viable tissue, or palliative treatment plan. Read More

Z Evid Fortbild Qual Gesundhwes 2019 Feb 15. Epub 2019 Feb 15.

Zentrum für Qualität in der Pflege (ZQP), Berlin, Deutschland.

Introduction: Chronic or non-healing wounds are a serious problem for both the parties involved and the healthcare system. Currently, there are hardly any reliable data on the prevalence of chronic wounds in outpatient care, although this setting is becoming increasingly important. Therefore, the aim of this study was to determine the prevalence of and the factors associated with chronic wounds in clients cared for by home care services. Read More

Int Wound J 2019 Apr 15;16(2):534-541. Epub 2019 Feb 15.

Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

The objectives of this study were to investigate the prevalence and the characteristics of pressure ulcers (PU) in community-dwelling older adults in Indonesia, including specific characteristics of the PU patients and their use of formal and informal care. A cross-sectional design was used for the study, with 325 participants aged 60 years or older, randomly chosen from the general community. The overall PU prevalence and the PU prevalence excluding category 1 were 10. Read More

Ulus Travma Acil Cerrahi Derg 2019 Jan;25(1):89-92

Department of General Surgery, Health Sciences University, Okmeydanı Training and Research Hospital, İstanbul-Turkey.

A 55-year-old male patient developed a duodenal re-leak, which caused severe peritonitis, on the second postoperative day after surgery to treat an acutely perforated duodenal ulcer. Relaparotomy was performed 2 days after surgery for the re-leak after omentoplasty. The necrotic omentum was dissociated from the bulbus duodeni. Read More

Scand J Caring Sci 2019 Feb 8. Epub 2019 Feb 8.

Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Talavera de la Reina, Spain.

Background: Pressure ulcers represent an important worldwide public health problem, which substantially decrease the quality of life of those affected. Yet, few studies to date have analysed the perceptions regarding home care for pressure ulcers.

Aims: To explore the conceptualisations regarding home care of pressure ulcers from the perspective of affected patients and their caregivers. Read More

Wound Manag Prev 2019 02;65(2):39-47

Mehmet Akif Ersoy University Faculty of Health Sciences, Nursing Department, Burdur, Turkey.

Nurses should be highly knowledgeable about and have a positive attitude toward pressure ulcer (PU) prevention.

Purpose: This descriptive study was conducted among intensive care unit (ICU) nurses in 6 hospitals in Turkey to identify their PU prevention knowledge, attitudes, and perceptions of barriers to care.

Methods: The study was conducted between January 1, 2017, and April 30, 2017, using supervised self-reporting, among nurses working in the ICUs of 3 education and research hospitals, 2 university hospitals, and a private hospital in Ankara, Turkey. Read More

Wound Manag Prev 2019 02;65(2):30-38

Nantong University, Nantong City, Jiangsu Province, PR China.

Use of a hydrocolloid dressing (HCD) is generally recommended to help prevent pressure ulcers (PUs) in high-risk patients, including ulcers caused by noninvasive ventilation (NIV).

Purpose: The study was conducted to compare the effect of preventive use of HCD to other methods in the rate of facial PUs caused by NIV.

Methods: PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were searched from date of index inception to August 2018 without language restrictions to identify randomized controlled trials (RCTs) that compared HCD use to other NIV-related PU prevention measures. Read More

Wound Manag Prev 2019 02;65(2):20-28

Istanbul University, Fatih, Istanbul, Turkey.

Pressure ulcers (PUs) are a common problem with serious health care implications.

Purpose: This study was conducted to assess PU prevalence, incidence, clinical features, nursing care measures, and patient variables and outcomes among inpatients admitted to 13 internal medicine departments at a university hospital in Turkey between 2010 and 2014.

Methods: Using a cross-sectional, retrospective design, records of all hospitalized patients were reviewed and records from patients with a PU abstracted. Read More

Wound Manag Prev 2019 02;65(2):14-19

UC Davis Medical Center, Sacramento, CA.

Hospital-acquired pressure ulcers/injuries (HAPU/I) have been a major focus of research, but information about community-acquired pressure ulcer/injuries (CAPU/I) is limited.

Purpose: The aim of this study was to compare HAPU/I and CAPU/I in a 620-bed academic medical center in the western United States.

Methods: This descriptive study involved prospective/retrospective data collected from the National Data for Nursing Quality Indicators, including pressure ulcer stage (January 1, 2015, through December 31, 2017); the hospital's incident reporting system (January 1, 2017, through December 31, 2017); electronic medical records (EMR) as needed for verification; and the hospital's pressure ulcer registry (January 1, 2012, through December 31, 2017), developed by both EMR and manual extraction. Read More

J Wound Care 2019 Jan;28(Sup1):S4-S13

Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.

Objective:: Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU).

Method:: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Read More

Wounds 2019 Mar 31;31(3):68-74. Epub 2019 Jan 31.

Limb Preservation Platform, Valley Vascular Surgical Associates, Fresno, CA.

Introduction: Venous leg ulcers (VLUs) are often chronic and difficult to treat, which makes alternative options to conventional care necessary to improve ulcer healing rates. While human acellular dermal matrices (ADMs) have shown promise in treating diabetic foot ulcers, no comparative studies have been published regarding VLU treatment. Decellularized ADMs (D-ADMs) have been used successfully in the treatment of a wide variety of wound repairs and may be effective in treating VLUs. Read More

Nurs Clin North Am 2019 Mar;54(1):127-140

Vanderbilt University School of Nursing, 461 21st Avenue South, 216 Godchaux Hall, Nashville, TN 37240, USA.

This quality improvement project used the Model for Improvement including the Plan-Do-Study-Act cycle of change framework to educate pediatric intensive care unit (PICU) nurses on risk factors for pediatric pressure injuries and prevention strategies, improve turning compliance for PICU patients, and implement an electronic trigger to order nutrition consultations on all patients with a Braden Q score less than 16. The quality improvement project decreased preventable patient harm to PICU patients by decreasing the pressure injury incidence rate from 8% to 3% in the 6-week time period. Read More

Adv Wound Care (New Rochelle) 2019 Jan 5;8(1):1-6. Epub 2019 Jan 5.

Department of Endocrinology and Internal Medicine, Medical Research Laboratory, Aarhus University Hospital, Aarhus, Denmark.

The development of in-hospital acquired pressure ulcers (PUs) is of great concern for both patients and professionals in health care. Based on the hypothesis that identification of patients who are prone to develop PU will enhance preventive measures in this group of patients, we investigated a new tool, Qscale, for in-hospital prediction of PU. A total of 383 patients were recruited from three departments. Read More

J Pain Palliat Care Pharmacother 2019 Jan 31:1-5. Epub 2019 Jan 31.

Pain from pressure ulcers can severely impact a patient's quality of life. Evidence-based treatment of ulcer-related pain typically relies on systemic opioids with limiting side effects. Literature exists on the use of topical ketamine for neuropathic pain, but not for tissue injury in general and for decubitus ulcer pain specifically. Read More

Worldviews Evid Based Nurs 2019 Feb 30;16(1):29-35. Epub 2019 Jan 30.

Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.

Background: In previous studies about performance or factors affecting pressure ulcer (PU) care, old tools with nonupdated contents about the prevention and intervention of PU have been mainly used. Thus, there is little known how well evidence-based PU care is performed and what its' influencing factors are recently.

Aims: This study aimed to evaluate the PU care performance, based on evidence-based practice guidelines, and identify factors affecting it while considering nurses' individual and institutional characteristics. Read More

Int Wound J 2019 Jan 29. Epub 2019 Jan 29.

Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel.

Patients who are immobile endure prolonged bodyweight-related compressive, tensional and shear loads at their body-support contact areas that over time may lead to the onset of pressure ulcers (PUs). Approximately, one-third of the common sacral PUs are severe and classified as category 3 or 4. If a PU has occurred, off-loading is the basic, commonly accepted clinical intervention; however, in many situations, complete off-loading of sacral PUs is not possible. Read More

Int Wound J 2019 Jan 28. Epub 2019 Jan 28.

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Our objective was to estimate the US national cost burden of hospital-acquired pressure injury (HAPI) using economic simulation methods. We created a Markov simulation to estimate costs for staged pressure injuries acquired during hospitalisation from the hospital perspective. The model analysed outcomes of hospitalised adults with acute illness in 1-day cycles until all patients were terminated at the point of discharge or death. Read More

Geriatr Gerontol Int 2019 Feb 28;19(2):135-140. Epub 2019 Jan 28.

Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Aim: Temporal muscle wasting is subjectively evaluated during nutritional assessment of protein-energy malnutrition. However, a quantitative evaluation method has not been established. The aim was to verify the validity and reliability of temporal muscle thickness measurement in comparison with established indicators of nutritional status, such as body mass index. Read More

Trials 2019 Jan 24;20(1):77. Epub 2019 Jan 24.

Department of Neurology, Haukeland University Hospital, Jonas Lies vei 71, 5053, Bergen, Norway.

Background: Individuals with spinal cord injuries (SCI) are prone to pressure ulcers (PUs) because of the loss of sensorimotor function involved as well as increased skin moisture. Treatment of PU after SCI is complicated, involving different specialties and with need for long-lasting follow-up. This study should identify risk factors for PU after SCI, and find an effective and less time-consuming treatment for the condition among different available methods for follow-up. Read More