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J Wound Care 2022 May;31(Sup5):S3-S4

University of Pittsburgh Medical Center; Director of Blair Medical Associates, UPMC Wound Clinic, Altoona, PA, US.

J Wound Care 2022 May;31(Sup5):S6-S12

Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, US.

Objective: Pressure ulcers (PUs) are hard-to-heal, open wounds that affect millions of adults worldwide. Patients experience physical, mental, social and financial impairment. On average, <50% of stage 3 and 4 PUs heal by the sixth month. Read More

Int Wound J 2022 May 11. Epub 2022 May 11.

Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA.

People with spinal cord injury (SCI) are at high risk of developing a pressure injury. It is unclear why some people with SCI develop pressure injury while others with similar predisposing risk factors do not during acute hospitalisation. This may hinder healthcare utilisation to prevent pressure injuries. Read More

J Wound Ostomy Continence Nurs 2022 May-Jun 01;49(3):211-219

Laura E. Edsberg, PhD, Center for Wound Healing Research and Natural & Health Sciences Research Center, Daemen University, Amherst, New York.

Purpose: The purpose of this study was to evaluate the implementation of pressure injury (PI) prevention strategies in adult acute care settings in the United States using the data from the 2018/2019 International Pressure Ulcer Prevalence (IPUP) Survey.

Design: Observational, cohort study with cross-sectional data collection and retrospective data analysis.

Subjects And Setting: The sample comprised 296,014 patients hospitalized in 1801 acute care facilities in the United States that participated in the 2018 and/or 2019 IPUP Survey. Read More

J Am Podiatr Med Assoc 2022 Apr 27;112(2). Epub 2022 Apr 27.

†Haycock Foot and Ankle Center, Lima, OH.

Heel decubitus ulcerations are relatively common occurrences that can be limb threatening. There are many options to treat these ulcerations, ranging from conservative wound care to serial debridement with flap reconstruction. However, not all patients are good candidates for major reconstructive surgery. Read More

J Diabetes Res 2022 11;2022:3954740. Epub 2022 Apr 11.

Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Introduction: Autologous cell therapy (ACT) is one of the last options for limb salvage in patients with chronic limb-threatening ischemia (CLTI) and diabetic foot ulcers (DFU). However, some patients may still undergo a major amputation even after ACT, but the risk factors for this are not known. Therefore, the aim of our study was to assess the risk factors for major amputation in patients with CLTI and DFU during a 2-year follow-up after ACT. Read More

Adv Skin Wound Care 2022 May;35(5):263-270

General Purpose: To provide information on the effectiveness of active and reactive support surfaces in reducing the incidence and prevalence of pressure injuries (PIs) in adult ICU patients.

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 participating in this educational activity, the participant will: 1. Read More

Adv Skin Wound Care 2022 05;35(5):252-259

Diane Langemo, PhD, RN, FAAN, is Distinguished Professor Emeritus, College of Nursing and Professional Development, University of North Dakota, Grand Forks, United States. Julie Anderson, PhD, RN, is Dean, Winona State University, Minnesota. Also at the University of North Dakota, Darlene Hanson, PhD, RN, is Clinical Professor, College of Nursing and Professional Development; Patricia Thompson, MS, RN, is Clinical Assistant Professor, College of Nursing and Professional Development; and Erika Johnson, MLIS, is Clinical Campus Librarian, School of Medicine and Health Sciences. Submitted June 8, 2021; accepted in revised form October 20, 2021.

Adv Skin Wound Care 2022 05;35(5)

JMIR Form Res 2022 Apr 19;6(4):e27692. Epub 2022 Apr 19.

Spinal Cord Unit, Department of Neurology, Haukeland University Hospital, Bergen, Norway.

Background: Geographical, financial and travel-related barriers may impact access to necessary health care for people in need of long-term follow-up.

Objective: The goal of the research was to perform a nonblinded, randomized, controlled trial on health-related quality of life (HRQoL), healing, interaction, and satisfaction of patients with spinal cord injury (SCI) and PI receiving multidisciplinary videoconference consultations from a wound clinic to the participant's home versus regular outpatient care. The multidisciplinary team consisted of a medical doctor, a wound nurse, and an occupational therapist. Read More

Nurs Child Young People 2022 Apr 19. Epub 2022 Apr 19.

James Cook University, Cairns Clinical School, Cairns, Queensland, Australia.

Medical devices such as peripheral intravenous cannulae (PIVC) are commonly used in the care of children across all hospital settings. However, the association between PIVC and the development of pressure injuries in this population became a concern on one Australian paediatric ward. A quality improvement project was conducted to reduce the incidence of pressure injuries in children caused by PIVCs. Read More

Int J Nurs Stud 2022 Jun 10;130:104191. Epub 2022 Feb 10.

NHMRC Centre of Research Excellence in Wiser Wound Care; School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.

Background: Pressure injuries are a leading hospital adverse event, yet they are mostly preventable. Understanding their financial costs will help to appreciate the burden they place on the health system and assist in better planning and management of health expenditures to prevent pressure injuries.

Objective: To estimate the cost of pressure injuries in Australian public hospitals in 2020 demonstrating its economic burden in a well-resourced health system. Read More

Adv Skin Wound Care 2022 May 1. Epub 2022 May 1.

Symone Everett Day, BSN, RN, is Registered Nurse, Suburban Hospital, Bethesda, Maryland, United States. At Johns Hopkins School of Nursing, Baltimore, Maryland, Binu Koirala, PhD, MGS, RN, is Assistant Professor; and Kimberly McIltrot, DNP, CRNP, CWOCN, CNE, FAANP, FAAN, is Assistant Professor and DNP Program Director. The authors have disclosed no financial relationships related to this article. Submitted March 2, 2021; accepted in revised form May 11, 2021.

Objective: To survey the literature to gain insight into nursing facilitators of and barriers to implementation of positioning/turning strategies to prevent hospital-acquired pressure injuries (PIs) in adult critical care patients.

Data Sources: This integrative review surveyed literature across databases including PubMed, CINAHL, Embase, and Cochrane Library, and through hand searching.

Study Selection: Key terms included "pressure ulcer" OR "pressure sore*" OR "pressure injur*" AND "patient positioning" OR "turn" OR "turning" OR "patient repositioning" AND "critical care" OR "intensive care unit*" OR "inpatient*" AND "prevent*. Read More

Cureus 2022 Mar 9;14(3):e23003. Epub 2022 Mar 9.

Neurology Department, Rush University Medical Center, Chicago, USA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the etiologic agent of coronavirus disease 2019 (COVID-19), causes an excessive inflammatory response and hemostatic abnormalities in the lungs, kidney, and skin. Four patients with COVID-19 admitted to an acute care community hospital developed nonblanchable purpuric macules, patches, and retiform purpura-like lesions at the sacrum, buttocks, lower extremities, and upper back. These lesions can be misdiagnosed as deep tissue pressure injuries. Read More

J Wound Care 2022 Apr;31(4):322-328

Nursing Department, Tor Vergata University Hospital, Rome, Italy.

Objective: To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection.

Method: This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. Read More

J Wound Care 2022 Apr;31(4):294-303

School of Human & Health Sciences, University of Huddersfield, UK.

Objective: This study assesses anonymous patient-level data on the use of sub-epidermal moisture (SEM) assessment technology as a tool in the prevention of pressure ulceration in at-risk hospital patients.

Method: The relationship between technology-generated prompts for clinical action (patient turning, application of pressure redistributing equipment, heel protection or cream) and consequent clinical action was evaluated using data cross-tabulations (using data aggregated over multiple anatomical sites); in a multilevel model with patients clustered within wards, clustered in turn within hospitals, and controlling for additional patient- and institution-level factors; and using receiver operating characteristic (ROC) analyses of anatomy-specific data. The ability of the SEM assessment technology to detect deep and early-stage pressure ulcers/injuries on specific anatomical areas of a patient's body on admission, earlier than visual and tactile skin tissue assessments (STA), was assessed. Read More

J Wound Care 2022 Apr;31(4):310-320

1 Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Objective: Skin grafts after negative pressure wound therapy (NPWT) and acellular dermal matrix (ADM) usage have both been useful for treating diabetic foot amputation. We hypothesised that injectable ADM combined with NPWT would be more useful than NPWT only for healing after amputation in patients with diabetic foot ulcers (DFUs). The aim of this study was to investigate the clinical outcomes of injectable ADM combined with NPWT in patients with DFU who have undergone amputation. Read More

J Tissue Viability 2022 May 21;31(2):294-301. Epub 2022 Mar 21.

School of Nursing, Peking University, Beijing, China. Electronic address:

Background: Diabetic foot ulcers (DFUs) are one of the major complications of diabetes, representing a leading cause of hospitalization and non-traumatic lower limb amputations. Clinical practice guidelines (CPGs) are statements that include recommendations intended to improve patients' outcomes by providing recommendations for key clinical issues with alternative care options. The aim of this study is to systematically review CPGs on DFUs care and generate an evidence-map for visualizing research trends and gaps in the CPGs. Read More

Front Endocrinol (Lausanne) 2022 15;13:848695. Epub 2022 Mar 15.

Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Background: Remotely delivered interventions may be more efficient in controlling multiple risk factors in people with diabetes.

Purpose: To pool evidence from randomized controlled trials testing remote management interventions to simultaneously control blood pressure, blood glucose and lipids.

Data Sources: PubMed/Medline, EMBASE, CINAHL and the Cochrane library were systematically searched for randomized controlled trials (RCTs) until 20 June 2021. Read More

Int Wound J 2022 Mar 29. Epub 2022 Mar 29.

Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.

The study aims to follow up on the analysis of Pressure injuries (PIs) prevalence conducted between 2007 and 2014 and after the new methodological requirements for PIs surveillance establishment at the national level. A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist was collected by the National Health Information System (NHIS). The International Classification of Diseases (ICD-10) diagnoses L89. Read More

J Wound Care 2022 Mar;31(Sup3):S51-S52

1 Unidad de Procedimientos del Centro de Consultas y Procedimientos, Hospital Clínico, University of Chile, Santiago, Chile.

This case study describes the combined use of a wound contact layer dressing containing collagen with negative pressure wound therapy (NPWT) on a diabetic foot ulcer (DFU). The patient was treated at a university hospital in Santiago, Chile. A wound size reduction of 58% was observed within the first 10 weeks of treatment, and the wound went on to heal fully over the next 14 weeks. Read More

BMC Complement Med Ther 2022 Mar 27;22(1):91. Epub 2022 Mar 27.

Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: The use of complementary and alternative medicine (CAM) therapies has increased in recent years throughout the world and in Iran. Nonetheless, there are limited data about the prevalence of their use. This study aimed to assess the prevalence of using CAM therapies among patients with pressure ulcer (PU). Read More

Wound Manag Prev 2022 02;68(2):34-41

University of Piemonte Orientale, Novara, Italy.

Background: The Munro Pressure Ulcer Risk Assessment Scale for Perioperative Patients - Adult (Munro scale) is a pressure ulcer/injury risk assessment scale for adult surgical patients. It consists of 3 sections relating to the preoperative, intraoperative, and postoperative periods. It is not available in Italian. Read More

Wound Manag Prev 2022 02;68(2):16-21

PRISMA Health-Upstate, Greenville, South Carolina.

Background: Chronic podiatric wounds are common causes of morbidity and mortality in older patients. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been recommended in wounds with high levels of exudate, contaminated wounds, and wounds in which healing progression has stalled.

Purpose: This retrospective case series describes the use of NPWTi-d to prepare 4 chronic wounds for closure in older patients with multiple comorbidities. Read More

Surgeon 2022 Mar 22. Epub 2022 Mar 22.

Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.

Introduction: Critical limb ischemia (CLI) in diabetic patients is defined by non-healing foot ulcer or rest pain for more than 2 weeks with ankle pressure of less than 40 mmHg. The SVS WIfI classification system stratifies CLI on the basis of perfusion, extent of wound and superadded infection to provide a composite score which guides further management and predicts final prognosis OBJECTIVE: The aim of the study was to use the SVS WIfI scoring system to predict the need for early revascularization versus early amputation depending on the composite WIfI score at presentation.

Methodology: This was a retrospective observational study. Read More

Arch Osteoporos 2022 03 25;17(1):54. Epub 2022 Mar 25.

Department of Geriatrics, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.

This study was carried out to analyze the evolution of the quality indicators in the Spanish National Hip Fracture Registry, after disseminating a series of recommendations based on available clinical practice guidelines to the participating hospitals. Six of the seven proposed quality indicators showed a significant improvement.

Purpose: The Spanish National Hip Fracture Registry (RNFC) arises from the need to know the process and improve the quality of care. Read More

Int Wound J 2022 Mar 23. Epub 2022 Mar 23.

Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

The pandemic of coronavirus (COVID-19) has significantly increased the admission of patients with extensive complications, especially for respiratory support, to intensive care units (ICUs) worldwide. These patients also suffer from pressure ulcers (PUs) as another complication that occurs due to increased length of hospitalisation and acute conditions of patients. Therefore, this study aimed to evaluate the incidence and prevalence of PU and the factors affecting it in COVID-19 patients admitted to ICUs. Read More

Adv Skin Wound Care 2022 Apr;35(4):1-6

At Hasan Kalyoncu University in Gaziantep, Turkey, Faculty of Health Sciences, Nursing Department, Ezgi Dirgar is Research Assistant; and Betül Tosun is Associate Professor. Hakan Dokumuş, RN, is a nurse at Aralık Public Hospital, Gaziantep, Turkey. Tuba Bülbül is Master's Student of Nursing, Hasan Kalyoncu University, Institute of Postgraduation Education, Gaziantep, Turkey.

Objective: To evaluate nurses' knowledge on pressure injury (PI) prevention.

Methods: Four hundred six nurses in Turkey participated in this descriptive study between January and February 2020. Participants completed an information form and the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI). Read More

SAGE Open Med 2022 15;10:20503121221085097. Epub 2022 Mar 15.

Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Objectives: Tuning fork vibration sensation testing is widely used as a diagnostic test to detect diabetic neuropathy. However, evidence-based literature indicates that reliability between examiners is low. Attaching isosceles triangle diagrams on tuning forks lowers the discrepancy between examiners. Read More

Int Wound J 2022 Mar 20. Epub 2022 Mar 20.

School of Nursing, Jilin University, Changchun, China.

To carry out the translation and cultural adaptation of the attitude towards pressure ulcer prevention instrument for use in Chinese and to analyse the validity and reliability of the adapted version of the questionnaire. In this quantitative, descriptive, cross-sectional study, after translation of the questionnaire from English to Chinese, back-translation, and assessment of equivalence between the original and back-translated version by an expert panel, the Chinese version instrument was assessed by a convenience sample of registered nurses in several hospitals in cities of China. The internal consistency and content validity of the instrument was tested, and a confirmatory factor analysis was also performed. Read More