NewsWound digest Wound digest


This digest summarises recent key papers published in the areas of pressure ulcers, skin integrity and venous leg ulcers.


SELECTED PAPERS OF INTEREST 1. Medical device-related pressure ulcers are prevalent and of concern 2. Risk factors for PU in vulnerable neonates identified 3. Knowledge and use of water-filled gloves for prevention of pressure ulcers to be encouraged 4. Australian Medical Sheepskin aids pressure ulcer prevention 5. Two-stage pressure ulcer reconstruction achieves good clinical outcomes 6. New tool for pressure ulcer risk assessment shows promise 7. Liposomal delivery of oleic acid a promising new approach to management of MRSA infections of skin for the future


8. An approach to improving management of Marjolin’s ulcer 9. Causes of chronic leg ulceration in German patients evaluated 10. 980nm diode laser treatment does not improve healing of chronic leg ulcers


To compile the digest a Medline search was performed for the three months ending 1 December, 2010 using the search terms ‘pressure ulcers’, ‘skin integrity’ and ‘leg ulcers’. Papers have been chosen on the basis of their potential interest to practitioners involved in day-to-day wound care. The papers were rated according to readability, applicability to daily practice, and novelty factor.


Pressure Ulcers 1


Medical device-related pressure ulcers are prevalent and of concern


Readability Relevance to daily practice Novelty factor


n The aim of this study was to determine the extent of the problem of pressure ulcers caused by medical devices in hospitalised patients, and to identify risk factors


n The authors report on the results of a secondary analysis of data collected by the Nebraska Medical Center on pressure ulcer quality improvement initiatives and outcomes. A subset of data from eight quarterly studies of pressure ulcer incidence and prevalence, involving 2,178 patients, was analysed


n Study subjects included all adult (17 years or older) hospitalised patients on the specified survey dates, excluding psychiatric patients and obstetric cases staying in hospital for less than three days


35 Wounds International Vol 2 | Issue 1 | ©Wounds International 2011


n Wound care nurses directed the collection of data on pressure ulcer risk factors, preventative measures and outcomes. The collection process utilised specific tools and definitions; reliability checks were conducted on 5% of the sample and showed reliability to be 95-100%


n Secondary analysis involved the calculation of pressure ulcer prevalence and hospital-acquired pressure ulcer rates, as well as the stage and location of pressure ulcers and whether the data collector considered pressure ulcers to be medical device-related


n Further analyses determined statistically significant differences between patients with and without pressure ulcers for risk factors including immobility, incontinence and perception


n The study showed that, at the time of data collection, 1.4% of patients had at least one medical device-related pressure ulcer (MDR PU), and in the secondary analysis, 1.3% had at least one hospital- acquired MDR PU


n 35% of the hospital-acquired MDR PUs were stage 1; 24% were unstageable and 3% were stage 3. Most were found on the ears (35%), lower legs (11%) and heels (8%)


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