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EPUAP 201417th Annual Meeting of the EuropeanPressure Ulcer Advisory Panel27 -29 August 2014 Stockholm, Sweden
PRESSURE ULCERSFROM BIRTH TO DEATHPrevention,Treatment and Rehabilitation
PROGRAMMEAND ABSTRACT BOOK
Organised by the European Pressure Ulcer Advisory Panelin cooperation with the Swedish Association of Tissue ViabilityNurses SSiS and Sophiahemmet University
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EPUAP BUSINESS OFFICEProvaznicka 11110 00 Prague 1 Czech RepublicTel: +420 251 019 379 [email protected]
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CONTENT
Welcome 4About EPUAP 5About SSiS 5Programme overview 6Oral presentation overview 17Abstracts of oral presentations 19Poster presentations overview 44Abstracts of poster presentations 46Author index 84General information 86About Stockholm 88Social events 89Sponsors and Exhibitors 90Industry satelllite symposia and workshops 91Exhibitor directory 95Exhibition plans 96
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DEARPARTICIPANTS, Finally, after a year of intense planning, the 17th conference ofEPUAP is about to take off. It is a thrilling and challengingexperience.
I would like to sincerely thank everyone involved in the planningof this event; Codan Consulting the company who organized theconference, the Swedish organizing committee, SSiS, VisitStockholm, Stockholm County Council, the City of Stockholm andSophiahemmet University. We also thank the companies, sponsorsand exhibitors for their valuable support.
We hope you will enjoy our beautiful city, the Venice of the North, ofwhich we will try to give you some glimpses in the social programme.
Most importantly, we hope that you will enjoy the scientificprogramme, carefully planned by the Scientific Committee ofEPUAP. We think this is one of the most interesting and exciting
programmes which we have ever presented at an EPUAPconference.
The programme is a mixture of key lectures, free paper sessions,symposia, workshops and poster sessions addressing the maintheme of the conference Pressure Ulcers from Birth to Death Prevention, Treatment and Rehabilitation.
This year the conference has attracted more than 500 participantsfrom 32 countries all over the world, which is a new record forEPUAP!
So, we wish you a real good time in Stockholm, returning to yourrespective country inspired and more knowledgeable and ready totake on the big challenge of providing an even better preventionand care of persons at risk of, or with manifest pressure ulcers.
Prof. Christina Lindholm Prof. Amit Gefen Prof. Dimitri Beeckman Susanne DufvaChair of the EPUAP 2014 Annual Meeting President of EPUAP Chair of the Scientific Committee President SsiS
Carina Bth Eila Sterner Lena Karlsson Madeleine Stenius Lena Gunningberg BrittLouise Andersson Ammi Hommel
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About EPUAP
The European Pressure Ulcer Advisory Panel was created inLondon in December 1996 to lead and support all Europeancountries in the efforts to prevent and treat pressure ulcers. At itsinaugural meeting in London in December 1996, which includedexperts from many European countries, the group of over twentyagreed their mission statement and the initial Executive Board andTrustees.
The mission statement reads: To provide the relief of personssuffering from or at risk of pressure ulcers, in particular through
research and the education of the public and by influencingpressure ulcer policy in all European countries towards anadequate patient centred and cost effective pressure ulcer care. Avery important activity for the EPUAP is our annual conference.These meetings are aimed at bringing together clinical carepractitioners, researchers and people from industry, to discuss thecurrent status of the problem in Europe and the world and todiscuss new developments in pressure ulcer prevention, treatmentand care.
About Swedish Societyof Wound Care Nurses SSiS
SSiS is a professional organization under the umbrella of theSwedish Nursing Society.
The aim is to work on a nation based level to improve woundmanagement in Sweden.
The Society is also official partner to different authoritiesconcerning wound related questions.
SSiS has 350 members. The Council consist of both academicallyqualified and clinically active nurses.
Every year SSiS organizes a conference on different themes,attracting approximately 200 nurses. Next conference will be inApril 2015 in Stockholm with the theme wound management andtechnology.
This years close cooperation with and support of the EPUAPconference is a welcome event for SSiS, providing internationalcontacts and extended educational options.
We welcome speakers and participants from all over the globe tothis truly inspiring conference.
EPUAP Executive BoardAmit Gefen,PresidentMichael Clark,Immediate Past PresidentJane Nixon,TreasurerDimitri Beeckman,Chair Scientific CommitteeCees Oomens,Deputy Chair Scientific CommitteeLisette Schoonhoven,Chair Guidelines CommitteeJan Kottner, Co-Chair Guidelines CommitteeZita Kis Dadara, Chair Public Relations CommitteeChristina Lindholm, Chair 17th Annual Meeting EPUAP 2014
EPUAP TrusteesDan Bader, United KingdomGuido Ciprandi, ItalyJeannie Donnelly, Northern IrelandLena Gunningberg, SwedenHilde Heyman, BelgiumNils Lahmann, GermanyPablo Lopez Casanova, SpainLenche Neloska, Republic of MacedoniaElia Ricci, ItalyMarco Romanelli, ItalyJos Schols, NetherlandsJakub Taradaj, PolandGeert Vanwalleghem, BelgiumJos Verd Soriano, SpainErik de Laat, Netherlands
Local Organising CommitteeChristina Lindholm, ChairLena GunningbergAmi HommelCarina BthEila SternerMadeleine SteniusLena KarlssonBritt Louise Anderssson
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PRESSURE ULCERS FROM BIRTH TO DEATH Prevention, Treatment and Rehabilitation. 27-29 August 2014 Stockholm, Sweden
WEDNESDAY 27.08.2014 PROGRAMMERegistration area
08:00 Registration, badge and bag collection - Registration area08:00 - 09:30 Morning coffee & tea - registration and exhibition area
Auditorium / Left side
09:30 - 10:15 Opening Ceremony in the Auditorium Left Side, Chairs: Christina Lindholm, Dimitri BeeckmanOpening festivity: Traditional Swedish horn blowing, Jan Johansson Opening of the conference by Barbro Westerholm, member of the Swedish House of ParliamentFrom off - piste to off - load: a patient experience, Ronny PerssonOpening by the President and the local organiser, Amit Gefen, Christina Lindholm
10:15 - 12:00 Key sessions, Chairs: Christina Lindholm, Dimitri BeeckmanThe skin in a gender perspective, sa BostrmPressure ulcers in neonates and a paediatric population, Guido CiprandiPressure ulcers in palliative care patients, Christina LindholmPressure ulcers after surgery, Ami HommelReconstructive surgerny of pressure ulcers, Jakob LagergrenPressure ulcers in a rehabilitation unit, Claes HultlingGeriatric experiences in the prevention of pressure ulcers, Dag Salaj
12:00 - 13:15 Lunch break and exhibition viewingAuditorium / Left side Auditorium / Right side
13:15 - 14:45 Key lectures, Chairs: Michael Clark, Jan Kottner 13:15 - 14:15 Industry WorkshopRisk factors in context; from conceptual framework to risk assessment in practice, Jane NixonThe effect of sustained loads on cells and tissues, Cees OomensContoured foam cushions in spinal cord injury care: Cinderella's shoe does not fit anymore!, Amit GefenMicroclimate, Dan BaderNutrition and pressure ulcers, Jos Schols
14:45 - 15:30 Coffee break and exhibition viewing
15:30 - 16:00 EPUAP Initiatives Key lectures, Chairs: Amit Gefen, Jeannie Donnely
15:30 - 17:00 Industry Satellite Symposium
Launch of the 2014 International Guideline for PressureUlcer Prevention and Management, Lisette SchoonhovenPuClas3 show, Dimitri BeeckmanStop Pressure Ulcer Day, Zita Kis Dadara
16:00 - 17:00 Free paper session 1: Pressure Ulcers in Trauma and ICU Patients,Chairs: Marco Romanelli, Guido Ciprandi
Pressure ulcer prevention in critical ill neonates and infants,Anne-Barbara SchlurPressure Ulcers and Pain Due to the Extrication Collar andHeadblocks in Trauma Patients, Wietske HamA prospective cohort study of the clinical effectiveness ofmulti-layer soft silicone dressings in the prevention of heelpressure ulcers in trauma and critically ill patients, Nick Santamaria
The Impact of a 5-Layered Silicone Bordered Foam Dressingon Intensive Care Unit (ICU) Patients Sacral Pressure UlcerIncidence: A Randomized Clinical Trial, Peggy Kalowes
17:00 - 17:30 Official opening of the exhibition and refreshments (in the exhibition area)19:00 Welcome reception at the Stockholm City Hall, Nobel Prize Hall
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08:0008:00 - 09:30
09:30 - 10:15
10:15 - 12:00
Bergsmannen Spelbomskan13:15 - 14:45
14:45 - 15:30
15:30 - 16:00
Free paper session 2: Pressure Ulcers in Older Persons,Chairs: Cees Oomens, Hilde Heyman
Free paper session 3: Tailoring of care: one size doesn'tfit all, Chairs: Geert Vanwalleghem, Elia Ricci
16:00 - 17:00
Higher mortality if admitted with a pressure ulcer to a nursing home Results of a cohort study, Nils Lahmann
Can a multi-faceted intervention affect pressure ulcer prevention?, Eva Sving
Pressure ulcers on a static air mattress: incidence and risk factors, Brecht Serraes
Clinical Unit Microsystem Pressure Ulcer Prediction and Prevention, Nancy Donaldson
A randomised control trial into the impact of prescribed seating in pressure ulcer prevention for nursing home residents, Olivia McVey
Head, Shoulders, Hips and Heels A Multi-Modal Approachto the Reduction of Pressure Ulcers in Infants, Children andYoung People, Sarah Kipss
A clinical evaluation of a specifically designed alternatingsupport surface device for achieving the 30 degree tilt in older individuals at risk of pressure ulcer development,Zena Moore
Can real-time feedback of interface pressure optimise adequate repositioning in bed?, Lena Gunningberg
17:00 - 17:3019:00
See the industry satellite symposia and workshops at page 91
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Registration area
08:00 Registration, badge and bag collection Registration area
Auditorium / Left side Auditorium / Right side
08:00 - 09:00 Free paper session 4: Pressure Ulcers: Learningfrom the Lab and Applying to the Patient, Chairs: Jos Schols, Lena Gunningberg
Buttock pressure management of able-bodied people seatedon a rigid surface for two hours, Olivier Chenu
Evaluating the Sensitivity of Actimetry to detect PosturalChanges in Seated Individuals, Peter Worsley
08:30 - 09:30 Industry Satellite Symposium
Does the calcaneus morphology have an influence on the riskof posterior heel ulcer?, Vincent Luboz
Simulation and Discussion of the Microclimate in Heel Protector Boots, Evan Call
09:00 - 10:00 Key lectures, Chairs: Dan Bader, Jose Verdu SorianoThe skin in a lifepan perspective, Jan KottnerRecent health economic data from a systematic review of international literature, Dimitri BeeckmanNeglect - shame or blame, Agnetha Folestad
10:00 - 10:45 Coffee break and exhibition viewing 10:00 - 11:00 Industry Workshop10:45 - 11:45 EPUAP Experienced and Novice Investigator
Awards 2014, Introduction to the Awards by theChair of the Scientific Committee, Dimitri Beeckman
Experienced Investigator Award: Wound healing from past tofuture: What can we learn from history?, Christina LindholmLactic acid bacterial symbionts in honeybees an unknownkey to honeys antimicrobial and therapeutic activities, AlejandraVsquez Novice Investigator Award: Pressure ulcer care: the Netherlands vs. Germany 0 - 1, Esther Meesterberends
11:45 - 13:15 Lunch break and exhibition viewing12:45 - 13:15 Annual General Meeting of the EPUAP13:15 - 14:15 Session for physiotherapists / occupational
therapists, Chair: Richard GoossensFree paper session 7: Biomechanics and Etiology,Chairs: Lena Gunningberg, Jos Schols
The five why's about seating, Milja Vaitilo Self-Propagation of Cell Death in Muscle Tissue via Myoglo-bin Release: A Computational Model of Mechano-ChemicalInterplay in Deep Tissue Injury (DTI), Lisa Tucker-Kellogg
Position changes - why, when and how often, Ulrika Kallman The Role of Mathematics in Ulcer Development and WoundHealing, Fred Vermolen
Cognition and compliance with pressure ulcer prevention, Dorothy Riedel
A novel MR compatible indentation setup to study the etiology of pressure ulcers and related deep tissue injury,Jules Nelissen
Characterization of walk and seating in young adults withspina bifida; Challenges and possibilities, Martina Bendt
Discrimination between diabetic patients with and without diabetic foot ulcer based on testing the cutaneous microcirculationin response to low pressure, Dominique Sigaudo Roussel
PRESSURE ULCERS FROM BIRTH TO DEATH Prevention, Treatment and Rehabilitation. 27-29 August 2014 Stockholm, Sweden
Thursday 28.08.2014 PROGRAMME
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08:00
Bergsmannen Spelbomskan
Free paper session 5: Innovative Approaches forRisk Assessment, Chairs: Hilde Heyman, Geert Vanwalleghem
Free paper session 6: Pressure Ulcer Research andBasic Science, Chairs: Zita Kis Dadara, Lenche Neloska
08:00 - 09:00
Pressure ulcer prevalence and prevention practices a comparison between formal risk assessment and assessment using clinical judgement alone, Zena Moore
PRESSURE 2 Trial: Considerations on the design of the trial and the decision making process at the interim analyses,Sarah Brown
Improving the risk assessment of pressure ulcer by nurses for elderly with psychiatric disorder a pilot project,Florence Bassin
The Effect of a Bacteria and Fungi Binding Mesh Dressingon the Bacterial Load of Pressure Ulcers Treated with Negative Pressure Wound Therapy (NPWT), a Pilot Study,Marino Ciliberti
Is pain a predictor of Category 2 pressure ulcers? Analysis of skin site level data from the PURPOSE Pain CohortStudy, Isabelle Smith
Numerical Study of different Types of Supporting Structuresregarding the Prevention of Deep Tissue Injuries,Alexander Siefert
Early pressure ulcer prevention and Intervention for patientsundergoing fasttrack surgery, Brigitte Skovgaard
A clinical comparative study on 940, 808 and 658 nm lasertherapy in pressure ulcer healing: early and long term results,Jakub Taradaj
09:30 - 10:30 Industry Workshop 09:00 - 10:00
10:00 - 10:4510:45 - 11:45
11:00 - 12:30 Industry Workshop
11:45 - 13:1512:45 - 13:15
Workshop: The implementation of the 2014 pressure ulcerguidelines in clinical practice, Lisette Schoonhoven
Workshop: Pressure Ulcer Classification: PuClas3, Dimitri Beeckman
13:15 - 14:15
See the industry satellite symposia and workshops at page 91
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Auditorium / Left side Auditorium / Right side
14:15 - 15:15 EWMA - EPUAP Session, Chair: Jane Nixon 14:15 - 15:45 Industry Satellite Symposium
EWMA: Working together for better wound care education inEurope, Salla SeppnenEPUAP: Integrating pressure ulcer prevention and management in educational curricula: current status, views and joint initiatives, Trudie Young
EWMA: EWMA Managing wounds as a team document,Zena Moore
15:15 - 16:00 Coffee break and exhibition viewing16:00 - 17:15 Key lectures, Chairs: Nihls Lahman, Jakub Tarafaj 16:00 - 17:00 Industry Workshop
SSiS scholarship
Telemedicine in pressure ulcer prevention and management,Rolf JelnesThe National Register of Wounds, RiksSar (RUT), Ruth ien
Swedish National Prevalence Study Initiative 2009 - 2014, Agneta Andersson
Mobile pressure ulcer team, Karin Hagqvist and Mona Johansson
19:30 Conference Dinner, Solliden Restaurant
PRESSURE ULCERS FROM BIRTH TO DEATH Prevention, Treatment and Rehabilitation. 27-29 August 2014 Stockholm, Sweden
Thursday 28.08.2014 PROGRAMME
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Bergsmannen Spelbomskan
Free paper session 8: Patient Safety, Quality of Care and Policy (1), Chairs: Lena Gunningberg, Lisette Schoonhoven
14:15 - 15:30 Student free papers session: Clinicaland Applied Science, Chairs: Lenche Neloska, Marco Romanelli
14:15 - 15:15
Home-care wound care a EWMA document, Sebastian Probst Patients and nurses experiences of using the 30 degree tilt forthe prevention of pressure ulcers, Urmila Victor
What Percentage of Hospital-Acquired Grade 3 and 4 Pressure Ulcers are Avoidable?, Fiona Downie
Evidence-based skin care at a university hospital in Germany- Andrea Lichterfeld
Do patient safety culture items affect pressure ulcer prevalence in a sample of Norwegian hospitals?,Ida Marie Bredesen
RNs knowledge of PU risk factors and prevention in internal medicine of a University Hospital In Iceland,Iris Gsladttir & Arna rardttirPressure Ulcers due to Stroke patients receiving PercutaneousEndoscopic Gastrostomy, Gunnel Wrn HedeRole of Braden scale scoring as a prognostic tool for pressureulcers, Kumar Madhaver
15:15 - 16:0016:00 - 17:15 Student free papers session: Basic Science, Chairs: Zita Kis Dadara, Jeannie Donnelly
16:00 - 17:00 Workshop: Pressure Ulcer PreventionPathways (PUPPS): Active Monitoring Model of Care Incorporating PURPOSE T', Susanne Coleman
16:00 - 17:15
Heel Ulcers: Simulations of Injurious Tissue Loads and Remedial Local Drug Delivery, Rinat FriedmanChanges in topography and structural properties of healthyaged skin after loading, Gabor DobosThe quest for smart materials to protect the fragile skin:Computational modeling of how shear and microclimate influence skin that rubs against clothing, incontinence pads,diapers etc., Mor Ben-or Frank
Development of biomarkers for the Wound Fluid RT-PCRmethod to detect critically colonised and infected wounds,Mayumi Asada
Biomechanical simulation of the Charcot neuroarthropathicfoot with plantar ulcer, Antoine Perrier
19:30
See the industry satellite symposia and workshops at page 91
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Registration area
08:00 Registration, badge and bag collection - Registration area
Auditorium / Left side Auditorium / Right side
09:00- 10:00 Key lectures, Chairs: Jane Nixon, Jeannie Donnely Free papers session 9: Pressure Ulcer Epidemiology, Chairs: Lisette Schoonhoven, Geert Vanwalleghem
International initiatives and experiences, Terence Ryan Pressure Ulcers in Iceland prevalence, seriousness and prevention, Gubjrg Plsdttir
Pressure ulcers: an African initiative, Katarzyna Trok The effect of a simple three-step pressure relieving strategyfor preventing pressure ulcers: an explorative longitudinalstudy from 2002-2011, Martin van Leen
Pressure ulcers in the darkly pigmented skin, Madeleine Stenius Suspected Deep Tissue Injury on Heels of Nursing Home Residents: Development and Evolution within 16 weeks,Barbara Bates-Jensen
Pressure Ulcer Prevalence 2011-2014: Data from the International Pressure Ulcer PrevalenceTM Survey,Charlie Lachenbruch
10:00 - 10:45 Coffee break and exhibition viewing10:45 - 12:00 Clinical case discussions: interactive session, Chairs:
Michael Clark, Marco RomanelliPressure ulcers in the amputation stump and how they can beavoided, Anton JohannessonPressure ulcers in the paediatric population, Guido Ciprandi
A multidisciplinary approach to prevention and treatment ofpressure ulcers in palliative care, Lenche NeloskaSuccessful management of a non-healing pressure ulcer foran immuno-compromised child with a bacteria binding geldressing, Anna Sahlqvist
12:00 - 12:30 Presentation of EPUAP 2015 Gent, Belgium, Dimitri Beeckman, Geert Vanwalleghem, Hilde HeymanClosing of the conference, Amit Gefen
PRESSURE ULCERS FROM BIRTH TO DEATH Prevention, Treatment and Rehabilitation. 27-29 August 2014 Stockholm, Sweden
Friday 29.08.2014 PROGRAMME
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08:00
Bergsmannen Spelbomskan
09:00 - 10:30 Workshop: Debridement: Why - When -When not? Carolyn Wyndham - White
Free paper session 10: Patient Safety, Quality ofCare and Policy (2), Chairs: Michael Clark, Marco Romanelli
09:00- 10:00
Cost analysis and effects of one of the first outpatient woundclinics in the Netherlands, Armand Rondas
Nurses' attitudes and perceived barriers to pressure ulcer prevention, Ahmad Tubaishat
Knowledge among ICU nurses about pressure ulcers prevention, Maria Hansbo
Patients with pressure ulcers from prevention through treatment to healing results from the national quality registries RUT (Registry of Ulcer Treatment) and Senior alert, Ruth ien
10:00 - 10:4510:45 - 12:00
12:00 - 12:30
See the industry satellite symposia and workshops at page 91
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EPUAP WORKSHOP:
The implementation of the 2014 pressure ulcer guidelines in clinical practice
EPUAP WORKSHOP:
Pressure Ulcer Classification: PuClas3The new PuClas version includes an update of the classification systemaccording to the latest international guideline, an updated terminology forincontinence- associated dermatitis, high quality photographs, an assessmentmodule for basic level and advance level, and a separate assessment moduleincluding cases and photographs.
Speaker: Dimitri BeeckmanDate: 28 August 2014Time: 13:15 14:15Meeting room: Spelbomskan
WORKSHOP:
Pressure Ulcer Prevention Pathways (PUPPS): ActiveMonitoring Model of Care Incorporating PURPOSE T' The NIHR PURPOSE Programme of research, highlighted the limitations ofpressure ulcer risk assessment practice and the standard 'assess, plan,implement and evaluate' model of care (Nixon et al. Submitted). This promptedthe development of a new evidenced-based risk assessment framework -PURPOSE T and an active monitoring model of care incorporating primaryand secondary Pressure Ulcer Prevention Pathways (PUPPs). The workshop willpresent the new Risk Assessment Framework PURPOSE T and allow delegatesto practice using the tool. PUPPs will also be introduced.
Speakers: Susanne ColemanDate: 28 August 2014Time: 16:00 17:00Meeting room: Spelbomskan
Implementation of guidelines in clinical practice requires a systematic approach.This approach should target relevant barriers and facilitators for use of theguidelines.This workshop will focus on the identification of these barriers andfacilitators and the development of a matching implementation strategy.
Speaker: Lisette SchoonhovenDate: 28 August 2014Time: 13:15 14:15Meeting room: Bergsmannen
DEBRIDEMENT WORKSHOP:
Why When When not? Participants will gain knowledge about wound evaluation, the goals ofdebridement (when and why), limits, dangers, and related measures. Attendeeswill be able to practice sharp debridement and learn the necessary practicalskills.
Speaker: Carolyn Wyndham - WhiteDate: 29 August 2014Time: 09:00 10:30Meeting room: Bergsmannen
SCIENTIFIC WORKSHOPS
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WWW.EWMA2015.ORGWWW.EWMA.ORG WWW.TVS.ORG.UK
LONDON UKEWMA 2015
13-15 MAY 2015
25th Conference of the European Wound Management Association
WOUND CARE SHAPING THE FUTUREA PATIENT, PROFESSIONAL, PROVIDER AND PAYER PERSPECTIVE
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How can you get involved? Host educational activities on prevention and treatment of pressure ulcers Organise awareness raising events to share information about pressure ulcers Reach out to your local community to inform them about pressure ulcers Make policy makers aware about pressure ulcers
Download support material for free at: www.epuap.org
EPUAP Business OfficeEmail: [email protected]: +420 251 019 379
one GOALWorldwide
20thNovember2014
www.epuap.org
STOP PRESSURE ULCER DAY
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Oral presentations overview(Bold = presenting author)
1 Pressure ulcer prevention in critical illneonates and infantsSchlur Anne-Barbara, Degenhardt Johanna
2 Pressure Ulcers and Pain Due to theExtrication Collar and Headblocks inTrauma PatientsHam Wietske H.W., Schoonhoven Lisette,Leenen Luke P.H., Schuurmans Marieke J.
3 A prospective cohort study of the clinicaleffectiveness of multi-layer soft siliconedressings in the prevention of heelpressure ulcers in trauma and criticallyill patientsSantamaria Nick, Gerdtz Marie, Liu Wei,DeVincentis Stephanie, Ng Wei Ai
4 The Impact of a 5-Layered SiliconeBordered Foam Dressing on IntensiveCare Unit (ICU) Patients Sacral PressureUlcer Incidence: A Randomized ClinicalTrialKalowes Peggy, Messina Valerie, Li Melanie,Carlson Carole, Lukaszka Diana
5 Higher mortality if admitted with a pressure ulcer to a nursing home Results of a cohort studyLahmann Nils
6 Pressure ulcers on a static air mattress:incidence and risk factorsSerraes Brecht, Schoonhoven Lisette,Beeckman Dimitri
7 A randomised control trial into theimpact of prescribed seating in pressureulcer prevention for nursing homeresidentsMcVey Olivia, Tierney Martina, Casey Jackie, Daly Orlagh, Martin Suzanne
8 A clinical evaluation of a specificallydesigned alternating support surfacedevice for achieving the 30 degree tilt inolder individuals at risk of pressure ulcerdevelopmentMoore Zena, Urmila, Victor
9 Can a multi-faceted intervention affectpressure ulcer prevention?Sving Eva, Hgman Marieann, Mamhidir Anna-Greta, Gunningberg Lena
10 Clinical Unit Microsystem Pressure UlcerPrediction and PreventionDonaldson Nancy, Aydin Carolyn, StottsNancy, Fridman Moshe, Browne Storer Diane
11 Head, Shoulders, Hips and Heels AMulti-Modal Approach to the Reductionof Pressure Ulcers in Infants, Childrenand Young PeopleKipss Sarah Jane, Maxwell Jan
12 Can real-time feedback of interfacepressure optimise adequate repositioningin bed? Gunningberg Lena, Carli Cheryl
13 Buttock pressure management of able-bodied people seated on a rigid surfacefor two hoursChenu Olivier, Payan Yohan, Moreau-Gaudry Alexandre, Diot Bruno,Cannard Francis, Vuillerme Nicolas
14 Evaluating the Sensitivity of Actimetry todetect Postural Changes in SeatedIndividualsWorsley Peter, Webb Sally, Bader Dan L.
15 Does the calcaneus morphology have aninfluence on the risk of posterior heelulcer?Luboz Vincent, Perrier A., Bucki M., Diot B., Cannard F., Vuillerme N., Payan Y.
16 Simulation and Discussion of theMicroclimate in Heel Protector BootsCall Evan, Oberg Craig, Bill Brian, McLean Chad, Drennan Joseph W.
17 Pressure ulcer prevalence and preventionpractices a comparison between formalrisk assessment and assessment usingclinical judgement aloneMoore Zena, Johansen Edda, van Etten Menno, Strapp Helen
18 Improving the risk assessment ofpressure ulcer by nurses for elderly withpsychiatric disorder a pilot projectBassin Florence, Queiros Alcina, Djamel Moad, Charbonneau Lucie, Schet Vronique
19 Is pain a predictor of Category 2pressure ulcers? Analysis of skin site leveldata from the PURPOSE Pain CohortStudySmith Isabelle, Brown Sarah, McGinnis Elizabeth, Stubbs Nikki, Nixon Jane
20 "Early pressure ulcer prevention andIntervention for patients undergoing fast-track surgery" Skovgaard Brigitte Brask, Appelt Henriette Djuurhus
21 PRESSURE 2 Trial: Considerations onthe design of the trial and the decisionmaking process at the interim analysesBrown Sarah, Smith Isabelle, Hulme Claire,Nixon Jane
22 The Effect of a Bacteria and FungiBinding Mesh Dressing on the BacterialLoad of Pressure Ulcers Treated withNegative Pressure Wound Therapy(NPWT), a Pilot StudyCiliberti Marino
23 Numerical Study of different Types ofSupporting Structures regarding thePrevention of Deep Tissue InjuriesSiefert Alexander, Hofmann-RsenerMonika, Lachenbruch Charlie
24 A clinical comparative study on 940, 808and 658 nm laser therapy in pressureulcer healing: early and long term resultsTaradaj Jakub, Polak Anna, Halski Tomasz
25 "Self-Propagation of Cell Death inMuscle Tissue via Myoglobin Release: A Computational Model of Mechano-Chemical Interplay in Deep TissueInjury (DTI)"Tucker-Kellogg Lisa, Gefen Amit
26 The Role of Mathematics in UlcerDevelopment and Wound HealingVermolen Fred, Gefen Amit
27 A novel MR compatible indentationsetup to study the etiology of pressureulcers and related deep tissue injuryNelissen Jules, Traa Willeke, Nicolay Klaas,Strijkers Gustav, Oomens Cees
28 Discrimination between diabetic patientswith and without diabetic foot ulcerbased on testing the cutaneousmicrocirculation in response to lowpressureVouillarmet Julien, Josset-Lamaugarny A.,Viart-Ferber Ch, Sigaudo-Roussel D.
29 Home-care wound care a EWMAdocumentProbst Sebastian, Seppnen Salla, GerberVeronika, Rimdeika Rytis, Hopkins Alison,Gethin Georgina
30 What Percentage of Hospital-AcquiredGrade 3 and 4 Pressure Ulcers areAvoidable? Downie Fiona, Sandoz Heidi, PaulineGilroy, Royall Dawn, Davies Sarah
31 Do patient safety culture items affectpressure ulcer prevalence in a sample ofNorwegian hospitals?Bredesen Ida Marie, Bjro Karen L. K.,Gunningberg Lena, Hofoss Dag
32 RNs knowledge of PU risk factors andprevention in internal medicine of aUniversity Hospital In IcelandGsladttir Iris, rardttir Arna
33 Patients and nurses experiences of usingthe 30 degree tilt for the prevention ofpressure ulcersUrmila Victor, Moore Zena
34 Evidence-based skin care at a universityhospital in GermanyLichterfeld Andrea, Hauss Armin, SauberChristian, Blume-Peytavi Ulrike, Kottner Jan
35 Pressure Ulcers due to Stroke patientsreceiving Percutaneous EndoscopicGastrostomy Hede Gunnel Wrn, Faxen-Irving Gerd,Ekman Sirkka-Liisa, Crisby Milita,Ebbeskog Britt
36 Role of Braden scale scoring as a prognostic tool for pressure ulcersMadhavan Kumar, Singhal Maneesh,Ranjan Piyush, Sagar Sushma, Garg Kavita
37 Heel Ulcers: Simulations of InjuriousTissue Loads and Remedial Local DrugDeliveryFriedman Rinat, Haimy Ayelet, Shabshin Nogah, Zilberman Meital, Gefen Amit
38 Changes in topography and structuralproperties of healthy aged skin afterloadingDobos Gabor, Richter Claudia, Trojahn Carina, Blume-Peytavi Ulrike, Gefen Amit, Kottner Jan
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39 The quest for smart materials to protectthe fragile skin: Computational modelingof how shear and microclimate influenceskin that rubs against clothing,incontinence pads, diapers etc.Ben-Or Frank Mor, Limbert Georges, Fader Mandy, Kottner Jan, Gefen Amit
40 Development of biomarkers for theWound Fluid RT-PCR method to detectcritically colonised and infected woundsAsada Mayumi, Nakagami Gojiro, Tochiori Ayaka, Sugama Junko, Sanada Hiromi
41 Biomechanical simulation of the Charcotneuroarthropathic foot with plantar ulcerPerrier Antoine, Vuillerme N., Luboz V.,Bucki M., Diot B., Cannard F., Havan G.,Payan Y.
42 Pressure Ulcers in Iceland prevalence,seriousness and preventionPlsdttir, Gubjrg, Gurn Sigurjnsdttir,sta Thoroddsen
43 The effect of a simple three-step pressurerelieving strategy for preventing pressureulcers: an explorative longitudinal studyfrom 2002-2011van Leen Martin, Schols Jos, Hovius Steven E.R., Halfens Ruud J.G.
44 Suspected Deep Tissue Injury on Heelsof Nursing Home Residents:Development and Evolution within 16weeks Bates-Jensen Barbara, Patlan Anabel,McCreath Heather E., Nakagami Gojiro
45 Pressure Ulcer Prevalence 2011-2014:Data from the International PressureUlcer PrevalenceTM SurveyLachenbruch Charlie, Van Gilder Catherine,Meyer Stephanie
46 Cost analysis and effects of one of thefirst outpatient wound clinics in theNetherlandsRondas Armand, Schols Jos, Halfens R,Hull H, Stobberingh E, Evers
47 Nurses' attitudes and perceived barriersto pressure ulcer preventionTubaishat Ahmad, Aljezawi Maen, Al Qadire Mohammad
48 Knowledge among ICU nurses aboutpressure ulcers preventionHansbo Maria, Mattsson Gunilla, Bth Carina
49 Patients with pressure ulcers fromprevention through treatment to healing results from the national qualityregistries RUT (Registry of UlcerTreatment) and Senior alertien Rut, Lindholm Christina, Trinks Anna
50 Lactic acid bacterial symbionts inhoneybees an unknown key to honeysantimicrobial and therapeutic activitiesAlejandra Vasquez, Christina Lindholm,Tobias Olofsson
Publikace EPUAP_Sestava 2 14.8.14 10:07 Strnka 18
19
Pro
ce
ed
ing
s o
f th
e 1
7th
An
nu
al E
uro
pe
an
Pre
ssu
re U
lce
r M
ee
tin
g
Sto
ckh
olm
, S
we
de
n
Co
py
rig
ht
2
01
4 b
y E
PU
AP
Pre
ssu
re u
lcer
pre
ven
tio
n i
n c
riti
cal
ill
neo
nate
s a
nd
in
fan
ts
Sc
hl
er
An
na
-Ba
rba
ra 1
,2,
De
ge
nh
ard
t J
oh
an
na
1
1* D
ep
art
me
nt
of
Nu
rsin
g s
cie
nce
an
d d
eve
lop
me
nt,
Ch
ildre
ns
Un
ive
rsity H
osp
ita
l Z
uri
ch
(S
witze
rla
nd
),
ba
rba
ra.s
ch
lue
er@
kis
pi.u
zh
.ch
2 C
hild
ren
s R
ese
arc
h C
en
ter,
Ch
ildre
ns
Un
ive
rsity H
osp
ita
l Z
uri
ch
(S
witze
rla
nd
),
Intr
od
uc
tio
n
Th
ere
is g
rea
ter
aw
are
ne
ss t
ha
t p
ae
dia
tric
pa
tie
nts
in
ce
rta
in
he
alth
ca
re
se
ttin
gs
are
a
t h
igh
ri
sk
of
de
ve
lop
ing
pre
ssu
re u
lce
rs.
In d
iffe
ren
t ca
re s
ett
ing
s,
su
ch
a
s p
ae
dia
tric
in
ten
siv
e ca
re u
nits (P
ICU
s)
an
d
acco
rdin
g
to
diffe
ren
t ri
sk
facto
rs,
su
ch
a
s
me
dic
al
de
vic
es,
diffe
ren
t p
ressu
re u
lce
r p
reva
len
ce
ra
tes h
ave
b
ee
n p
ub
lish
ed
[1
, 2
]. P
ressu
re u
lce
r p
reva
len
ce
ra
tes
in n
eo
na
tes a
nd
in
fan
ts v
ary
fro
m 1
1%
to
61
.5%
[3
,4].
R
isk
facto
rs
for
ho
sp
ita
lize
d
ne
on
ate
s
an
d
infa
nts
in
clu
de
a
P
ICU
sta
y
an
d
me
ch
an
ica
l ve
ntila
tio
n
su
pp
ort
. T
hu
s,
cri
tica
lly i
ll p
atie
nts
of
yo
un
ge
r a
ge
are
a
t ve
ry h
igh
ri
sk o
f d
eve
lop
ing
p
ressu
re u
lce
rs [5
,6].
T
he
refo
re
the
a
im
of
this
stu
dy
wa
s
to
imp
lem
en
t sp
ecific
p
reve
ntio
n
str
ate
gie
s
to
de
cre
ase
p
ressu
re
ulc
er
risk in
ne
on
ate
s a
nd
in
fan
ts t
rea
ted
on
a P
ICU
.
Me
tho
ds
In 2
01
3 a
lo
ng
itu
din
al
stu
dy w
as c
on
du
cte
d i
n a
Sw
iss
PIC
U
se
ttin
g
inclu
din
g
all
ne
on
ate
s
an
d
infa
nts
in
cri
tica
l lif
e
co
nd
itio
ns
ad
mitte
d
to
a
PIC
U
wh
ich
n
ee
de
d m
ech
an
ica
l ve
ntila
tio
n su
pp
ort
. A
ll n
eo
na
tes
an
d in
fan
ts w
he
re a
sse
sse
d e
ve
ry 1
2 h
ou
rs if
the
y h
ad
(1
) a
ny m
ech
an
ica
l ve
ntila
tio
n s
up
po
rt,
(2)
an
y o
the
r d
evic
e w
hic
h c
an
ca
use
pre
ssu
re in
th
e f
ace
ae
ra,
an
d
(3)
if
the
y
de
ve
lop
ed
a
p
ressu
re
ulc
er
(in
clu
din
g
ca
teg
ory
).
Th
e
asse
ssm
en
t w
as
pe
rfo
rme
d
in
all
pa
tie
nts
u
ntil
48
h
ou
rs p
ost
dis
ch
arg
e fr
om
P
ICU
o
r u
ntil d
ea
th o
f a
pa
tie
nt.
M
ech
an
ica
l ve
ntila
tio
n
su
pp
ort
d
evic
es
inclu
de
d
tra
ch
ea
l tu
be
s,
co
ntin
uo
us p
ositiv
e a
irw
ays p
ressu
re
ma
sks (
with
an
d w
ith
ou
t p
ron
gs),
ma
sks,
na
sa
l tu
be
s
an
d t
rach
eo
sto
my.
A
fte
r a
firs
t p
ha
se
la
stin
g
4
mo
nth
, a
n
ew
fixa
tio
n
str
ate
gy to
se
cu
re tr
ach
ea
l tu
be
s a
nd
u
nd
erp
ad
din
g
an
y m
asks w
as im
ple
me
nte
d.
Re
su
lts
In 2
01
3 a
to
tal
of
24
5 n
eo
na
tes a
nd
in
fan
ts w
ith
th
e
ne
ed
fo
r m
ech
an
ica
l ve
ntila
tio
n
su
pp
ort
w
he
re
asse
sse
d.
In
th
e f
irst
stu
dy p
ha
se
th
e in
cid
en
ce
of
pre
ssu
re u
lce
r (i
ncl. c
ate
go
ry 1
) w
as 4
4%
.
Aft
er
imp
lem
en
tin
g th
e sp
ecific
p
reve
ntio
n str
ate
gie
s
with
u
nd
erp
ad
din
g
an
y
ma
sks
an
d
a
ne
w
fixa
tio
n
tech
niq
ue
to
se
cu
re
tra
ch
ea
l tu
be
s
the
in
cid
en
ce
d
ecre
ase
d t
o 2
5%
.
Dis
cu
ss
ion
Incid
en
ce
ra
te
for
pre
ssu
re
ulc
er
de
ve
lop
me
nt
in
ne
on
ate
s a
nd
in
fan
ts i
n a
PIC
U s
ett
ing
are
hig
h.
Th
is
is in
lin
e w
ith
p
revio
us p
ub
lish
ed
in
cid
en
ce
ra
tes in
th
ese
se
ttin
g [
5,6
]. V
en
tila
tio
n s
up
po
rt d
evic
es s
uch
as
CP
AP
or
me
ch
an
ica
l ve
ntila
tio
n i
ncre
ase
d t
he
ris
k o
f p
ressu
re u
lce
rs.
N
eo
na
tes
an
d
infa
nts
w
ith
co
ng
en
ita
l h
ea
rt
de
fects
a
nd
a
fte
r ca
rdio
-su
rge
ry
pro
ce
du
res
wh
ere
th
e
pa
tie
nts
mo
st
at
risk f
or
pre
ssu
re u
lce
r d
eve
lop
me
nt.
W
ith
a
n
ea
sy
to
ap
ply
, b
ut
ad
ap
ted
to
th
e
stu
dy
po
pu
latio
n,
inte
rve
ntio
n t
he
pre
ssu
re u
lce
r in
cid
en
ce
in
th
e s
tud
y g
rou
p d
ecre
ase
d.
Cli
nic
al
rele
va
nc
e
Th
e p
reve
ntio
n o
f p
ressu
re u
lce
rs i
n t
his
pa
tie
nt
gro
up
m
ust
sta
rt
ea
rly
to
avo
id
an
y
furt
he
r h
arm
to
th
eir
h
igh
ly v
uln
era
ble
skin
. T
he
refo
re t
he
se
ch
ildre
n n
ee
d
evid
en
ce
ba
se
d a
nd
ap
pro
pri
ate
pre
ve
ntive
me
asu
res
to d
ecre
ase
th
eir
pre
ssu
re u
lce
r ri
sk.
Un
de
r-p
ad
din
g,
ca
refu
l fixa
tio
n
an
d
po
sitio
nin
g
of
me
dic
al
de
vic
es,
esp
ecia
lly v
en
tila
tio
n s
up
po
rt d
evic
es,
in t
he
se
hig
hly
vu
lne
rab
le p
atie
nts
are
ma
nd
ato
ry a
nd
ea
sy t
o a
pp
ly
to d
ecre
ase
th
e r
isk o
f p
ressu
re u
lce
rs.
A
ck
no
wle
dg
em
en
ts
We
ap
pre
cia
te t
he
he
lp o
f P
rof
Dr.
Be
rnh
ard
Fre
y a
nd
D
r. V
. C
an
niz
za
ro a
nd
th
e P
ICU
te
am
at
the
Ch
ildre
ns
U
niv
ers
ity h
osp
ita
l Z
uri
ch
, S
witze
rla
nd
.
Co
nfl
ict
of
Inte
res
t N
on
e.
Re
fere
nc
es
[1]
Ko
ttn
er
J.
et
al.,
Int.
J.
Nu
rs.
Stu
d,
47
:13
30
-13
40
, 2
01
0
[2]
Sch
le
r A
B.
et
al.,
Osto
my W
ou
nd
Ma
n,
58
:18
-31
, 2
01
2
[3]
Gro
ne
ve
ld A
. e
t a
l.,
J W
ou
nd
Osto
my C
on
tin
en
ce
N
urs
, 3
1:1
08
-12
2,
20
04
[4
] S
ch
le
r A
B.
et
al.,
J C
lin N
urs
, 1
8:3
24
4
32
52
, 2
00
9
[5]
Ba
ha
resta
ni M
. e
t a
l.,
Ad
v S
kin
Wo
un
d C
are
, 2
0:2
08
-22
0,
20
07
[6
] C
url
ey M
AQ
. e
t a
l.,
Pe
dia
tr C
rit
Ca
re M
ed
, 4
: 2
84
-2
90
, 2
00
3
Pro
ce
ed
ing
s o
f th
e 1
7th
An
nu
al E
uro
pe
an
Pre
ssu
re U
lce
r M
ee
tin
g
Sto
ckh
olm
, S
we
de
n
Co
py
rig
ht
2
01
4 b
y E
PU
AP
Pre
ssu
re U
lcers
an
d P
ain
Du
e t
o t
he E
xtr
icati
on
Co
llar
an
d H
ead
blo
cks i
n T
rau
ma P
ati
en
ts
Wie
tsk
e H
.W.
Ha
m,
MS
c,
RN
1* , L
ise
tte
Sc
ho
on
ho
ve
n,
Ph
D 2
, L
uk
e P
.H.
Le
en
en
, P
hD
, M
D,
FA
CS
3
Ma
rie
ke
J.
Sc
hu
urm
an
s,
Ph
D,
RN
1 3
4 * U
niv
ers
ity M
ed
ica
l C
en
ter
Utr
ech
t, T
he
Ne
the
rla
nd
s,
H.W
.Ha
m@
um
cu
tre
ch
t.n
l 2 R
ad
bo
ud
Un
ive
rsity M
ed
ica
l C
en
ter,
Nijm
eg
en
, th
e N
eth
erl
an
ds &
Un
ive
rsity o
f S
ou
tha
mp
ton
, S
ou
tha
mp
ton
, U
K
Intr
od
uc
tio
n
At
the
sce
ne
of
an
accid
en
t, e
ve
ry t
rau
ma
pa
tie
nt
with
su
sp
ecte
d
sp
ine
in
jury
is
im
mo
bili
ze
d
with
a
b
ackb
oa
rd,
an
d
extr
ica
tio
n
co
llar
co
mb
ine
d
with
h
ea
db
locks,
an
d
tra
nsp
ort
ed
to
th
e
em
erg
en
cy
de
pa
rtm
en
t (E
D)
for
eva
lua
tio
n
an
d
tre
atm
en
t.
Th
e
ba
ckb
oa
rd
is
use
d
as
tra
nsp
ort
atio
n
de
vic
e,
an
d
sh
ou
ld i
de
ally
be
re
mo
ve
d b
efo
re i
nitia
l a
sse
ssm
en
t in
th
e
ED
.(1
) S
pin
al
imm
ob
iliza
tio
n
sh
ou
ld
furt
he
r b
e
co
ntin
ue
d
by
str
aig
ht
alig
nm
en
t o
f th
e
sp
ine
a
nd
su
pin
e
bo
dy
po
sitio
n.
Th
e
ce
rvic
al
sp
ine
re
ma
ins
imm
ob
ilize
d w
ith
a
n e
xtr
ica
tio
n co
llar
co
mb
ine
d w
ith
h
ea
db
locks u
ntil
inju
ry i
s d
iag
no
se
d o
r ru
led
ou
t, i
.e.
the
ce
rvic
al
sp
ine
is
c
lea
red
.
It
is
kn
ow
n
tha
t im
mo
bili
zin
g
de
vic
es
ca
use
p
ain
a
nd
in
cre
ase
p
ressu
re u
lce
r (P
U)
risk.
(2)
Ho
we
ve
r, p
ain
, a
s w
ell
as
the
d
eve
lop
me
nt,
clin
ica
l sym
pto
ms a
nd
e
vo
lutio
n o
f P
U
rela
ted
to
th
e
use
o
f th
e
extr
ica
tio
n
co
llar
an
d
he
ad
blo
cks,
ha
ve
no
t b
ee
n d
escri
be
d.
Th
e p
urp
ose
of
this
stu
dy w
as t
o g
ain
in
sig
ht
into
PU
s a
nd
pa
in f
rom
th
e e
xtr
ica
tio
n c
olla
r co
mb
ine
d w
ith
la
tera
l h
ea
db
locks
in tr
au
ma
p
atie
nts
a
dm
itte
d to
th
e E
D fo
r e
va
lua
tio
n
an
d t
rea
tme
nt
of
acu
te t
rau
ma
tic in
juri
es.
Me
tho
ds
Pro
sp
ective
d
ata
o
f 3
42
co
nse
cu
tive
a
du
lt
tra
um
a
pa
tie
nts
ad
mitte
d t
o t
he
ED
aft
er
acu
te t
rau
ma
we
re
co
llecte
d
fro
m
Ja
nu
ary
2
01
3
un
til
De
ce
mb
er
20
13
. T
rain
ed
E
D
nu
rse
s
asse
sse
d
pa
in
inte
nsity
an
d
co
nd
itio
n o
f th
e skin
re
late
d w
ith
p
ressu
re a
rea
s fo
r e
ryth
em
a,
PU
a
nd
in
de
nta
tio
n m
ark
s a
t th
e m
om
en
t th
e e
xtr
ica
tio
n c
olla
r a
nd
he
ad
blo
cks w
ere
re
mo
ve
d o
r ch
an
ge
d.
Pre
ssu
re
are
as
we
re
de
fin
ed
a
s:
ch
in,
occip
ut,
cla
vic
les,
ba
ck,
ch
est
an
d e
ars
.
Re
su
lts
Th
e 3
42
tra
um
a p
atie
nts
we
re i
n a
n e
xtr
ica
tio
n c
olla
r a
nd
h
ea
db
locks
for
an
a
ve
rag
e
of
13
7.7
m
inu
tes
(Ra
ng
e (R
) 1
0-8
45
, S
tan
da
rd D
evia
tio
n (S
D)
95
.30
),
un
til
ce
rvic
al
sp
ine
cle
ara
nce
. S
eve
nty
-on
e
(20
.8%
) p
atie
nts
re
po
rte
d m
od
era
te p
ain
(N
RS
4
-6)
an
d 1
11
(3
2.5
%)
se
ve
re p
ain
(N
RS
7-1
0)
on
pre
ssu
re a
rea
s.
In
ap
pro
xim
ate
ly
ha
lf
of
the
p
atie
nts
w
ho
re
po
rte
d
mo
de
rate
o
r se
ve
re
pa
in,
pa
in
wa
s
loca
ted
a
t th
e
occip
ut.
26
8 (
78
.3%
) p
atie
nts
de
ve
lop
ed
a P
U o
f w
hic
h
75
.4%
w
as
ca
teg
ory
1
, a
nd
2
.9%
ca
teg
ory
2
. 2
05
(5
9.9
%)
ha
d m
ore
th
an
1 P
U s
ite
. T
he
ma
jori
ty o
f th
e
PU
s w
ere
lo
ca
ted
on
th
e b
ack,
ch
est
an
d s
ho
uld
ers
of
the
p
atie
nts
(1
13
, 1
35
, a
nd
1
18
tim
es,
resp
ective
ly).
2
18
p
atie
nts
d
eve
lop
ed
in
de
nta
tio
n
ma
rks;
12
5
(36
.5%
) h
ad
m
ild
an
d
93
(2
8.1
%)
ha
d
se
ve
re
ind
en
tatio
n m
ark
s.
12
6 (
36
.9%
) p
atie
nts
ha
d m
ore
tha
n o
ne
in
de
nte
d s
ite
. T
he
ma
jori
ty o
f th
e i
nd
en
tatio
n
ma
rks w
ere
lo
ca
ted
at
the
ch
est,
ba
ck,
an
d s
ho
uld
ers
(7
1,
90
, a
nd
11
1 t
ime
s,
resp
ective
ly).
Dis
cu
ss
ion
Th
is w
as t
he
fir
st
pro
sp
ective
stu
dy o
n P
U a
nd
pa
in
fro
m
extr
ica
tio
n
co
llars
a
nd
h
ea
db
locks
in
tra
um
a
pa
tie
nts
with
su
sp
ecte
d c
erv
ica
l sp
ine
in
jury
. T
he
use
o
f m
ultip
le
da
ta
co
llecto
rs
in
ou
r stu
dy
ca
n
lea
d
to
info
rma
tio
n b
ias,
ho
we
ve
r, t
he
in
terr
ate
r re
liab
ility
pri
or
an
d d
uri
ng
th
e stu
dy w
as M
Ka
pp
a 0
.58
a
nd
K
ap
pa
0
.85
re
sp
ective
ly.
A co
nsid
era
ble
n
um
be
r o
f tr
au
ma
p
atie
nts
d
eve
lop
ed
a
ca
teg
ory
1
o
r 2
P
U,
se
ve
re
ind
en
tatio
n m
ark
s a
nd
exp
eri
en
ce
d s
eve
re p
ain
wh
ile
in a
n e
xtr
ica
tio
n c
olla
r a
nd
he
ad
blo
cks.
Cli
nic
al
rele
va
nc
e
Th
e c
urr
en
t p
ractice
of
ce
rvic
al
imm
ob
iliza
tio
n i
n c
ase
o
f su
sp
ecte
d c
erv
ica
l sp
ine
in
jury
sh
ou
ld b
e e
va
lua
ted
. F
irst,
th
e p
roce
du
re o
f ce
rvic
al
sp
ine
cle
ara
nce
sh
ou
ld
be
o
ptim
ize
d
in
ord
er
to
min
imiz
e
tim
e
in
the
e
xtr
ica
tio
n
co
llar
an
d
he
ad
blo
cks.
Se
co
nd
, d
uri
ng
ce
rvic
al
sp
ine
im
mo
bili
za
tio
n,
the
n
um
be
r o
f tr
au
ma
p
atie
nts
with
PU
, in
de
nta
tio
n m
ark
s a
nd
pa
in c
ou
ld b
e
red
uce
d
by
reco
nsid
eri
ng
th
e
de
sig
n
an
d
ma
teri
als
th
at
are
cu
rre
ntly
use
d
to
imm
ob
ilize
th
e
ce
rvic
al
sp
ine
.
Ac
kn
ow
led
ge
me
nts
We
ap
pre
cia
te t
he
he
lp o
f E
D s
taff
an
d a
ll E
D n
urs
es
fro
m t
he
Em
erg
en
cy D
ep
art
me
nt
of
the
Un
ive
rsity
Me
dic
al C
en
ter
Utr
ech
t. W
ith
ou
t th
eir
su
pp
ort
an
d
en
thu
sia
sm
, th
is s
tud
y w
ou
ld n
ot
ha
ve
be
en
po
ssib
le.
C
on
flic
t o
f In
tere
st
Re
fere
nc
es
(1)
Lu
bb
ert
PH
W,
Sch
ram
ME
, L
ee
ne
n L
PH
. Is
th
ere
a
rea
so
n f
or
sp
ine
bo
ard
im
mo
bili
za
tio
n in
th
e
em
erg
en
cy d
ep
art
me
nt
for
pa
tie
nts
with
a p
ote
ntia
l
sp
ina
l in
jury
? E
ur
J T
rau
ma
20
05
;31
(4):
37
5-3
78
.
(2)
Ha
m W
, S
ch
oo
nh
ove
n L
, S
ch
uu
rma
ns M
J,
Le
en
en
L
P.
Pre
ssu
re u
lce
rs f
rom
sp
ina
l im
mo
bili
za
tio
n in
tr
au
ma
pa
tie
nts
: A
syste
ma
tic r
evie
w.
J T
rau
ma
Acu
te
Ca
re S
urg
20
14
Ap
r;7
6(4
):1
13
1-1
14
1.
12
Publikace EPUAP_Sestava 2 14.8.14 10:07 Strnka 19
20
ABSTRACTS OF ORAL PRESENTATIONSP
roce
ed
ing
s o
f th
e 1
7th
An
nu
al E
uro
pe
an
Pre
ssu
re U
lce
r M
ee
tin
g
Sto
ckh
olm
, S
we
de
n
Co
py
rig
ht
2
01
4 b
y E
PU
AP
A p
rosp
ecti
ve c
oh
ort
stu
dy o
f th
e c
lin
ical
eff
ecti
ven
ess o
f m
ult
i-la
yer
so
ft s
ilic
on
e
dre
ssin
gs i
n t
he p
reven
tio
n o
f h
eel
pre
ssu
re u
lcers
in
tra
um
a a
nd
cri
tically i
ll p
ati
en
ts
Nic
k S
an
tam
ari
a 1
&2
* , M
ari
e G
erd
tz 1
&2,
We
i L
iu 1
&2 S
tep
ha
nie
De
Vin
ce
nti
s 2
, A
i W
ei
Ng
2,
1* U
niv
ers
ity o
f M
elb
ou
rne
, A
ustr
alia
, n
ick.s
an
tam
ari
a@
mh
.org
.au
2 R
oya
l M
elb
ou
rne
Ho
sp
ita
l, A
ustr
alia
.
Intr
od
uc
tio
n
Pre
ve
ntin
g p
ressu
re u
lce
rs (
PU
) in
cri
tica
lly i
ll p
atie
nts
is
ch
alle
ng
ing
fo
r clin
icia
ns
du
e
to
a
mu
ltip
licity
of
ph
ysio
log
ica
l a
nd
e
nvir
on
me
nta
l fa
cto
rs.
We
h
ave
p
revio
usly
d
em
on
str
ate
d
tha
t th
e
the
u
se
o
f p
rop
hyla
ctic
so
ft
sili
co
ne
m
ulti-
laye
r d
ressin
g
ca
n
sig
nific
an
tly re
du
ce
th
e in
cid
en
ce
o
f sa
cra
l a
nd
h
ee
l P
Us
in
this
g
rou
p
of
pa
tie
nts
[1
].
Th
e
me
ch
an
ism
s
un
de
rpin
nin
g
the
p
rote
ctive
e
ffe
ctive
ne
ss
of
the
se
d
ressin
gs
are
b
elie
ve
d
to
rela
te
to
the
ir
mu
lti-
laye
r co
nstr
uctio
n m
od
ifyin
g p
ressu
re,
fric
tio
n,
sh
ea
r fo
rce
s
an
d t
he
ma
na
ge
me
nt
of
mic
roclim
ate
.
Me
tho
ds
We
co
nd
ucte
d a
1
0-m
on
th p
rosp
ective
co
ho
rt stu
dy
with
a h
isto
rica
l co
ntr
ol
co
ho
rt (
n=
22
1)
fro
m a
re
ce
nt
ICU
pro
ject
[1]
as a
co
mp
ara
tor.
A t
ota
l o
f 1
91
cri
tica
lly
ill a
nd
tra
um
a p
atie
nts
we
re e
nro
lled
in
to t
he
stu
dy i
n
the
E
D.
E
ach
p
atie
nt
ha
d a
so
ft sili
co
ne
m
ulti-
laye
r d
ressin
g a
pp
lied
to
ea
ch
he
el
in E
D o
n a
dm
issio
n a
nd
m
ain
tain
ed
in
p
lace
th
rou
gh
ou
t th
eir
IC
U sta
y.
T
he
h
ee
ls
we
re
insp
ecte
d
da
ily
by
a
me
mb
er
of
the
re
se
arc
h
tea
m
an
d
dre
ssin
gs
we
re
rep
lace
d
eve
ry
thre
e d
ays o
r if t
he
y b
eca
me
dis
lod
ge
d.
All
pa
tie
nts
w
ere
ca
red
fo
r o
n
the
sa
me
lo
w
air
lo
ss
be
ds
thro
ug
ho
ut
the
ir sta
y in
IC
U.
Th
e e
nd
p
oin
t fo
r th
e
stu
dy w
as t
he
in
cid
en
ce
ra
te o
f h
ee
l p
ressu
re u
lce
rs.
An
aly
sis
wa
s b
ase
d o
n i
nte
ntio
n t
o t
rea
t a
nd
mu
ltip
le
reg
ressio
n
an
d
su
rviv
al
an
aly
sis
o
f tim
e
to
PU
d
eve
lop
me
nt.
Re
su
lts
Ta
ble
1:
Pa
tie
nt
ch
ara
cte
ris
tic
s a
nd
ou
tco
me
s
In
terv
en
tio
n C
oh
ort
N
= 1
91
Me
an
(S
D)
Co
ntr
ol
Co
ho
rt
N=
22
1
Me
an
(S
D)
Ag
e
54
(1
9.7
) 5
6 (
20
.5)
Ma
le/F
em
ale
M
AP
(m
mH
g)
Te
mp
(C
) S
pO
2 %
H
R (
BP
M)
Bra
de
n
AP
AC
HE
II
Le
ng
th o
f s
tay
(Hrs
) E
D
OR
IC
U
Pre
ss
ure
Ulc
ers
(%)
12
3/6
7
91
(2
1.8
)
36
.0 (
1.8
) 9
7
96
(2
5.9
)
11
(2
.9)
18
.9
6
.7 (
5.2
)
4.5
(3
.9)
10
7 (
12
2.6
)
0 (
0)
13
2/8
2
93
(2
2.7
)
36
.2 (
1.6
) 9
8
95
(2
6. 6
)
12
(3
.9)
19
.5
6
.4 (
4.6
)
5.2
(4
.2)
86
(1
00
)
19
(8
.5)
Dis
cu
ss
ion
Wh
ilst
pa
tie
nts
in
ou
r in
terv
en
tio
n a
nd
co
ntr
ol
co
ho
rts
we
re
sim
ilar
on
ke
y
de
mo
gra
ph
ic
an
d
ph
ysio
log
ica
l fa
cto
rs (
Ta
ble
1),
th
e i
nte
rve
ntio
n c
oh
ort
ha
d a
lo
ng
er
len
gth
of
sta
y i
n I
CU
wh
ich
co
uld
be
co
nsid
ere
d a
s a
g
rea
ter
risk f
or
the
se
pa
tie
nts
of
de
ve
lop
ing
a P
U.
Ou
r fin
din
g t
ha
t th
e i
nte
rve
ntio
n g
rou
p d
id n
ot
de
ve
lop
an
y
he
el
PU
s o
ve
r th
e c
ou
rse
of
the
stu
dy s
ug
ge
sts
th
at
the
d
ressin
gs a
re a
via
ble
p
rote
ctive
in
terv
en
tio
n fo
r th
is g
rou
p o
f cri
tica
lly ill
pa
tie
nts
.
We
be
lieve
th
at
furt
he
r re
se
arc
h i
s r
eq
uir
ed
to
be
tte
r e
lucid
ate
th
e p
rote
ctive
m
ech
an
ism
s o
f th
ese
m
ulti-
laye
r sili
co
ne
dre
ssin
gs.
Ad
ditio
na
lly i
t is
no
t cle
ar
at
pre
se
nt
if
oth
er
dre
ssin
gs
co
mp
risin
g
diffe
ren
t co
nstr
uctio
n
an
d/o
r fo
rmu
latio
ns
of
sili
co
ne
p
rovid
e
sim
ilar
pro
tective
pe
rfo
rma
nce
.
Cli
nic
al
rele
va
nc
e
Th
e fin
din
gs o
f th
is stu
dy h
igh
ligh
t a
nd
su
pp
ort
o
ur
ea
rlie
r w
ork
on
th
e c
linic
al
eff
ective
ne
ss o
f m
ultila
ye
r so
ft s
ilico
ne
dre
ssin
gs i
n p
reve
ntin
g P
Us i
n c
ritica
lly i
ll p
atie
nts
. T
he
se
dre
ssin
gs a
pp
ea
r to
eff
ective
ly r
ed
uce
p
ressu
re,
fric
tio
n a
nd
sh
ea
r fo
rce
s a
t th
e h
ee
l.
Ac
kn
ow
led
ge
me
nts
We
are
in
de
bte
d t
o t
he
nu
rse
s f
rom
th
e E
D a
nd
IC
U a
t th
e R
oya
l M
elb
ou
rne
Ho
sp
ita
l fo
r th
eir
assis
tan
ce
with
th
is r
ese
arc
h.
Co
nfl
ict
of
Inte
res
t N
il
Re
fere
nc
es
[1]
Sa
nta
ma
ria
N,
Ge
rdtz
MF
, S
ag
e S
, M
cC
an
n J
, F
ree
ma
n A
, V
assili
ou
MT
, D
eV
ince
ntis S
, N
g A
W,
Ma
nia
s E
, L
iu W
, K
no
tt J
. A
ra
nd
om
ise
d c
on
tro
lled
tri
al
of
the
eff
ective
ne
ss o
f so
ft s
ilico
ne
fo
am
mu
lti-
laye
red
d
ressin
gs in
th
e p
reve
ntio
n o
f sa
cra
l a
nd
he
el p
ressu
re
ulc
ers
in
tra
um
a a
nd
cri
tica
lly ill
pa
tie
nts
: T
he
Bo
rde
r T
ria
l. I
nt
Wo
un
d J
20
13
do
i:1
0.1
11
1/iw
j.1
21
01
.
34
Publikace EPUAP_Sestava 2 14.8.14 10:07 Strnka 20
21
Pro
ce
ed
ing
s o
f th
e 1
7th
An
nu
al E
uro
pe
an
Pre
ssu
re U
lce
r M
ee
tin
g
Sto
ckh
olm
, S
we
de
n
Co
py
rig
ht
2
01
4 b
y E
PU
AP
Hig
her
mo
rtality
if
ad
mit
ted
wit
h a
pre
ssu
re u
lcer
to a
nu
rsin
g h
om
e
Resu
lts o
f a c
oh
ort
stu
dy
Nil
s A
La
hm
an
n 1
*
1* In
stitu
te o
f H
ea
lth
a
nd
Nu
rsin
g S
cie
nce
; C
ha
rit
Un
ive
rsit
tsm
ed
izin
Be
rlin
, G
erm
an
y,
nils
.la
hm
an
n@
ch
ari
te.d
e
Intr
od
uc
tio
n
Pre
ssu
re u
lce
rs (
PU
s)
are
ch
ron
ic w
ou
nd
s t
ha
t m
ostly
occu
r in
cri
tica
lly ill
or
fra
il p
atie
nts
as t
ho
se
usu
ally
su
ffe
r fr
om
mu
ltip
le r
isk f
acto
rs,
e.g
. im
pa
ire
d m
ob
ility
o
r d
istu
rbe
d p
erf
usio
n.
Ho
sp
ita
l-a
cq
uir
ed
PU
s h
ave
b
ee
n f
ou
nd
to
be
re
late
d t
o in
cre
ase
d m
ort
alit
y.
Wh
ile
the
pre
va
len
ce
of
pre
ssu
re u
lce
rs o
n h
osp
ita
l a
dm
issio
n a
mo
ng
nu
rsin
g h
om
e r
esid
en
ts t
ran
sfe
rre
d
to t
he
ho
sp
ita
l is
kn
ow
n t
o b
e h
igh
, th
ere
is a
la
ck o
f e
vid
en
ce
re
ga
rdin
g t
he
pre
va
len
ce
on
ad
mis
sio
n t
o a
n
urs
ing
ho
me
an
d h
ow
it
do
es a
ffe
ct
mo
rta
lity.
Th
e a
im
of
this
stu
dy is t
o c
om
pa
re t
he
mo
rta
lity o
f n
urs
ing
h
om
e r
esid
en
t w
ith
an
d w
ith
ou
t p
ressu
re u
lce
rs o
n
ad
mis
sio
n,
wh
eth
er
or
no
t in
div
idu
als
wh
o h
ave
be
en
a
dm
itte
d t
o a
nu
rsin
g
Me
tho
ds
30
7 n
urs
ing
h
om
e re
sid
en
ts in
1
1 n
urs
ing
h
om
es in
B
erl
in
we
re
en
rolle
d
in
a
co
ho
rt
stu
dy.
De
taile
d
info
rma
tio
n a
bo
ut
the
me
tho
do
log
y c
an
be
fo
un
d o
pe
n
at
Me
este
rbe
ren
ds e
t a
l. (
1).
Stu
dy n
urs
es e
xa
min
ed
in
div
idu
als
acco
rdin
g t
o a
sta
nd
ard
ize
d s
tud
y p
roto
co
l o
nce
a w
ee
k f
or
3 m
on
ths a
fte
r re
sid
en
ts a
dm
issio
n t
o
the
nu
rsin
g h
om
es.
Aft
er
tha
t th
e r
esid
en
ts w
as v
isite
d
eve
ry 6
m
on
th fo
r 2
.5 ye
ars
. K
ap
lan
-Me
ier
An
aly
sis
a
nd
C
ox
Pro
po
rtio
na
l H
aza
rd
will
b
e
use
d.
F
or
sta
tistica
l sig
nific
an
ce
a
n
alp
ha
o
f
8
h
ou
rs i
n b
ed
) a
nd
/or
ch
air
-bo
un
d,
(2)
a B
rad
en
sco
re
65
ye
ars
, (4
) w
eig
ht
2 P
U a
t
the
sa
me
skin
site
aft
er
ad
justin
g f
or
be
twe
en
pa
tie
nt
va
ria
tio
n.
Re
su
lts
Th
ere
w
ere
6
02
p
atie
nts
w
ith
a
co
mb
ine
d
tota
l o
f 7
,86
3
po
ten
tia
l skin
site
s
asse
sse
d,
of
the
se
7
48
3
(95
.2%
) w
ere
e
va
lua
ble
in
th
e a
na
lysis
(i
.e.
all
skin
site
s o
bse
rve
d a
s b
ein
g h
ea
lth
y,
alte
red
or
ca
teg
ory
1
at
ba
se
line
w
ith
a
t le
ast
on
e fo
llow
u
p a
sse
ssm
en
t).
Ove
rall
22
3 (3
.0%
) e
va
lua
ble
skin
site
s d
eve
lop
ed
a
ca
teg
ory
>2
PU
, a
nd
th
e i
ncid
en
ce
wa
s h
igh
er
for
skin
site
s w
ith
pa
in a
t b
ase
line
at
10
.3%
co
mp
are
d t
o s
kin
site
s
with
n
o
pa
in
at
ba
se
line
a
t 1
.7%
. T
he
fin
al
mu
ltile
ve
l lo
gis
tic
reg
ressio
n
mo
de
l o
n
the
d
eve
lop
me
nt
of
a c
ate
go
ry >
2 P
U a
t a
skin
site
le
ve
l in
clu
de
d t
wo
va
ria
ble
s;
skin
sta
tus w
hic
h c
on
sis
ted
of
two
le
ve
ls:
skin
a
lte
ratio
ns (O
R 4
.65
, 9
5%
C
I (3
.01
, 7
.18
), p
(
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6
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%
,
$
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