Wound infections are a serious medical problem for patients with non-healing chronic wounds and burn injuries. The healing of these wounds is often compromised by colonisation of many different bacteria, predisposing patients to life-threatening infections. Infected wounds continue to represent a complex problem for both health professionals and patients. Bacterial infections are a critical component of hard-to-heal wounds, often leading to biofilm formation, inhibition of innate inflammatory responses and resistance to traditional therapeutics. Over the last 20 years, tremendous progress has been made in understanding the intricacies of wound biofilm pathology and bacteria–host interactions. This has been achieved by the development of in vitro and in vivo models of wound infection. This review will discuss the challenges in the development of wound infection models and will focus on different in vivo models of cutaneous wound infection, highlighting advantages and clinical applicability of each model. It will also describe the development of novel bioluminescent models of cutaneous wound infection in vivo, which may help to revolutionise the future testing of novel antimicrobial therapeutics for the treatment of wounds.

Background: Skin injuries are a common occurrence in neonatal units. Currently there are few tools that meet the specific needs of the neonatal population. To assist nurses in identifying neonates at risk and improve neonatal skin care, a working group developed a neonatal skin risk assessment and management tool (SRAMT) for their unit.

Setting: University-affiliated tertiary neonatal intensive care unit (NICU).

Design: Single-site prospective longitudinal study (2010–2014).

Method: The study was conducted over three phases: 1) skin injuries incidence study; 2) development of the SRAMT; and 3) post-implementation review of the SRAMT.

Results: The SRAMT lists eight risk categories: gestational age, sensory perception, activity/mobility, moisture, respiratory support, visual examination, blood collection and nutrition and these categories are graded from low (grade 1) to extreme risk (grade 4). The tool also provides assessment and management guidelines. Evaluation of the SRAMT showed a reduction in neonates who acquired skin injuries pre SRAMT from 37/60(61.7%), compared to post 12/30(40%), (OR 0.41 95% CI 0.17–1.02; p-value 0.085).

Conclusion: The study has shown introducing a skin risk assessment tool may reduce the incidence of skin injuries and standardise skin management in the NICU. Future research will be undertaken to validate the SRAMT and assess its suitability across neonatal units.

Background: Pressure injuries lead to lower quality of life and incur substantial health care resources and costs. Pressure injury prevention is reported to be much cheaper than treatment of the condition itself.

Aim: To evaluate the incremental effectiveness of silicone foam dressing and fatty acids oil spray, in addition to standard care, in preventing sacral pressure injuries among high-risk patients.

Method: A randomised controlled trial (RCT) was conducted. Using simple random sampling, patients were allocated into one of the three groups: (1) Silicone foam dressing plus standard care; (2) fatty acids oil spray plus standard care; (3) standard care only.

Results: Four hundred and sixty-one patients were recruited. Of these, 3.9% (n=5) developed pressure injuries in the silicone foam dressing group, 5.4% (n=7) developed pressure injuries in the fatty acids oil group and 5% (n=10) developed pressure injuries in the standard care group. The difference was not statistically significant. However, significant statistical differences were found between the silicone foam dressing and standard care group (p=0.04) and between the fatty acids oil and standard care group (p=0.048) for patients with Braden score ≤12.

Conclusion: Additional preventive measures seem to be clinically beneficial in reducing sacral pressure injuries among very high-risk patients in the general ward acute care setting.

Objective: Venous leg ulceration (VLU) is a common condition associated with significant patient morbidity. This prospective case series investigated the use of PICO^® topical negative pressure therapy (TNPT) in addition to graduated compression therapy for VLU.

Methods: Patients with VLU were recruited from a specialist vascular surgery clinic and treated with the novel combination of TNPT (PICO) underneath graduated compression therapy.

Results: Twelve patients (15 VLUs) were treated over a median of 20 days (7–42). Median surface area reduced from 2.1 cm² (1.1–5.8) to 0.8 cm² (0.2–3.2) (p=0.022), and depth from 3.0 mm (1.8–3.3) to 0 mm (0–0) (p=0.005 Wilcoxon Signed-Rank Test). Time to heal was compared to a historical cohort with similar characteristics that was treated with compression therapy alone. The addition of TNPT was found to reduce time to heal from 6.3 to 4.3 weeks (p=0.024).

Conclusion: This pilot study supports the benefit of combining TNPT (PICO) with compression bandaging to accelerate VLU healing.