Diabetic patients are at a high risk of amputations with most of these debilitating and life-threatening procedures being preceded by ulcers. Risk factors for the development of a foot ulcer in the diabetic patient include long diabetes duration, the presence of peripheral neuropathy, peripheral vascular disease, a history of any prior foot ulcer, and prior amputation. Moreover, recent medical forecasts have shown that neuroischaemic diabetic foot ulcers (DFUs) are on the increase worldwide. Health care professionals have a pivotal role to provide optimal management of DFUs, leading to a reduction in amputation rates. A TLC-NOSF (TLC-sucrose octasulfate) dressing has been shown in various clinical and observational studies that it may well play a key role in the local management of these wounds. The Explorer Study, conducted over six years in five European studies, has provided health care professionals with robust clinical evidence and it has been shown to have the potential to improve health outcomes and strengthen health systems by providing more efficient and cost-effective care.

Background: The heel has become the second most common site for the development of pressure ulcers in recent years. Hospitals worldwide have been implementing preventive measures to tackle pressure ulcers in patients, such as the use of offloading devices and dressing.

Aim: To evaluate the effectiveness of a soft silicone multilayer heel dressing (Mepilex^® Heel) in reducing the incidence of heel pressure injuries (HPI) among critical ill patients in the intensive care unit (ICU).

Method: This was a quasi-experimental, pre-, and post-intervention study design conducted in three adult ICUs in an academic teaching hospital. A convenience sampling was used to recruit 326 patients (195 patients in pre-intervention, 131 patients in intervention group).

Result: Statistical analysis was made using Fisher exact test to compare between the two groups. The results showed a reduction of 86% in the incidence of HPI between the two groups (pre-intervention: 10.8% versus post-intervention: 1.5%). Patients in the intervention group were less likely to develop HPIs (p=<0.007).

Conclusion: A prophylactic multilayer foam heel dressing has shown to be effective at reducing the incidence of HPIs among critically ill patients in ICU, even with the tropical climate in Singapore.

Background: Chronic wounds are a silent epidemic in Australia. They are an under-recognised public health issue, and their significant health and economic impact is underestimated. Evidence-based practice in wound care has significant health and economic benefits, yet there are still considerable evidence–practice gaps.

Methods: Stakeholders attended a national forum to refine and prioritise solutions to the chronic wounds problem in Australia. A survey was administered to identify key priorities and recommendations.

Results: Stakeholders agreed on 17 recommendations and strategies to improve the outcomes of Australians with chronic wounds. The identified priorities for immediate action were to raise awareness of the significance of chronic wounds, and to make chronic wounds a strategic priority for governments. The Chronic Wounds Solutions Collaborating Group was established to encourage, support and monitor action on the implementation of these recommendations.

Conclusions: Large health and economic gains can be achieved with modest investments in evidence-based strategies for the prevention and control of chronic wounds in Australia. We call for a critical and sustained national effort to prevent and treat chronic wounds in Australia. Urgent action is needed at all levels if Australia is to reduce the significant preventable burden of chronic wounds and improve patient outcomes.

Skin tears increase morbidity and implicit and explicit costs for the individual and the health care system. A 580-bed private hospital in Brisbane undertook a prospective interventional study and results were compared to historical controls. A purposive sample of patients aged 65 years or older were invited to participate. The intervention was twice-daily application of pH-friendly, non-perfumed moisturiser to the extremities. The primary outcome measure was the average monthly incidence of skin tears. Monthly skin tear incidence rates were calculated as number of skin tears/patient-occupied bed days × 1000. Overall, 762 eligible patients were enrolled in the intervention group and their outcomes were compared with 415 patients in the historical control group. In total, 104 patients developed at least one skin tear (intervention group: n=60, the control group: n=44). An overall 185 skin tears were reported (mean=1.79 skin tears/patients, SD=1.55, range=19). The average monthly incidence rate in the intervention group was 4.35 per 1000 occupied bed days (96 skin tears over 12 months) which was significantly lower (p=0.006) than those found in the historical control group of 6.61 per 1000 occupied bed days (89 skin tears over 6 months). The results indicate the efficacy of twice-daily application of moisturiser when applied to the extremities of elderly patients for the prevention of skin tears.