Background Despite a process of rigorous investigation of the cause of severe pressure injuries (PIs) and implementing specific interventions, the number did not decrease in our adult intensive care unit (ICU). The aim of this project was to reduce the incidence of stage III and IV PIs acquired in the ICU and associated costs.

Methods A Plan-Do-Study-Act (PDSA) quality improvement approach incorporating thorough ICU-wide multicomponent broad skin care/hygiene focused intervention and a multifaceted communication strategy (Save Our Skin: SOS) was used. The project was conducted in a 600-bed tertiary referral hospital in Sydney, Australia from 2015 to 2019. The main outcomes were the number of ICU-acquired stage III and IV PIs and costs associated with treating PIs per annum, and the number of severe PIs per 1,000 ICU bed days.

Results There was a sustained decrease in the incidence of PIs (52 during 2014 and four during 2018). The number per 1,000 ICU bed days decreased; 2.57 during 2014 and 0.29 during 2018, with lower costs associated with the treatment of stage III and IV PIs.

Conclusions This pragmatic multicomponent ICU-wide PI prevention project resulted in sustained outcomes in our ICU and cost savings.

The ability to heal an acute traumatic wound or wounds is a complex matrix of overlapping biological processes impacted by intrinsic and extrinsic human factors. As we age, the body’s physiological resilience is compromised and homeostasis becomes difficult to maintain. This scoping review examines the influence of biological ageing and the impact of age-related concerns on wound healing, including frailty, malnutrition, pre-existing medical conditions and clinician practices. Frailty rather than age was seen to have a greater physiological impact on outcome, resilience and healing. Clinician support, education and engagement were fundamental to achieve acute wound healing in the aged population. With an increasing ageing population, specialised knowledge, guidelines and structures to support geriatric care are recommended for best clinical practice.

Venous leg ulcers (VLUs) are a common affliction in an ever ageing population. These wounds are challenging for clinicians to heal, but also affect badly the health-related quality of life of patients and their families. This article provides epidemiological information as well as discusses the etiopathogenesis of VLUs. Two VLU cases from Singapore that were managed using a two-layer compression bandage system (UrgoK2^®) and a polyacrylate fibre dressing (UrgoClean^®) are presented.

Reconstructive surgery is a very common procedure during breast cancer treatment. In the presence of adjunctive radiotherapy, failure rates are very high due to poor wound healing.

We present two case studies where expected significant surgery was avoided due to treatment with hyperbaric oxygen therapy (HBOT), particularly in the presence of a prosthesis.

Background Wound management following sarcoma removal can pose various clinical challenges. Occupational therapists support patients through positioning to allow maximum wound healing, while promoting patient function. Limited literature is available to define post-surgery seating options for this population.

Methods This timeline case study highlights the design and use of custom-made seating for a patient after an anterior left thigh sarcoma resection.

Results A modified high wedge cushion for positioning and postoperative care of the flap through management of shear, friction and pressure was provided. This incorporated seating design strategies considering thigh to back angle, heel to popliteal height, stability for ischial tuberosities, sacrum and coccygeal pressure relief, patient height, width and weight. Through provision of the cushion the patient was able to engage in early sitting and maintained physical function.

Conclusion This case study highlights that design and use of custom-made seating for pressure care, wound healing and patient function can be utilised to improve patient healthcare outcomes post sarcoma removal.