The aim of this study was to examine healing times and dressing costs for older adults with skin tears using the Skin Tear Audit Research (STAR) classification system. This retrospective study comprised all persons aged 65 years and over who had received wound care for a skin tear from a Western Australian not-for-profit community nursing organisation between 22 June 2016 and 31 December 2018. In total, 2161 skin tear images sustained by 1300 older adults (632 females and 668 males) aged between 65–103 (median number of healing days [Mdn]=86.0) years were examined. All skin tears had been photographed and recorded in an integrated database at point of care by nurses who had received formal training in using the STAR classification. The findings from this study show that STAR subcategory 2b, which the investigators found to be associated with the presence of a haematoma under a skin tear flap, significantly (p<0.001) increased healing times (days) and wound dressing costs ($AUD) compared to other STAR categories and subcategories. The STAR classification proved efficacious for determining healing times and dressing costs associated with skin tear management.

Aim Hospital inpatients are encouraged to sit out of bed to maintain function and reduce deconditioning; however, this increases the risk of hospital-acquired pressure injuries (HAPI) especially if seated on incorrect surfaces. This study aimed to reduce HAPI by providing pressure redistribution cushions and enhanced education.

Methods A before and after study design was utilised where hospital inpatients were provided with a pressure care intervention. Outcome measures consisted of the Waterlow Risk Assessment (WRA), incidence, stage and location of any pressure injuries, frequency of time spent sitting out of bed and hospital length of stay (LOS).

Results A total of 105 patients were recruited, with nine pressure injuries identified (control group n=5/52 vs intervention group n=4/53). Sixty percent of pressure injuries in the control group were HAPI compared to 25% in the intervention group (p=0.44). Patients in the intervention group reported increased comfort (86% versus 56%, p=0.05) and reduced pain (10% versus 43%, p=0.03). Patients in the intervention group sat out of bed more often (2.45 versus 1.63, p=0.02) and had a 17% increase in education engagement.

Conclusions Enhanced seating and education significantly improved patient reported outcomes including comfort and pain, and increased the patients’ time out of bed.

Background The predominant aetiology of lower leg ulcers (VLU) are caused by venous insufficiency. In 2016 a new district nursing model was introduced using nurses specialising in leg ulcer assessment and management. The specialist nurses provided district nurse education on leg ulcers and conducted vascular assessments to identify venous ulcer aetiology, enabling early compression therapy to increase healing rates and prevent wound chronicity.

Method A retrospective electronic chart audit was conducted to determine if the new model diagnosed and treated VLUs earlier. All newly presenting lower leg wounds entering the service over a period of 7 months were reviewed, with healing rates studied up to 24 weeks.

Results Healing rates of all lower leg wounds were 84% with an average heal time of 9.7 weeks. The time to heal for recurrent ulcers was the same as new wound presentations. Of interest, Māori and Pacific Island (Pasifika) patients ulcerated at a younger age compared to European patients.

Conclusion A nurse-led model facilitated early diagnosis and treatment of VLUs to reduce healing time. The correlation of Māori and Pasifika patients presenting younger with leg ulcers necessitates further research to determine if there is an ethnicity causation factor in these populations.

Objectives Complex actions are thought to be risk factors for pressure injuries (PIs) in wheelchair basketball athletes. However, no study has been conducted on the characteristics of dynamic pressure distributions during performance. This study aimed to identify the characteristics of dynamic pressure distributions and to determine the parameters that relate to PIs in wheelchair basketball athletes.

Method This cross-sectional study was conducted in November 2017 at the training camp of the national team in Japan. The study participants were 14 elite wheelchair basketball athletes who had joined the training camp. A wound, ostomy and continence nurse (WOCN) and a sonographer evaluated the presence of PIs by inspection and ultrasonography. Pressure distributions under static and dynamic conditions were measured using sheet-type sensors.

Results Sixteen PIs were found in five (35.7%) of the 14 participants. Participants with PIs showed distribution of high pressure in unilateral/bilateral ischium and belting regions. In three participants who had PIs on the buttocks, total high-pressure periods were 60.25, 68.33 and 155.16 seconds, respectively. Maximum high-pressure periods were 12.10, 2.53 and 23.53 seconds. The numbers of high-pressure periods were 242, 190 and 706 times. Under dynamic conditions, these parameters were higher than those of participants without PIs.

Conclusions Our findings suggested that continuous and/or repetitive high-pressure loading was related to the occurrence of PIs during performance. Further prospective studies are required to establish the methods to predict and prevent PIs in wheelchair basketball athletes.

Aim To explore the risk factors associated with the development of medical device-related pressure injuries (MDRPI).

Method A single reviewer searched electronic databases PubMed, MEDLINE, CINAHL, The Cochrane Library and Google Scholar databases (last searched August 2020) to identify all published studies. Six studies met inclusion criteria and were evaluated for identification of risk factors associated with the development of MDRPI in the adult intensive care (ICU) patient.

Results Nine risk factors emerged as independent predictors associated with the development of MDRPIs from this review – length of stay (LOS), vasopressor administration, low Braden Scale, use of mechanical ventilation, increasing age, admission type, increasing severity of illness, development of a non-device-related hospital-acquired pressure injury (HAPI) and administration of enteral feeds. These results indicate that further research is required to identify risk factors for MDRPI development to guide research and practice.

Conclusion This scoping review has identified a modest evidence base with respect to risk factors for the development of MDRPI in the adult ICU patient. Further research identifying risk factors is required that measures a broad number of potential risk factors, including those identified in this scoping review, to enable further clarification of the relative contribution of these risk factors to MDRPI development.

Necrotising fasciitis (NF), which can develop in any part of the body, is a serious and life-threatening rapidly progressive infection. In this case report, a case of NF located at a Pfannenstiel incision is presented and the treatment process of the patient is discussed. A 39-year-old primiparous woman who had a diagnosis of superimposed pre‑eclampsia was admitted to the emergency department with an eclampsia attack at 32 weeks of her pregnancy. Her medical history included diabetes mellitus and hypertension. An emergency caesarean section was performed. The patient was discharged on the 3rd day of her caesarean section without complications. On the 7th day of discharge, the patient fell in the bathroom. The patient was admitted to the emergency department on the second day of the fall due to foul-smelling discharge and wound dehiscence at the incision site. The patient was referred to the general surgery clinic and underwent emergency surgery by general surgeons with the diagnosis of NF. All necrotic tissues were removed until clean surgical margins were reached. Daily wound debridement was performed. On the 4th day of debridement, vacuum-assisted closure (VAC) treatment was started. After six sessions of VAC treatment, the patient’s wound was completely closed.

Background While many aspects of the wound repair process are understood, there is still limited understanding about why chronic wounds develop, how we predict, diagnose and improve healing outcomes, and why some wounds heal with scarring. Identifying current gaps in knowledge, as well as areas of strengths, will inform recommendations for future research-based themes and influence the targeting of resources.

Aims This scoping review aims to (i) map current knowledge and research activities into wound healing in Australia and (ii) understand strengths and identifying research gaps in science-focused wound research in Australia.

Methods Guided by the PRISMA-ScR framework, this scoping review will include original laboratory-based science studies on wounds conducted in Australia. Records will be searched in PubMed, CINAHL and Embase from January 2010 to March 2021. All screened titles and abstracts will be independently assessed by two reviewers using Rayyan^®. A third reviewer will solve any conflicts that arise. This will be followed by full text screening and in-depth analysis after resolution of conflicts.

Results and dissemination Following data extraction from the final included articles, results will be grouped according to area of research and synthesised in a narrative review. Findings will be published in a peer-reviewed journal.

Introduction Chronic wounds lead to devastating health and economic consequences for individuals and the healthcare system. These wounds do not heal within expected timeframes, often recur, and/or are complicated by underlying comorbidities. There is a significant need to identify and implement evidence-based practice in the prevention and management of chronic wounds in Australia to minimise the impact to persons and healthcare systems.

Objectives This scoping review aims to identify (i) current research activity and outcomes in assessment, management and prevention of chronic wounds and (ii) gaps in chronic wound research relevant to Australia.

Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMAS-ScR) framework will be used to guide this scoping review. Searches will be conducted in Medline, Embase, CINAHL, Joanna Briggs Institute Library, Cochrane Library, APA PsycInfo databases, websites and publications of relevant professional organisations, and clinical trial registries for publications between 2010–2021. Two independent researchers will review the identified records based on the inclusion criteria and any conflicts will be resolved by a third researcher. This scoping review will include Australian original studies, international and national systematic review and evidence-based guidelines or consensus statements on the assessment, management or prevention of chronic wounds.

Background This preliminary study aims to present our experience regarding the efficacy of non‑centrifuged autologous fat graft in the treatment of lower extremity ulcers.

Methods A total of 16 ulcers from 16 cases were retrospectively analysed. VAC (vacuum-assisted therapy) or silver-impregnated dressings were used to achieve a healthy wound bed before fat grafting. Autologous fat graft was harvested from the patients’ abdominal or gluteal regions and injected into the wound edge, wound bed and surrounding environment. Clinical observation and photographic records were used to analyse the ulcers.

Results The mean age was 55.88±9.71 years old; 52 years old (range: 44–65.5) for venous ulcers, 57 years old (range: 51–63) for diabetic ulcers and 49.5 years old (range: 45–54) for traumatic ulcers. Of the cases, nine were male. Twelve ulcers needed a skin graft or flap surgery, and four had secondary healing. At the beginning, the mean wound surface area was 92.69±62.74cm²; 125cm² (range: 52–175) for venous ulcers, 100cm² (range: 25–112) for diabetic ulcers and 81cm² (range: 42–120) for traumatic ulcers. The mean number of fat injection procedures was 1.63±0.89, and the mean fat volume used was 26.56±15.33cc. The mean healing time was 32.56±12.03 days. The ulcers were deemed uneventful in the following 12-month period.

Conclusion It can be determined that non‑centrifuged autologous fat graft is a quite effective and useful method in reducing the treatment time for lower extremity ulcers.