Journal of wound care最新文献

{"title":"Implementing antimicrobial stewardship in wound care: four case collections illustrating early intervention following a new international guideline on antimicrobial stewardship and the role of microbial-binding dressings.","authors":"Bodo Günther, Klarida Hoxha, Paulo Ramos, George Smith, Kevin Woo","doi":"10.12968/jowc.2026.0426","DOIUrl":"10.12968/jowc.2026.0426","url":null,"abstract":"<p><strong>Declaration of interest: </strong>This supplement was supported by Essity AB, Sweden. The authors received honoraria for their contributions. Essity AB could provide feedback on product-related content, with implementation at the authors' discretion.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 Sup10D","pages":"S4-S10"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EPUAP 2026: ensuring sustainability in pressure ulcer/injury education, research and practice.","authors":"Tom O'Connor","doi":"10.12968/jowc.2026.0499","DOIUrl":"https://doi.org/10.12968/jowc.2026.0499","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"719-720"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-based pressure ulcer/injury education in undergraduate nursing: perceived effectiveness versus demonstrated clinical competence.","authors":"Beáta Grešš Halász","doi":"10.12968/jowc.2026.0374","DOIUrl":"10.12968/jowc.2026.0374","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a simulation-based educational programme designed to support evidence-based pressure ulcer/injury (PU/I) prevention and management among undergraduate nursing students (P.J. Šafárik University in Košice, Slovakia) and to examine the relationship between perceived educational effectiveness and objectively demonstrated clinical competence.</p><p><strong>Method: </strong>A single-group post-intervention observational study was conducted among second-year undergraduate nursing students. The educational programme was developed according to international PU/I clinical practice guidelines and the Healthcare Simulation Standards of Best Practice. Students' perceived educational effectiveness was assessed using the simulation effectiveness tool-modified (SET-M), while clinical competence was evaluated using an objective structured clinical examination (OSCE). Associations and group differences were examined using non-parametric tests.</p><p><strong>Results: </strong>The experimental cohort comprised 61 second-year undergraduate nursing students. Students demonstrated high levels of psychomotor competence, with >90% correct performance across all assessed OSCE competencies. The SET-M total score was 46.13±6.54, indicating highly positive perceptions of the simulation experience. No significant association was found between the SET-M total score and OSCE performance (ρ=-0.129, p=0.321), nor between individual SET-M domains and objectively assessed competence. Previous simulation experience and previous secondary education were not associated with either educational outcome.</p><p><strong>Conclusion: </strong>The simulation-based educational programme was associated with high levels of objectively demonstrated psychomotor competence and highly positive learner perceptions. However, perceived educational effectiveness was not associated with objectively assessed clinical competence, highlighting the importance of combining learner-reported and performance-based outcome measures when evaluating simulation-based education. These findings support simulation as a strategy for teaching evidence-based PU/I management in undergraduate nursing education.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"788-800"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does teamwork make the dream work? A scoping review of multidisciplinary teams in pressure injury prevention and management.","authors":"Gdiom Gebreheat, Alison Porter-Armstrong","doi":"10.12968/jowc.2026.0335","DOIUrl":"10.12968/jowc.2026.0335","url":null,"abstract":"<p><strong>Objective: </strong>To identify, map and synthesise, available contemporary evidence on multidisciplinary team roles and approaches in delivering person-centred prevention and management of pressure injuries (PIs) across the lifespan.</p><p><strong>Method: </strong>A scoping review was conducted. Searches were undertaken in MEDLINE/PubMed, CINAHL Ultimate, APA PsycInfo, Cochrane Library, PEDro, and Web of Science, alongside grey literature searches and reference screening. Studies published in English between 2016 and 2026 were included if they addressed multidisciplinary team roles in person-centred prevention and management of PIs.</p><p><strong>Results: </strong>Eight studies published between 2018 and 2025 were included, with most focusing on adult inpatient populations. Multidisciplinary teams commonly included nurses, wound care specialists, physicians, dietitians, physiotherapists and quality improvement professionals. Nurses held central roles in assessment, prevention implementation, education, coordination and monitoring, while wound care specialists provided leadership and clinical expertise. Multidisciplinary team approaches incorporated staff education, skin care champion programmes, standardised risk assessment, quality surveillance and rapid response systems. Only two studies demonstrated patient and family engagement through education, digital communication and shared care planning. All studies reported reductions in PI incidence or prevalence, supported by leadership engagement, embedded multidisciplinary team structures and continuous quality improvement processes.</p><p><strong>Conclusion: </strong>Sustainable person-centred prevention and management of PIs require integrated multidisciplinary team approaches that promote shared accountability, clinical expertise and ongoing improvement. Future research should explore the development and support of expanded person-centred multidisciplinary team models across broader age groups and community settings to enhance clinical implementation of PI prevention and management strategies.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"768-778"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From risk scores to prevention action: the development of BEPU2025 to standardise and optimise pressure ulcer risk assessment and prevention in Belgium.","authors":"Steven Smet, Magali Nys, Annelies de Graaf, Koen Cortebeeck, Kelly Ruysch, Wouter van Roy, Dimitri Beeckman","doi":"10.12968/jowc.2026.0325","DOIUrl":"10.12968/jowc.2026.0325","url":null,"abstract":"<p><strong>Objective: </strong>Effective pressure ulcer (PU) prevention requires the timely identification of patients at risk and the prompt implementation of appropriate preventive interventions. However, many PU risk assessment instruments are complex, time-consuming and difficult to integrate into routine clinical workflows, potentially limiting their uptake in practice.</p><p><strong>Method: </strong>In Belgium, these challenges led to the initiation of the Belgian Pressure Ulcer Risk Assessment project in 2016, which aimed to develop a clinically feasible approach to PU risk assessment and prevention. Building on the experiences of the earlier local assessment tools BEPU2016 and UZL-RWD2017, BEPU2025 was developed as a nationally aligned pressure risk assessment and prevention approach that integrates risk assessment, daily reassessment and structured PU prevention pathways within routine care processes.</p><p><strong>Results: </strong>Rather than generating numerical risk scores, BEPU2025 focuses on supporting prevention-oriented clinical decision-making through rapid and repeated assessment of risk. Developed through almost a decade of Belgian quality improvement initiatives, BEPU2025 combines a concise assessment framework with workflow integration, electronic patient record implementation and a strong emphasis on nurse-led prevention.</p><p><strong>Conclusion: </strong>This viewpoint argues for a shift from score-based risk assessment towards a dynamic, prevention-oriented approach embedded within routine care processes. Further research is needed to evaluate its impact on clinical outcomes and its applicability in other healthcare settings.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"744-749"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for pressure ulcer development among adults undergoing surgery: a systematic review.","authors":"Sadie Badrie, Pinar Avsar, Sherly George, Shijimol Kurian, Zena Moore, Hannah Wilson","doi":"10.12968/jowc.2026.0321","DOIUrl":"10.12968/jowc.2026.0321","url":null,"abstract":"<p><strong>Objective: </strong>To examine risk factors for pressure ulcer (PU) development among adults undergoing surgery.</p><p><strong>Method: </strong>A total of five electronic databases were searched from inception to March 2024. Study selection, data extraction and quality appraisal were performed by two independent reviewers, using the Crowe Critical Appraisal Tool (CCAT v1.4; Michael Crowe, James Cook University, Australia), with scores ≥75% indicating high methodological quality. Results were categorised and reported as preoperative, intraoperative and postoperative risk factors, with percentages representing the proportion of studies assessing each risk factor in which it was statistically significant. Due to methodological heterogeneity, findings were synthesised narratively.</p><p><strong>Results: </strong>A total of 41 studies were included, 20 (48.8%) of which had retrospective designs. Among the preoperative risk factors, Braden score was statistically significant in 11 (68.8%) of the 16 studies assessing this factor, age in 19 (61.3%) of 31 studies, and diabetes in 11 (61.1%) of 18 studies. Among intraoperative risk factors, duration of surgery was statistically significant in 15 (53.6%) of 28 studies assessing this factor, patient positioning in nine (60.0%) of 15 studies, and type of surgery in nine (60.0%) of 15 studies. Postoperatively, Braden Scale score was statistically significant in five (83.3%) of six studies, while sepsis and pneumonia were each statistically significant in all three (100%) studies assessing these factors. The mean methodological quality score was 82±9.7%.</p><p><strong>Conclusion: </strong>This systematic review identified several risk factors for PU development across the included studies during the preoperative, intraoperative, and postoperative surgical period. Due to the complex interplay between competing factors that impact PU development during surgery, the development of a core outcome set of risk factor variables for inclusion in future studies may enhance homogeneity and support risk stratification alongside optimisation of modifiable exposure factors.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"722-736"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engineering performance as the foundation for support surface selection.","authors":"David M Brienza, Michele A Deppisch","doi":"10.12968/jowc.2026.0401","DOIUrl":"10.12968/jowc.2026.0401","url":null,"abstract":"<p><strong>Objective: </strong>To describe a performance-based framework for support surface selection that integrates contemporary understanding of pressure injury aetiology with standardised engineering performance testing, and to demonstrate its clinical application using engineering performance data from commercially available support surfaces. Method: Current evidence describing pressure injury (PI) aetiology, support surface biomechanics and standardised engineering performance testing was synthesised to develop a framework for individualised support surface selection. Seven commercially available full-body support surfaces representing technologies commonly used in acute care were evaluated using American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America Support Surfaces-1 (ANSI/RESNA SS-1) standardised engineering test methods. Engineering performance characteristics, including pressure redistribution, immersion, envelopment, shear management and microclimate management, were compared and interpreted in representative clinical scenarios.</p><p><strong>Results: </strong>Engineering testing demonstrated substantial variability among support surfaces across all measured performance characteristics, despite similarities in product category, construction or marketed features. Support surfaces with comparable design intent frequently exhibited markedly different performance profiles, while products using different technologies on occasion demonstrated similar biomechanical performance. No support surface demonstrated superior performance across all engineering domains, illustrating that support surface performance is multidimensional and cannot be reliably inferred from product construction, operating principles or marketing terminology. Clinical interpretation of these findings demonstrated how standardised engineering performance data can be integrated with contemporary understanding of pressure ulcer aetiology to support individualised support surface selection.</p><p><strong>Conclusion: </strong>Support surface selection should be based on measurable engineering performance characteristics rather than product categories or construction alone. Standardised engineering testing provides an objective basis for comparing support surfaces, and matching performance characteristics to the biomechanical and physiological needs of the individual user. This performance-based framework offers clinicians a practical approach for selecting the right support surface for the right user and provides a foundation for future studies relating engineering performance to clinical outcomes.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"802-810"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Italian adaptation of the End-of-Life Wound Assessment Tool: translation, content validity and preliminary usability testing.","authors":"Greta Ghizzardi, Valentina Vanzi, Rosario Caruso, Rita Marson, Michela Guarda, Gianpaolo Fortini, Brigid M Gillespie, Gianluca Castiello, Sharon Latimer","doi":"10.12968/jowc.2026.0322","DOIUrl":"10.12968/jowc.2026.0322","url":null,"abstract":"<p><strong>Objective: </strong>To translate, culturally adapt and evaluate the content validity and preliminary usability of the End-of-Life Wound Assessment Tool (EoL-WAT) for use in the Italian healthcare context.</p><p><strong>Method: </strong>A methodological study was conducted between March and May 2026 in collaboration between the Italian Association for the Study of Skin Lesions and the Italian Society of Palliative Care. Following forward and back translation, content validity was evaluated by nine experts, and preliminary usability by seven healthcare professionals.</p><p><strong>Results: </strong>All items exceeded the predefined acceptability threshold for content validity (item-level content validity index (I-CVI)≥0.89). A total of 19 of the 20 evaluations achieved complete agreement (I-CVI=1.00). Overall content validity was excellent (scale-level content validity index (S-CVI)/Ave=0.994; S-CVI/universal agreement=0.95). Usability ratings were favourable across all domains (mean score range: 4.00-4.43). Qualitative feedback led to minor wording refinements without substantial modifications to the instrument.</p><p><strong>Conclusion: </strong>The Italian version of the EoL-WAT demonstrated excellent content validity and favourable usability. The instrument is a promising tool for assessing end-of-life wounds, and may facilitate shared clinical understanding and interdisciplinary collaboration in wound care and palliative care settings.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"738-743"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The continuing debate on silver in wound management: addressing frequently asked questions, controversies and misconceptions.","authors":"Philip G Bowler, Joachim Dissemond, Kate Meredith, Scarlet Milo, Daniel G Metcalf","doi":"10.12968/jowc.2026.0387","DOIUrl":"10.12968/jowc.2026.0387","url":null,"abstract":"<p><p>The use of silver has a long history in human civilisation, particularly as an antimicrobial agent in infection control and prevention. Although silver was first used to treat wound infection approximately 2000 years ago, issues such as its safety profile, clinical and cost-effectiveness, potential overuse and risk of bacterial resistance, remain topics of discussion. Therefore, this review re-examines these issues in light of contemporary microbiological and clinical evidence. The silver cation (Ag⁺) is a broad-spectrum topical antiseptic with a well-established safety profile, supported by regulatory evaluations and extensive clinical use. Concerns around bacterial resistance largely stem from laboratory models that do not reflect real wound environments. Known genetic resistance mechanisms exist but are rare in clinically relevant wound pathogens, and have not resulted in stable resistance, with key organisms remaining susceptible to modern silver-containing dressings. Reduced silver activity observed in vitro, particularly in biofilm models, is often a consequence of extracellular polymeric substance-mediated shielding rather than heritable resistance mechanisms. Within the wound hygiene framework, emphasising cleansing and debridement to disrupt biofilm, silver-containing dressings remain an effective tool for managing bioburden and supporting wound progression. Concerns regarding overuse underscore the need for appropriate, indication-driven application rather than reduced access. Overall, evidence shows that silver remains a highly effective option in antimicrobial wound care and that clinically relevant silver resistance is negligible. When used judiciously, silver-containing dressings remain safe and effective, and are an important component in the management of wounds that are infected or at risk of infection. This review aims to critically re-evaluate the role, benefits and limitations of silver-containing dressings in wound management, and to address questions that have recently arisen.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"844-852"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence density and device-related pressure injury patterns in paediatric intensive care.","authors":"Jung-Hea Youn, Hyun-Ju Kim","doi":"10.12968/jowc.2026.0317","DOIUrl":"10.12968/jowc.2026.0317","url":null,"abstract":"<p><strong>Objective: </strong>To determine pressure injury (PI) incidence density in a paediatric intensive care unit (PICU) over five years and describe diagnosis-specific anatomical and device-related PI (DRPI) patterns.</p><p><strong>Method: </strong>This single-centre retrospective study included patients with stage 2 or higher PIs recorded in a tertiary hospital PICU incidence report from January 2021 to December 2025, using de-identified quality-indicator data. The incidence density was calculated per 1000 patient days. PIs were grouped as superficial (stage 2), severe (deep tissue PI, unstageable, stage 3-4) or mucosal. Patient variables were analysed per patient and injury variables per PI, using Mann-Whitney U and Kruskal-Wallis tests.</p><p><strong>Results: </strong>The study cohort comprised 94 patients. During 12,371 patient days, 107 PIs occurred, giving an incidence density of 8.65 per 1000 patient days. Patients with cardiovascular illness (n=41, 43.6%; median age 15 months) were younger than other groups (U=750.0; p=0.010). The head/neck was the most common site overall, but pelvic/gluteal PIs were more frequent in patients with cardiovascular illness (37.0%), whereas 83.3% of PIs in patients with respiratory and neurological illness occurred at the head/neck. At least one device was in place for every PI (median 5), and 51 PIs (47.7%) were classified as DRPIs. DRPIs accounted for 71.2% of head/neck PIs, of which 95.7% involved respiratory devices. Risk scores did not differ across severity groups (Braden Scale H=2.40; p=0.301, Braden Q H=1.68; p=0.431, Neonatal/Infant Braden Q H=0.70; p=0.705).</p><p><strong>Conclusion: </strong>In this study PI patterns differed by diagnostic group, supporting pelvic/gluteal protection for patients with cardiovascular illness and device-related head/neck prevention for patients with respiratory and neurological illness. A risk-assessment tool reflecting device-related risk should be considered.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 9","pages":"760-766"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}