WHS guidelines for the treatment of pressure ulcers-2023 update.

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million.

Subacute and Chronic Spinal Cord Injury: A Scoping Review of Epigenetics and Secondary Health Conditions.

Background: Epigenetics studies the impact of environmental and behavioral factors on stable phenotypic changes; however, the state of the science examining epigenomic mechanisms of regulation related to secondary health conditions (SHCs) and neuroepigenetics in chronic spinal cord injury (SCI) remain markedly underdeveloped.

Objective: This scoping review seeks to understand the state of the science in epigenetics and secondary complications following SCI.

Methods: A literature search was conducted, yielding 277 articles.

Development and use of a porcine model with clinically relevant chronic infected wounds.

Chronic ischemic wounds affect millions of people causing significant pain and disability. They can be considered to be stalled in the inflammatory stage and cannot heal without additional measures. A valid animal model is necessary to evaluate the efficacy of topical wound healing therapies and wearable technologies.

Flexible and Scalable Dry Conductive Elastomeric Nanocomposites for Surface Stimulation Applications.

Objective: The study describes the development and testing of a dry surface stimulation flexible electrode (herein referred to as Flexatrode), a low-cost, flexible, and scalable elastomeric nanocomposite using carbon black (CB) and polydimethylsiloxane (PDMS).

Methods: Flexatrodes composed of CB and PDMS were developed and tested for mechanical and functional stability up to 7 days. Uniform CB distribution was achieved by optimizing the dispersion process using toluene and methyl-terminated PDMS.

Interactive Evidence-Based Pressure Injury Education Program for Hospice Nursing: A Quality Improvement Approach.

Purpose: The purpose of this quality improvement (QI) project was to develop and implement an interactive, evidence-based pressure injury (PI) education program and evaluate the impact on frontline hospice nursing staff knowledge and practice.

Participants And Setting: The QI setting was a 12-bed inpatient hospice unit in a tertiary care Veterans Affairs (VA) Medical Center in Cleveland, Ohio. Nineteen licensed and unlicensed hospice nursing staff participated in this pre-/postworkshop project.

Meet the Editor.

I provide a brief personal introduction including my professional background, interests, and qualifications. I invite authors with a wide diversity of interests to submitted manuscripts to the journal. My overarching goals is to improve the journal's impact through (1) strategic partnerships with professional organizations and research consortia, (2) publication of targeted Special Collections focused on topics of interest to the field and (3) improved efficiency in manuscript submission and review.

An Absorbent, Flexible, Transparent, and Scalable Substrate for Wound Dressings.

Wound dressings that create and maintain a moist environment provide the optimal conditions for wound healing by increasing the rate of epithelialization and angiogenesis. However, current wound dressings require periodic removal which exposes the wound to the surrounding environment, thereby increasing the likelihood for infection and drying out the wound itself. There remains an unmet medical need for the development of an absorbent, flexible, and transparent wound dressing that can conform to the irregular geometry of the wound for a long-term duration.

An End-User's Personal Perspective on the Need of Consumer Involvement in Research.

There is growing understanding that the consumer's voice in research needs to be stronger. Translational research studies need consumer inclusion in order to be effectively implemented. This narrative article provides the perspective of a Veteran with spinal cord injury (SCI) who is an active member of several study teams and serves as a Consumer Advocate, providing the voice of the person with SCI.

Development of Foot Displacement Detection Algorithm for Power Wheelchair Footplate Pressure and Positioning.

Inadvertent lower extremity displacement (ILED) puts the feet of power wheelchair (PWC) users at great risk of traumatic injury. Because disabled individuals may not be aware of a mis-positioned foot, a real-time system for notification can reduce the risk of injury. To test this concept, we developed a prototype system called FootSafe, capable of real-time detection and classification of foot position.

A review of animal models from 2015 to 2020 for preclinical chronic wounds relevant to human health.

Significance: Chronic wounds fail to heal in a timely manner and exhibit sustained inflammation with slow tissue repair and remodelling. They decrease mobility and quality of life, and remain a major clinical challenge in the long-term care of many patients, affecting 6.5 million individuals annually in the U.

Exploring adipogenic and myogenic circulatory biomarkers of recurrent pressure injury risk for persons with spinal cord injury.

Purpose:: To investigate linkages between circulatory adipogenic and myogenic biomarkers, gluteal intramuscular adipose tissue (IMAT), and pressure injury (PrI) history following spinal cord injury (SCI).

Methods:: This is an observational repeated-measures study of 30 individuals with SCI. Whole blood was collected regularly over 2-3 years.

Development of Predictive Informatics Tool Using Electronic Health Records to Inform Personalized Evidence-Based Pressure Injury Management for Veterans with Spinal Cord Injury.

Background: Pressure injuries (PrI) are serious complications for many with spinal cord injury (SCI), significantly burdening health care systems, in particular the Veterans Health Administration. Clinical practice guidelines (CPG) provide recommendations. However, many risk factors span multiple domains.

Wheelchair Mobility-Related Injuries Due to Inadvertent Lower Extremity Displacement on Footplates: Analysis of the FDA MAUDE Database From 2014 to 2018.

Objectives: The aims of the study were to assess reports of wheelchair mobility-related injuries from inadvertent lower extremity displacement (ILED) on footplates, which were submitted to the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database during 2014-2018, characterize injury types, and evaluate MAUDE data quality.

Methods: A systematic MAUDE database review was performed. Annual reports were searched using keywords: (a) "power wheelchair" and "injury" and (b) "mechanical (also known as manual) wheelchair" and "injury.

Fabrication of a Silver-Based Thermistor on Flexible, Temperature-Sensitive Substrates Using a Low-Temperature Inkjet Printing Technique.

Inkjet printing has been identified as a cost-effective method to fabricate sensors on polymeric substrates. However, substrate materials suitable for printing are limited by the annealing temperature required by conventional inks. In this article, we describe the fabrication of an inkjet-printed thermistor on polyethylene and cellophane substrates that are not thermally compatible with the conventional inkjet printing processes.

Vascular Pressure-Flow Measurement Using CB-PDMS Flexible Strain Sensor.

Regular monitoring of blood flow and pressure in vascular reconstructions or grafts would provide early warning of graft failure and improve salvage procedures. Based on biocompatible materials, we have developed a new type of thin, flexible pulsation sensor (FPS) which is wrapped around a graft to monitor blood pressure and flow. The FPS uses carbon black (CB) nanoparticles dispersed in polydimethylsiloxane (PDMS) as a piezoresistive sensor layer, which was encapsulated within structural PDMS layers and connected to stainless steel interconnect leads.

Biomarkers for recurrent pressure injury risk in persons with spinal cord injury.

To investigate potential linkages between pressure injury (PrI) recurrence following spinal cord injury (SCI) and muscle-based and circulatory biomarkers, specifically fatty metabolites and inflammatory cytokines. Observational study. Tertiary Care Center.

Honey-Based Salve and Burdock Leaf Dressings as an Alternative to Surgical Debridement of a Traumatic Wound Eschar.

Nonviable necrotic eschar is an impedance to wound healing and can ultimately lead to failure of soft tissue coverage in traumatic or high-risk wounds. Topical therapeutic agents can provide a less invasive management alternative to surgical debridement of eschar. The case of a 40-year-old male with a traumatic right lower extremity amputation complicated by surgical incision ischemic eschar formation is reported.

What Lies Beneath: Why Some Pressure Injuries May Be Unpreventable for Individuals With Spinal Cord Injury.

Objective: To investigate intersections between pressure injury (PrI) history, muscle composition, and tissue health responses under physiologically relevant loading conditions for individuals with spinal cord injury (SCI).

Design: Repeated measures study design with annual follow-up for up to 3 years.

Setting: Tertiary care center.

Power Wheelchair Footplate Pressure and Positioning Sensor.

Power wheelchair users are at risk for severe injuries caused by foot mis-position on the footplate. This can lead to collisions or foot dragging which are severe or lifethreatening injuries for people with spinal cord injuries. The foot cannot be safely immobilized due to tilting pressure relief injuries, therefore, the foot can easily fall into a vulnerable position without the user realizing it.

The Modular Adaptive Electrotherapy Delivery System (MAEDS): An Electroceutical Approach for Effective Treatment of Wound Infection and Promotion of Healing.

Background: Infected wounds are painful and cannot heal, with antibiotics showing reduced efficacy. Appropriate wound electrotherapy may limit incident planktonic and polymicrobial colonization, inhibit biofilm formation and accelerate healing.

Methods: The Modular Adaptive Electrotherapy Delivery System (MAEDS) is a lightweight, flexible, battery-powered disposable bandage which delivers controlled reliable electrotherapy to the wound for up to 7 days.

Individualized Clinical Practice Guidelines for Pressure Injury Management: Development of an Integrated Multi-Modal Biomedical Information Resource.

Background: Pressure ulcers (PU) and deep tissue injuries (DTI), collectively known as pressure injuries are serious complications causing staggering costs and human suffering with over 200 reported risk factors from many domains. Primary pressure injury prevention seeks to prevent the first incidence, while secondary PU/DTI prevention aims to decrease chronic recurrence. Clinical practice guidelines (CPG) combine evidence-based practice and expert opinion to aid clinicians in the goal of achieving best practices for primary and secondary prevention.

Preliminary development of an advanced modular pressure relief cushion: Testing and user evaluation.

Study Aim: Effective pressure relief cushions are identified as a core assistive technology need by the World Health Organization Global Cooperation on Assistive Technology. High quality affordable wheelchair cushions could provide effective pressure relief for many individuals with limited access to advanced assistive technology.

Materials: Value driven engineering (VdE) principles were employed to develop a prototype modular cushion.

Flexible, Structured MWCNT/PDMS Sensor for Chronic Vascular Access Monitoring.

Graft wall pulsation amplitude sensing can provide a measure of functional status, e.g. in hemodialysis access grafts.

Development of a Sitting MicroEnvironment Simulator for wheelchair cushion assessment.

Study Aim: Pressure ulcers (PU) are a common comorbidity among wheelchair users. An appropriate wheelchair cushion is essential to relieve pressure and reduce PU development during sitting. The microenvironment, specifically excessive heat and moisture, impacts risk for PU development.