Publikace EPUAP 2015.qxp katalog velkż · 2020. 3. 17. · Publikace EPUAP 2015.qxp_katalog velký...

EPUAP 201518th Annual Meeting of the EuropeanPressure Ulcer Advisory Panel16 – 18 September 2015 · Ghent, Belgium · www.epuap2015.org

PUTTING THE PRESSUREIN THE HEART OF EUROPE

PROGRAMME AND ABSTRACT BOOK

Organised by the European Pressure Ulcer Advisory Board and the University Centre for Nursing & Midwifery (Ghent University) incooperation with EduWond, CNC, WCS België and AfiScep.

Publikace EPUAP 2015.qxp_katalog velký 22.08.15 13:34 Stránka 1

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Ziudergang

1st Floor1. Priorzaal2. Library/Speakers room (mezzanine)3. Zaal Rector GillisS. Stairs

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Ground Floor

1. Refter Hall2. Registration3. Courtyard Exhibition4. Kapittelzaal Exhibition5. Poster area6. Meeting room SacristieS. Stairs

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2nd Floor1. Zaal Rector Vermeylen2. Oude infirmerieS. Stairs

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3rd Floor1. Zaal Rector Blanquert3. Stairs

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CONTENT

EPUAPBUSINESS OFFICEProvaznicka 11110 00 Prague 1 Czech RepublicTel: +420 251 019 379 [email protected]

Follow EPUAP on

LinkedIn Twitter

Welcome 4About EPUAP 5Programme overview 8Dutch symposium programme 14French symposium programme 16EPUAP interactive sessions 19Key session overview 20Key sessions presentations 21Quality improvement projects abstracts 34Oral presentation overview 41Abstracts of oral presentations 43Poster presentations overview 67Abstracts of poster presentations 70Author index 101General information 103EPUAP and SAGE product 105About Ghent 106Social events 109Sponsors EPUAP 2015 110Industry satelllite symposia and workshops 112Exhibitors EPUAP 2015 115Exhibition plans 117


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WELCOME

Dear colleague, Dear friend

Welkom in Gent! Bienvenue à Gand! Welcome to Ghent!

On behalf of all of us at the European Pressure Ulcer Advisory Panel(EPUAP) we wish you a warm welcome at our 18th Annual Meeting.The host of this year’s conference is the University Centre for Nursingand Midwifery based at Ghent University. The conference is organizedin collaboration with all Belgian woundcare organizations (EduWond,CNC, WCS België, and AfiScep).

Ghent, a city of culture and science in the Flemish Region, is ourhosting city. Ghent is without doubt one of the most beautiful historiccities in Europe and was given several pretty names: historic heart ofFlanders, a city of all times, medieval Manhattan, Europe’s best keptsecret and received some international tourist nominations. In 2008National Geographic Traveler Magazine ranked Ghent third in its listof 109 most authentic destinations. In the 2011 edition of the LonelyPlanet’s ’Best in Travel’ guide, Ghent took the 7th place on the list ofmust-see cities.

More than 500 experts from 35 countries in Europe, The United States,Asia, Australia and Middle East are attending the conference. Morethan 120 abstracts were submitted and more than 30 companies willbe exhibiting the next 3 days. The quality of the scientific programmehas been acknowledged by the European Accreditation Council forContinuing Medical Education (EACCME) by assigning 14 EuropeanCME Credits (ECMEC). A real success!

Like every year, the aim of the conference is bringing together clinicalcare practitioners, researchers and people from industry, to discussthe current status of the problem in Europe and the world and todiscuss new developments in pressure ulcer prevention, treatmentand care. The overall theme of this year’s conference is “Putting thePressure in the Heart of Europe” and the main topics of the scientificprogramme are:

• the societal impact of pressure ulcers• health economics• how to put pressure ulcers on the international agenda for

healthcare• pressure ulcers and quality indicators• developing and evaluating local and national quality improvement

projects• international collaboration in practice, research and education• EPUAP - International Society for Pediatric Wound Care (ISPeW)

Session• Preview of the EPUAP Book: Science and Practice of Pressure Ulcer

Management

With this scientific program, which blends top-tier science, the latestclinical research, and also region-specific activities covered in aFlemish and a French speaking session, we hope you will enjoy theconference and your time in Ghent!

Welcome!

Kind regards, Prof. Dimitri Beeckman Prof. Amit Gefen Prof. Lisette Schoonhoven Chair of EPUAP 2015 President of EPUAP President-Elect of EPUAP Chair of the EPUAP Scientific Committee Chair of the Guidelines Committee

The Local Organising Committee: Hilde Heyman Hilde Beele Steven Smet Evelien Touriany Luc Gryson Christian Thyse

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ABOUT EPUAP

About EPUAP

The “European Pressure Ulcer Advisory Panel” was created in Londonin December 1996 to lead and support all European countries in theefforts to prevent and treat pressure ulcers. At its inaugural meetingin London in December 1996, which included experts from manyEuropean countries, the group of over twenty agreed their missionstatement and the initial Executive Board and Trustees.

The mission statement reads: “To provide the relief of personssuffering from or at risk of pressure ulcers, in particular throughresearch and the education of the public and by influencing pressureulcer policy in all European countries towards an adequate patientcentred and cost effective pressure ulcer care.“ A very importantactivity for the EPUAP is our annual conference. These meetings areaimed at bringing together clinical care practitioners, researchers andpeople from industry, to discuss the current status of the problem inEurope and the world and to discuss new developments in pressureulcer prevention, treatment and care.

EPUAP Executive Board Members

Amit Gefen, PresidentLisette Schoonhoven, President Elect and Chair

of the Guidelines Committee

Jane Nixon, TreasurerJeannie Donnelly, Co-Treasurer Dimitri Beeckman, Chair of the Scientific CommitteeJan Kottner, Co-Chair of the Guidelines CommitteeZita Kis Dadara, Public RelationsChristina Lindholm, Public Relations

The Local Organising Committee

Dimitri Beeckman (Chair), University Centre for Nursing & Midwifery, Ghent University

Hilde Heyman, WCS België Hilde Beele, EduWond Steven Smet, EduWond Evelien Touriany, CNC Luc Gryson, CNCChristian Thyse, AfiScep

EPUAP Current Trustees

Maarit Ahtiala (Finland)Dan Bader (United Kingdom)Carina Bååth (Sweden)Guido Ciprandi (Italy)Lena Gunningberg (Sweden)Hilde Heyman (Belgium)Rolf Jelnes (Denmark)Lenche Neloska (Macedonia)Yohan Payan (France)Elia Ricci (Italy)Marco Romanelli (Italy)Jos Schols (The Netherlands)Jakub Taradaj (Poland)José Verdú Soriano (Spain)Erik de Laat (The Netherlands)

The mission

To provide the relief of persons suffering from or at risk of pressureulcers trough:

• research in prevention and treatment of pressure ulcers• raising awareness on the importance of prevention and treatment

of pressure ulcers• influencing pressure ulcer policy in all European countries• working towards an adequate patient centered and cost effective

pressure ulcer care

www.epuap.org


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ABOUT GHENT UNIVERSITY

Ghent University was founded in 1817 by King William I of Orange.The past 200 years, Ghent University employed many eminentscientists such as Nobel Prize winner Corneille Heymans, LeoBaekeland, Joseph Guislain, Walter Fiers, Marc Van Montagu, PeterPiot,... You'll also find many prominent persons among our alumnisuch as Robert Cailliau (co-inventor of the Internet), Dirk Frimout(astronaut), Peter Piot (United Nations) and Jacques Rogge (formerPresident of the International Olympic Committee). Today, GhentUniversity is a top 100 university and one of the major Belgianuniversities counting over 41,000 students and 9,000 employeesspread over 11 faculties and 117 faculty departments. Thesedepartments offer more than 230 high-quality courses in everyscientific discipline, each inspired by innovative research. GhentUniversity distinguishes itself as a socially committed and pluralisticuniversity in a broad international perspective.

The Faculty of Medicine was one of the four founding faculties ofGhent University. Today, with 200 professors instructing 6,200students, it remains one of its largest. Now formally named the Facultyof Medicine and Health Sciences, the Faculty provides training inseven disciplines: medicine; dentistry; biomedical sciences; physicaleducation; rehabilitation sciences and physiotherapy; medical andsocial sciences (nursing and midwifery, healthcare management andpolicy, and health education and promotion); and speechtherapy/audiology. It has a close relationship with Ghent UniversityHospital, the largest such institution in Belgium. The Faculty, alsorenowned for its postgraduate and continuing education programs,seeks to build a highly dynamic learning atmosphere linked to notonly strict healthcare but also to what is currently happening in thebroader society. More information: http://www.UGent.be

Ghent University - ‘Dare to think’: not just a slogan

The University Centre for Nursing and Midwifery (UCVV) is part of theDepartment of Public Health, Faculty of Medicine and Health Sciences,Ghent University. The team consists of 20 members of staff beingactive in academic education, research, societal/academic servicesand administrative support. The UCVV is led by Prof. dr. SofieVerhaeghe, Prof. dr. Ann Van Hecke, and Prof. dr. Dimitri Beeckman.The UCVV is a dynamic research center that focuses on thedevelopment, validation and valorization of scientific knowledge thatleads to safe, evidence-based and efficient care and organization ofcare. This includes a focus on the translation and implementation ofcomplex interventions in practice. Through partnerships and

collaborations with external partners, the UCVV aims to supportresearch skills of professionals in clinical practice. The research workis divided into six domains: skin care (pressure ulcers andincontinence- associated dermatitis), oncological care, midwifery,education and training, mental health care, and nutritional care. TheUCVV uses innovative research methods (quantitative, qualitative,mixed methods) and works with national and internationalgovernments, universities, healthcare organizations and the industryin order to accomplish its mission. The UCVV is responsible for theorganization of the Master in Science in Nursing and Midwifery. Moreinformation: http://www.UCVVGent.be

University Centre for Nursing and Midwifery (UCVV)


3rd EPUAPFOCUS MEETINGThe Role of Skin and Tissue Maturationand Aging in Pressure Ulcer Research and Practice

EPUAP Business [email protected]

+420 251 019 379

Organised by the European Pressure Ulcer Advisory Panel in partnership with Charité-Universitätsmedizin Berlin and Leeds University

4 – 6 April 2016 | Berlin, Germany www.focusmeeting2016.org

Receive an overview of current research and development trends in academia in regard to a spectrum of knowledge and technologies in the pressure ulcer field.

Receive an overview of current trends in commercialized technology in the pressure ulcer field as well as of needs and technological gaps identified by the industry.

Opportunities for commercialization of inventions and technologies which are still at the research lab phase.

Obtain an overview of the state-of-the-art in pressure ulcer prevention and treatment technology which is currently being developed at research labs internationally in the academia.

The EPUAP Focus Meeting is a relatively new initiative aimed at exchanging knowledge among scientists, clinicians, R&D and industry in regard to the latest developments in special areas of pressure ulcer research and practice. The focus meeting is intended to give room for in-depths discussion about special topics, to identify knowledge and technological gaps, as well as clinical needs in the pressure ulcer field and establish a platform of discussion for academia and industry.

Scientists and companies have opportunities for to work together towards commercialization of technologies – starting at an early stage of development of the technology – and in particular, to jointly shape the course of R&D so that it meets true clinical needs and bridges actual gaps which have been identified by the industry.

It is an appropriate environment for informal discussions that encourages follow-up contacts between scientists and companies such as for development of technologies, consultation projects for companies etc.

Why attend the Focus Meeting?


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PRELIMINARY PROGRAMME

18th Annual Meeting of the European Pressure Ulcer Advisory Panel 16 – 18 September 2015 · Ghent · Belgium

WEDNESDAY 16. 09. 2015 Registration area

07:30 Registration, badge and bag collection - registration area

07:30 - 09:00 Morning coffee and tea - registration and exhibition area

Refter Hall - Plenary room

09:00 - 10:15 OPENING CEREMONYChairs: Dimitri Beeckman, Lisette Schoonhoven

• Opening of the conference by Prof. Guy Vanderstraeten, Dean of the Faculty of Medicine and Health Sciences, Ghent University• Opening of the conference by The President of EPUAP and the EPUAP 2015 Local Organizer, Amit Gefen, Dimitri Beeckman• Pressure Ulcers and Quality of Care – Activities to Stimulate Quality of Care Discussions at a National Level, Prof. dr. Peter Van

Bogaert on behalf of the Belgian Federal Council on the Quality of the Nursing activities• Lecture of Appreciation for Prof. dr. Tom Defloor, Professor in Nursing Science at Ghent University and Past President of EPUAP

(2005 – 2007), Lisette Schoonhoven, Dimitri Beeckman

10:15 - 11:15 KEY SESSION 1: Ethics, accountability, and health economics in pressure ulcersChair: Dimitri Beeckman, Lisette Schoonhoven

• Health economics and pressure ulcers: importance, methods and reflections, Lieven Annemans • Assessing the severity of pressure ulcers: unstageable/ungradeable project, Carol Dealey

• The cost of prevention and treatment of pressure ulcers from an international perspective: a systematic review, Dimitri Beeckman

11:15 - 12:30 Lunch break, exhibition and poster viewing (in the exhibition area)

Refter Hall - Plenary room Zaal Rector Vermeylen

12:30 - 14:00 KEY SESSION 2: An update of pressure ulcer basic sciencesChair: Dimitri Beeckman, Lena Gunningberg

• Pressure induced deep tissue injury explained, Cees Oomens• The future of support surfaces and technologies for tissue

protection: where should we go, and what should we do, Amit Gefen

• Biomechanical modeling to prevent ischial and foot pressureulcers, Yohan Payan

• Angiogenesis and wound healing, Liesbet Geris• The association between microclimate and pressure ulcer

development, Jan Kottner

14:00 - 14:45 Coffee break, exhibition and poster viewing (in the exhibition area)

14:00 – 14:45 POSTER SESSION IN ZUIDERGANG

14:45 - 15:30 KEY SESSION 3: Pressure ulcer treatment - beyond the basicsChair: Christina Lindholm, Jeannie Donnely

• Tackling biofilms and infected pressure ulcers, Ron Legerstee• Wound dressings for pressure ulcer treatment: facts and

figures, Erik de Laat• Updated scar management practical guidelines: non-invasive

and invasive measures, Luc Téot• The role of negative pressure wound therapy in pressure ulcer

treatment: evidence and practice, Lubos Sobotka

14:15 - 15:45 INTERACTIVE SESSION 2: EPUAP - Internationalsociety for pediatric wound care (ISPeW) Session, Chair: Guido Ciprandi, Rolf JelnesPressure ulcers in children: introduction and examples to bediscussed, Hilde Beele, Steven SmetPressure ulcers prevention in NICU and PICU critical areas, Anna-Barbara SchluerNeonatal pressure ulcers. Focus on smallest patients, Guido CiprandiFinal discussion

15:45 - 17:15 INDUSTRY SYMPOSIUM (90') 16:15 - 17:15 FREE PAPER SESSION 2: Pressure ulcers: Patientsafety, quality of care and policy (1)Chairs: Lena Gunningberg, Lenche Neloska

• Strategic Benchmarking: Implementing and Evaluating EPUAP2014 Guidelines-Envisioning the Possibilities; Nancy Donaldson

• Pressure Ulcer and Wounds Reporting in English NHS Hospitals:Pressure Ulcer/Wound Audit (PUWA) and Survey; Jane Nixon

• The development of a preventive pressure ulcer preventionpolicy in a (General Hospital) AZ Nikolaas; Dirk Milliau

• Pressure ulcers and quality of care in the Centre Hospitalier deLuxembourg; Andree Marchal

18:30 Welcome reception at the Ghent City Hall


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See the programmes for the industry satellite symposia and workshops at page 112

07:30

07:30 - 09:00

09:00 - 09:45

09:45 - 11:15

11:15 - 12:30

Priorzaal Zaal Rector Blancquaert

INTERACTIVE SESSION 1: Patient and load handling teamUniversity GhentChairs: Filip Buckens, Heidi DeconinckPhysiotherapy: a complementary therapy, Jo DevleeschhouwerIntroduction to the practical workshop, Filip Buckens, HeidiDeconinckPractical workshop: Demonstrations of the use of lifting devicesHet Pand team

12:30 - 14:00

14:00 - 14:45

14:45 - 15:30 FREE PAPER SESSION 1: Basic science:Biomechanics and aetiology (1)Chairs: Carina Baath, Jan Kottner

• Modelling Cell Migration and Differentiation Processes inMuscle and Fat Structures; Fred Vermolen

• Computational Modeling of Angiogenesis Using a Cell-BasedFormalism; Fred Vermolen

• Changes in hypodermic adipose tissue could affect chronicskin wound healing during obesity; DominiqueSigaudo-Roussel

• Investigating the effect of shear on skin viability, in relation tothe development of pressure ulcers; Iris Hoogendoorn

14:45 - 15:30

15:45 – 16:45 STUDENT FREE PAPERS SESSION: Basic scienceChair: Christina Lindholm, Zita Kis Dadara

• Soft tissue loads in the penis during use of penile incontinenceclamps; Ayelet Levy

• Tissue loads applied by a novel medical device for closing largepressure ulcers; Rona Greifman

• Use of poly (lactic acid) biodegradable microparticles for tissuereconstruction of chronic wounds; Morgane Berthet

• Soft tissue loads around the sacrum in a three-dimensionalbuttocks model when confined to a rigid spinal board; AyeletLevy

15:45 - 16:45 FREE PAPER SESSION 3: Innovations in pressure ulcer prevention and treatmentChairs: Jakub Taradaj, Maarit Ahtiala

• Electrical stimulation in wound healing processes and tissueregeneration; Marino Ciliberti

• The Relationship between Nurses Assessment of Early PressureUlcer Damage and Sub Epidermal Moisture Measurement: AProspective Explorative Study; Gillian O'Brien

• What does it take to make video consultations succeed –experiences from Sunnaas hospital; Ingebjørg Irgens

• Magnetic Resonance Elastography of pressure ulcer relateddeep tissue injury; Jules Nelissen

15:45 - 17:15

18:30


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THURSDAY 17. 09. 2015 Registration area

08:00 Registration, badge and bag collection - Registration areaRefter (Main Auditorium) Zaal Rector Vermeylen

08:00 - 09:30 INDUSTRY BREAKFAST SYMPOSIUM (90') 08:00 - 09:00 FREE PAPER SESSION 4: Innovative approachesin clinical research (Prevention and treatment)Chairs: Carina Baath, Michael Renierkens

• The Relationships between Incontinence, Braden Risk Score,and Pressure Ulcer Stages from the 2013 and 2014 InternationalPressure Ulcer PrevalenceTM (IPUP) Survey; CharlieLachenbruch

• The golden hour for pressure ulcer risk assessment; RichardWhite

• Extracorporeal Shock Wave Therapy in Ulcer Therapy: a single-centre experience and systematic review; Jakub Taradaj

• Evaluation of an immersion type mattress for the prevention ofpressure ulcers; Peter Worsley

09:30 - 10:30 KEY SESSION 4: EPUAP Book preview, Chairs: Marco Romanelli, Amit Gefen, Mike Clark

• Preview of the book: Science and practice of pressure ulcermanagement

• The critical characteristics of good support surfaces forpressure ulcer prevention, Amit Gefen

• How innovative is pressure ulcer prevention and treatment?,Michael Clark

KEY SESSION 5: EWMA - EPUAP Session, infectionmanagement in pressure ulcer treatment: new insights andevolutionsChair: Lena Gunningberg, Carina Baath

• Infection management: old remedies for old wounds, Rose Cooper

• Infection management in pressure ulcers, Rolf Jelnes

10:30 - 11:00 Coffee break and exhibition viewing

10:30 – 11:00 POSTER SESSION IN ZUIDERGANG11:00 - 12:00 KEY SESSION 6: The EPUAP awards 2015

Chair: Dimitri Beeckman, Yohan Payan• Introduction by Prof. Dimitri Beeckman (Chair EPUAP Scientific Committee)• Experienced Investigator Award: Pressure ulcer research: a

tortuous road to travel, Cees Oomens• Novice Investigator Award: Translating Pressure Ulcer Risk

Factor Research into Clinical Practice, Susanne Coleman • Lifetime Achievement Award: Reflections of a Woundologist,

Keith Harding

11:00 - 12:30 INDUSTRY SYMPOSIUM (90')

12:00 - 12:30 EPUAP INITIATIVES KEY SESSION• International Stop Pressure Ulcer Day, Zita Kis Dadara• The international guideline: update on implementation and

development, Lisette Schoonhoven• PuClas3, Dimitri Beeckman

12:30 - 14:00 Lunch break, exhibition and poster viewing

12:30 – 14:00 POSTER SESSION IN ZUIDERGANG13:30 - 14:00 EPUAP Annual General Meeting

14:00 - 15:30 KEY SESSION 7: The organisation of pressure ulcer care – bestpractices and leadershipChair: Amit Gefen, Zita Kis Dadara

• The first Dutch nurse led wound centre, Alita Jaspar• Developing a national pressure ulcer organisation: the Dutch

experience, Michel Renierkens• Telemedicine in pressure ulcer risk assessment, prevention and

management, Rolf Jelnes• Nurse leadership in pressure ulcer management, Christina Lindholm

14:00 - 15:30 INTERACTIVE SESSION 3: Quality improvementprojects for pressure ulcers: From implementation tomeasuring and comparing quality improvementChairs: Lisette Schoonhoven, Jan Kottner

15:30 - 16:15 Coffee break exhibition and poster viewing

15:30 – 16:15 POSTER SESSION IN ZUIDERGANG16:00 - 17:15 KEY SESSION 8: Risk factors for pressure ulcer development in

specific patients groups - science meets practiceChair: Jane Nixon, Yohan Payan

• Pressure ulcer risk factors from the 2015 French national prevalence studyand comparison with previous prevalence studies, Brigitte Barrois

• Medical devices and vulnerable skin, Dan Bader• Incontinence - associated dermatitis as a risk factor for pressure

ulcer development in a geriatric population?, Sylvie Meaume• Pathophysiological factors and risk assessment methods for

pressure ulcers in ICU, Maarit Ahtiala

EPUAP 2015 QUALITY IMPROVEMENT AWARDSPreventing Skin Breakdown Projects: Tips and tricks from 5quality improvement storiesChairs: Dimitri Beeckman, Lena Gunningberg

19:30 Boat trip and conference dinner at restaurant "Oude Vismijn"


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08:00Priorzaal Zaal Rector Blancquaert

08:00 - 09:00 FREE PAPER SESSION 5: Pressure ulcer prevention andmanagement in specific patient groups (paediatrics, surgery, spinalcord injury, ER, older persons, palliative care, etc) (1)Chairs: Luc Gryson, Marco Romanelli

• How to prevent patients developing pressure ulcer (PU) whenundergoing cardio-thoracic surgery; Charlotte Walsoee

• Can Pressure Monitoring Influence Non-Concordant Patients andCarers in Their Decision Making with Regards to Repositioning andPressure Ulcer Prevention in the Community; Nicci Kimpton

• Pressure Ulcer Prevention in Geriatric Ward; Aase Fremmelevholm• An interdisciplinary team strategy for the prevention of

pressure ulcers for at risk ageing patients in communitysettings; Carolyn Wyndham-White

08:00 - 09:00 FREE PAPER SESSION 6: Pressure ulcer preventionand management in specific patient groups (paediatrics, surgery,spinal cord injury, ER, older persons, palliative care, etc) (2)Chairs: Erik de Laat, Lenche Neloska • Cost-effectiveness analysis of nutritional support for the prevention of

pressure ulcers in high-risk hospitalized patients; Shelley Roberts • Preventing pressure ulcers in aged care: A randomised controlled trial

of the effectiveness of prophylactic silicone foam dressings; NickSantamaria

• Physiological Responses to Pressure Loading and Unloading in Critically IllPatients as a Predictor of Pressure Ulcer Development; Janet Cuddigan

• Prevention of sacral pressure ulcers in pediatric cardiacintensive care unit; Miroslava Hargasova

08:00 - 09:30

09:00 - 10:00 FREE PAPER SESSION 7: Basic science:Biomechanics and aetiology (2)Chairs: Jakub Taradaj, Maarit Ahtiala

• Features of Dermal Lymphatic Dysfunction in Uniaxially-CompressedTissues – Implication in Pressure Ulcer Aetiology; Dan Bader

• Evaluating control of skin microclimate with AeroSpacer 3Dspacer mattress configurations; Dan Bader

• A Computational Model of the Competition between CellDamage and Cell Repair, in the Presence of Oxidative Stress andMechanical Deformation; Lisa Tucker-Kellogg

• Ultrasound Modulates Proinflammatory Cytokine Release inSoft Tissue; David Voegeli

09:00 - 10:00 INDUSTRY WORKSHOP (60') 09:30 - 10:30

11:00 - 12:00

11:00 - 12:00

12:00 - 12:30

12:30 - 14:00

13:30 - 14:00

14:00 - 15:30

15:30 - 16:15

16:00 - 17:15

19:30


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FRIDAY 18. 09. 2015 Registration area

08:00 Registration, badge and bag collection - Registration area

Refter (Main Auditorium) Zaal Rector Vermeylen

09:00 - 10:00 KEY SESSION 9: Pressure ulcer management: Innovativeapproaches need to go hand in hand with basic careChair: Christina Lindholm, Dimitri Beeckman

• Health policy: from a survey of the prevalence of pressureulcers in nursing homes in the Brittany, France to the start oftelemedicine for elderly and disabled people with chronicwounds, Sandrine Robineu

• Electric stimulation in practice for treatment of pressure ulcers,Mike Meuwissen

• What we should know about repositioning for pressure ulcerprevention and treatment, Zena Moore

• Using ITEM as a systematic approach towards pressure ulcertreatment, Steven Smet

09:00 – 10:00 STUDENT FREE PAPERS SESSION: ClinicalscienceChair: Evelien Touriany, Hilde Beele

• Risk Factors for Pressure Ulcer in Portuguese Surgical Patients;Marina Batalha Figueiredo

• Incontinence-associated dermatitis in elderly: a qualitativephenomenological study on patient experiences; Nele VanDamme

• Development and validation of an instrument to monitor thehealing of incontinence-associated dermatitis; Karen Van denBussche

• Evidence-based skin care: the development of a basic skin carealgorithm with formal care settings, Andrea Lichterfeld

10:00 - 10:45 Coffee break and exhibition viewing

10:45 - 12:15 KEY SESSION 10: Interactive clinical case discussionsChair: Luc Gryson, Marco Romanelli

• Pediatrics• General• Rehabilitation• Geriatrics• ICU

12:15 - 12:45 EPUAP 2016 Annual Meeting – Florence, Italy

EPUAP 3rd Focus Meeting 2016 - Berlin, Germany

Closing of the conferenceChair: Lisette Schoonhoven, Dimitri Beeckman


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08:00

Priorzaal Zaal Rector Blancquaert

FREE PAPER SESSION 8: Pressure ulcers: Patient safety, qualityof care and policy (2)Chairs: Jeannie Donnely, Jakub Taradaj

• The cost of pressure ulcer prevention and treatment inhospitals and nursing homes in Flanders: a cost-of-illnessstudy; Liesbet Demarré

• Priorities for pressure ulcer prevention: mixed methods analysisof patient safety incidents reports from primary care in Englandand Wales (2003-2013); Ray Samuriwo

• Continuous quality improvement project to reduce pressureulcer prevalence in a regional Belgian hospital; KatrienVanderwee

• Development of outcome measures and performanceindicators for PUPIS - a specialist pressure ulcer service in thecommunity; Mark Bowtell

FREE PAPER SESSION 9: Pressure ulcers: Implementationscience and educationChairs: Zita Kis Dadara, Jan Kottner

• Measuring practice change through clinical experts; Ann MarieDunk

• Implementation of evidence based pressure ulcer preventionin hospital units – important factors for success; Eva Sving

• INTroducing A Care bundle To prevent pressure injury: theINTACT trial; Wendy Chaboyer

• The implementation of effective quality management forPressure Ulcer Prevention at Germany’s largest universityhospital; Armin Hauss

09:00 - 10:00

10:00 - 10:45

10:45 - 12:15

12:15 - 12:45


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DUTCH SYMPOSIUM PROGRAMME

DONDERDAG 17. 09. 2015

Tijd: 10:00 – 17:00

Lokaal: Zaal Rector Blancquaert

Sessievoorzitters voormiddag: Mevr. Hilde Heyman, Mevr. Evelien Touriany

Sessievoorzitters namiddag: Dhr. Steven Smet, Dhr. Luc Gryson

10:00 - 10:10 Welkom en inleidingProf. dr. Dimitri Beeckman; Universiteit Gent, België

10:10 – 10:30 Het ontstaan van diepe weefselschade: inzichten uit de wetenschapProf. dr. Cees Oomens; Technische Universiteit Eindhoven, Nederland

10:30 – 10:50 De internationale richtlijnen voor decubituspreventie en behandeling zijn er: wat nu?Prof. dr. Lisette Schoonhoven; University of Southampton, UK

10:50 – 11:30 Decubitus en incontinentie- geassocieerde dermatitis: etiologie, preventie en behandelingProf. dr. Hilde Beele; Universitair Ziekenhuis Gent, België

11:30 – 12:00 Voorspellen van decubitusgenezing met de DECU-STICK bij dwarslaesiepatiënten tijdens conservatieve behandelingDr. Floris Van Asbeck; De Hoogstraat Revalidatie Utrecht, Nederland

12:00 – 12:30 Organisatie van het decubitus beleid in het ziekenhuis: best practicesAdinda Toppets; UZLeuven, België

12:30 – 13:30 Lunch

13:30 – 14:00 De behandeling van biofilms en geïnfecteerde decubituswondenRon Legerstee; Pe@r, Wound Healing and Tissue Repair, Nederland

14:00 – 14:30 Wondverbanden in de behandeling van decubitus: feiten en praktijkDr. Erik De Laat; UMC Radboud, Nijmegen, Nederland

14:30 – 15:00 De systematische aanpak van decubitus door het gebruik van ITEMSteven Smet; Universitair Ziekenhuis Gent, België

15:00 – 15:30 Electrostimulatie bij hard to heal ulcers, de ervaringen binnen de praktijkMike Meuwissen; Mitralis Expertise Centrum Wondzorg Heerlen, Nederland

15:30 – 16:15 Koffie pauze

16:15 – 16:45 De uitbouw en implementatie van een verpleegkundig gestuurde wondkliniek: praktijk en ervaringenAlita Jaspar; Mitralis Expertise Centrum Wondzorg Heerlen, Nederland

16:45 – 17:00 ConclusieDhr. Luc Gryson


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DUTCH SYMPOSIUM PROGRAMME

DONDERDAG 17. 09. 2015Tijd: 10:00 – 17:00Lokaal: PriorzaalSessievoorzitters voormiddag: Dhr. Steven Smet, Dhr. Luc GrysonSessievoorzitters namiddag: Mevr. Hilde Heyman, Mevr. Evelien Touriany

10:00 - 10:10 Welkom en inleidingDhr. Steven Smet, Dhr. Luc Gryson

10:10 - 10:40 De behandeling van biofilms en geïnfecteerde decubituswondenRon Legerstee; Pe@r, Wound Healing and Tissue Repair, Nederland

10:40 - 11:10 Wondverbanden in de behandeling van decubitus: feiten en praktijkDr. Erik De Laat; UMC Radboud, Nijmegen, Nederland

11:10 - 11:40 De systematische aanpak van decubitus door het gebruik van ITEMSteven Smet; Universitair Ziekenhuis Gent, België

11:40 - 12:10 Electrostimulatie bij hard to heal ulcers, de ervaringen binnen de praktijkMike Meuwissen; Mitralis Expertise Centrum Wondzorg Heerlen, Nederland

12:10 - 12:40 De uitbouw en implementatie van een verpleegkundig gestuurde wondkliniek: praktijk en ervaringenAlita Jaspar; Mitralis Expertise Centrum Wondzorg Heerlen, Nederland

12:30 – 13:30 Lunch

13:30 - 13:50 Het ontstaan van diepe weefselschade: inzichten uit de wetenschapProf. dr. Cees Oomens; Technische Universiteit Eindhoven, Nederland

13:50 -14:10 De internationale richtlijnen voor decubituspreventie en behandeling zijn er: wat nu?Prof. dr. Dimitri Beeckman; Universiteit Gent, België

14:10 -14:50 Decubitus en incontinentie- geassocieerde dermatitis: etiologie, preventie en behandelingProf. dr. Hilde Beele; Universitair Ziekenhuis Gent, België

14:50 - 15:20 Voorspellen van decubitusgenezing met de DECU-STICK bij dwarslaesiepatiënten tijdens conservatieve behandelingDr. Floris Van Asbeck; De Hoogstraat Revalidatie Utrecht, Nederland

15:30 – 16:15 Koffie pauze

16:15 - 16:45 Organisatie van het decubitus beleid in het ziekenhuis: best practicesAdinda Toppets; UZLeuven, België

16:45 – 17:00 ConclusieSteven Smet; Universitair Ziekenhuis Gent, België


16

FRENCH SYMPOSIUM PROGRAMME

YEUDI 17. 09. 2015Heure: 10:00 – 17:10 (L'enregistrement commence à 09:00)Salle de réunion: Oude Infirmerie (2ème étage)Président de séance le matin: Brigitte Barrois Président de séance l'après-midi: Christian Thyse

The French language symposium is organised in partnership with Afiscep and PERSE.

10:00 – 10:10 Introduction Mr. Christian Thyse, AfiScep Dr. Brigitte Barrois, PERSE

10:10 – 10:30 Optimalisation de la prise en charge des escarres: un cas SuisseMme. Lucie Charbonneau

10:30 – 10:50 IAD, un risque pour le développement d’escarres dans la population gériatrique? Dr. Sylvie Meaume

10:50 – 11:30 Etude nationale de prévalence des escarres réalisée en France : résultats préliminaires de l’enquête décennale (2014) et comparaisonavec les enquêtes précédentes (2004 et 1994)Dr. Brigitte Barrois, F. A Allaert

11:30 – 12:00 Avant l’ IAD, l’incontinence, est-elle évitable?Mr. Christian Thyse

12:00 – 13:30 Pause

13:30 – 14:00 Capacités d’ajustement de la microcirculation cutanée face aux pressions Dr. Dominique Sigaudo Roussel, Mme. Bérengère Fromy

14:00 – 14:30 Optimalisation de la prise en charge des escarres: un cas Luxembourgeois. Dr. René Dondelinger

14:30 – 15:00 Actualisation des guidelines pratiques de prise en charge des escarres: mesures invasives et non- invasivesProf. Luc Téot

15:00 – 15:30 TLM Plaies chroniques: Télémédecine entre un centre de médecine physique et réadaptation et les structures médicosociales ou le domicile : résultats après un an de téléconsultations.Dr. Sandrine Robineau, Dr. B. Nicolas, A. Chopin, A. Allain, C. Lemeur, M. Cristina, P. Gallien

15:30 – 16:15 Pause

16:15 – 16:45 Spécificités de la prise en charge des escarres chez l’enfantDr. Benoit Nicolas

16:45 – 17:00 Modélisation biomécanique pour prévenir les escarres ischiatiques et du pied Prof. Yohan Payan


Bremen

EWMA 2016PATIENTS. WOUNDS. RIGHTS11-13 MAY 2016BREMEN · GERMANY

www.deutscher-wundkongress.dewww.wund-dach.org

www.ewma2016.org

26th Conference of theEuropean Wound Management Association

Abstract submission d

eadline:

1 December 2015


How can you get involved?• Host educational activities on prevention and treatment of pressure ulcers• Organise awareness raising events to share information about pressure ulcers• Reach out to your local community to inform them about pressure ulcers• Make policy makers aware about pressure ulcers

Download support material for free at: www.epuap.org

EPUAP Business OfficeEmail: [email protected]: +420 251 019 379

YOUR VOICEfor pressure ulcerPREVENTION!

19thNovember2015

org

www.epuap.org


19

EPUAP INTERACTIVE SESSIONS

INTERACTIVE SESSION 1

Patient and load handling teamUniversity Hospital GhentPhysiotherapy: a complementary therapy, Jo DevleeschhouwerIntroduction to the practical workshop, Filip Buckens and Heidi DeconinckPractical workshop: Demonstrations of the use of lifting devices, Patient and loadhandling team University Hospital Ghent

Speakers: Jo DevleeschhouwerFilip BuckensHeidi Deconinck

Date: 16 September 2015Time: 12:30 – 14:00Meeting room: Priorzaal


EPUAP – International Society PaediatricWound Care (ISPeW) session

Pressure ulcers in children: introduction and examples to be discussed, Hilde Beele,Steven SmetPressure Ulcers Prevention in NICU and PICU critical areas, Anna-Barbara SchluerNeonatal pressure Ulcers. Focus on smallest patients, Guido CiprandiFinal discussion

Speakers: Hilde BeeleSteven SmetAnna-Barbara SchluerGuido Ciprandi

Date: 16 September 2015Time: 14:15 – 15:45Meeting room: Zaal Rector Vermeylen


Quality improvement projects for pressure ulcers: From implementationto measuring and comparing quality improvementIn this session key principles of implementation will be introduced and discussed inrelation to pressure ulcer guidelines. The model for implementation from Grol andWensing will be introduced and serve as a structure to implement better practices inhealth care.

Speakers: Lisette SchoonhovenJan Kottner

Date: 17 September 2015Time: 14:00 – 15:30Meeting room: Zaal Rector Vermeylen

KEY SESSION 10:

Interactive clinical case discussion• Pediatrics• General• Rehabilitation• Geriatrics• ICU

Date: 18 September 2015Time: 10:45 – 12:15Meeting room: Refter Hall


20

KEY SESSION OVEVIEW

WEDNESDAY 16. 09. 2015Refter Refter Hall (ground level)

10:15 – 11:15 KEY SESSION 1:Ethics, accountability and health economics in pressure ulcers

12:30 – 14:00 KEY SESSION 2:An update of pressure ulcer basic sciences

14:45 – 15:30 KEY SESSION 3:Pressure ulcer treatment – beyond basics

THURSDAY 17. 09. 2015Refter Refter Hall (ground level)

09:30 – 10:30 KEY SESSION 4:EPUAP book preview

11:00 – 12:00 KEY SESSION 6:The EPUAP Awards 2015

12:00 – 12:30 EPUAP INITIATIVES14:00 – 15:30 KEY SESSION 7:

The organisation of pressure ulcer care – best practices and leadership16:00 – 17:15 KEY SESSION 8:

Risk factors for pressure ulcer development in specific patients groups – science meets practice

Zaal Rector Vermeylen (1st level)

09:30 – 10:00 KEY SESSION 5:EWMA – EPUAP Session: Infection management in pressure ulcer treatment: new insights andevolutions

16:00 – 17:30 EPUAP 2015 Quality Improvement Awards:Preventing Skin Breakdown Projects: Tips and tricks from 5 quality improvement stories

FRIDAY 18. 09. 2015Refter Refter Hall (ground level)

09:00 – 10:00 KEY SESSION 9:Pressure ulcer management: Innovative approaches need to go hand in hand with basic care

10:45 – 12:15 KEY SESSION 10:Interactive clinical case discussions


KEY SESSIONS PRESENTATIONS

21

ASS

ESSI

NG

TH

E SE

VERI

TY O

F PR

ESSU

RE U

LCER

S:U

NST

AG

EABL

E/U

NG

RAD

EABL

E PR

OJE

CT

Caro

l Dea

ley1

1 U

nive

rsity

Hos

pita

l Birm

ingh

am N

HS

Foun

datio

n Tr

ust a

nd U

nive

rsity

of B

irmin

gham

, Uni

ted

King

dom

Intr

oduc

tion

: Th

e ai

m o

f thi

s aud

it w

as to

col

lect

info

rmat

ion

on th

e ou

tcom

e fo

r uns

tage

able

pre

ssur

e ul

cers

(PU

). In

par

ticul

arit

wou

ld d

emon

stra

te to

com

mis

sion

ers

the

impo

rtan

ce o

f acc

urat

e re

port

ing.

Met

hods

: D

ata

wer

e co

llect

ed o

ver a

9 m

onth

per

iod.

Info

rmat

ion

on p

ositi

on o

f PU

s, th

eir w

eekl

y pr

ogre

ss a

nd fi

nal o

utco

me

was

reco

rded

. Int

eres

ted

TVN

s ind

icat

ed th

eir i

nter

est v

ia th

e Ti

ssue

Via

bilit

y So

ciet

y w

ebsi

te a

nd w

ere

give

n de

tails

on h

ow to

regi

ster

thei

r pat

ient

s. Th

is a

lso

enab

led

regu

lar g

roup

em

ails

to b

e se

nt o

ut e

ncou

ragi

ng o

ngoi

ng d

ata

colle

ctio

n. It

was

hop

ed to

col

lect

dat

a on

100

pat

ient

s

Resu

lts:

By th

e en

d of

the

audi

t 56

patie

nts

had

been

regi

ster

ed a

nd fo

llow

up

data

col

lect

ed o

n 44

and

full

data

on

only

36 p

atie

nts.

At t

he e

nd o

f the

ass

essm

ent p

erio

d th

e fin

al c

lass

ifica

tion

of o

rigin

ally

uns

tage

able

PU

was

: int

act

skin

: 1 (2

.3%

); ca

tego

ry 2

: 1 (2

.3%

); Ca

tego

ry 3

: 17

(38.

6%);

Cate

gory

4: 8

(18.

2%);

unst

agea

ble:

17

(38.

6%).

A M

ann

Whi

tney

test

show

ed th

ere

was

no

sign

ifica

nt d

iffer

ence

bet

wee

n st

agea

ble

and

unst

agea

ble

ulce

rs (p

=0.1

3) w

ithre

spec

t to

the

num

ber o

f day

s ob

serv

ed.

Dis

cuss

ions

: W

e ha

d ex

pect

ed t

hat

it m

ight

tak

e so

me

time

to d

eter

min

e th

e ac

tual

cat

egor

y of

the

PU

thi

s w

as c

erta

inly

confi

rmed

by

the

audi

t with

39%

(17/

44) b

eing

stil

l uns

tage

able

/ung

rade

able

at t

he e

nd o

f the

per

iod

of d

ata

colle

ctio

n w

hich

rang

ed b

etw

een

0-16

7 da

ys.

Clin

ical

rele

vanc

e:

In th

e lig

ht o

f the

find

ings

of t

his

audi

t usi

ng th

e ca

tego

ry u

nsta

geab

le/u

ngra

deab

le m

ay b

e a

usef

ul a

dditi

on to

PU m

onito

ring

sche

mes

.

KS1

/2H

EALT

H E

CON

OM

ICS

AN

D P

RESS

URE

ULC

ERS:

IMPO

RTA

NCE

, MET

HO

DS

AN

D R

EFLE

CTI

ON

SLi

even

Ann

eman

s1

1 Pr

ofes

sor o

f Hea

lth E

cono

mic

s, G

hent

Uni

vers

ity, F

acul

ty o

f Med

icin

e, d

epar

tmen

t of p

ublic

hea

lth,

Ghe

nt, B

elgi

um

The

confl

ict

betw

een

wha

t so

ciet

ies

are

able

to p

ay fo

r hea

lth c

are

and

the

popu

latio

n’s

need

for h

igh

qual

ityhe

alth

car

e is

stil

l inc

reas

ing.

Hea

lth e

cono

mic

s ai

ms

to fi

nd t

he b

est

poss

ible

way

to s

pend

the

ava

ilabl

e fin

anci

al m

eans

. In

orde

r to

appl

yec

onom

ic th

inki

ng to

hea

lthca

re, o

ne sh

ould

vie

w th

e he

alth

sect

or a

s a p

rodu

ctiv

e se

ctor

who

se a

im is

to p

rodu

cehe

alth

, by

ensu

ring

that

peo

ple

live

long

er a

nd/o

r mor

e he

alth

ily. P

riorit

y m

ust b

e gi

ven

to th

ose

inte

rven

tions

(bot

h pr

even

tive

and

cura

tive)

whi

ch r

esul

t in

the

gre

ates

t am

ount

of h

ealth

for

the

mon

ey t

hat

is in

vest

ed.

Inte

rven

tions

with

a g

ood

ratio

bet

wee

n th

e in

vest

ed m

oney

and

the

resu

lting

hea

lth o

utco

me

are

calle

d co

st-

effec

tive.

In h

ealth

eco

nom

ic e

valu

atio

ns, t

he n

et c

osts

of a

n in

vest

men

t (e.

g. p

reve

ntio

n of

pre

ssur

e ul

cers

) are

calc

ulat

ed in

com

paris

on to

not

und

erta

king

the

inve

stm

ent,

and

the

ratio

bet

wee

n th

ese

net c

osts

and

the

net

heal

th b

enefi

ts is

then

ass

esse

d.

In th

e EU

this

con

cept

of c

ost-

effec

tiven

ess

is g

aini

ng m

ore

and

mor

e in

tere

st a

nd h

as a

n in

crea

sing

influ

ence

inde

cisi

ons

on a

lloca

tion

of h

ealth

car

e bu

dget

s.

Ove

r the

pas

t yea

rs a

n in

crea

sing

num

ber o

f hea

lth e

cono

mic

stud

ies h

ave

been

per

form

ed a

nd p

ublis

hed

in th

ear

ea o

f pre

ssur

e ul

cers

. The

lect

ure

disc

usse

s th

e ne

ed fo

r suc

h st

udie

s as

wel

l as

the

met

hodo

logi

cal c

halle

nges

,su

ch a

s un

cert

aint

y, d

iffer

ence

s in

per

spec

tive

and

time

horiz

on o

f the

ana

lysi

s.

KS1

/1



22

PRES

SURE

IND

UCE

D D

EEP

TISS

UE

INJU

RY E

XPLA

INED

Cees

Oom

ens1

1Ei

ndho

ven

Uni

vers

ity o

f Tec

hnol

ogy,

The

Net

herla

nds

Intr

oduc

tion

: Tr

aditi

onal

ly p

ress

ure

ulce

rs w

ere

cons

ider

ed to

resu

lt fr

om p

rolo

nged

isch

aem

ia. I

ndee

d w

hen

exte

rnal

load

soc

clud

e bl

ood

vess

els,

tissu

e is

dep

rived

of o

xyge

n an

d w

aste

pro

duct

s ca

nnot

be

rem

oved

. Thi

s w

ill e

vent

ually

lead

to c

ell d

eath

. Im

paire

d in

ters

titia

l flui

d flo

w a

nd ly

mph

atic

dra

inag

e co

ntrib

ute

to th

e pr

oble

m a

nd re

perf

usio

nin

jury

mig

ht a

ggra

vate

the

prob

lem

whe

n th

e bl

ood

stre

am is

rest

ored

. How

ever

, the

se m

echa

nism

s do

not

fully

expl

ain

why

sev

ere

wou

nds,

oft

en w

ith a

vas

t un

derm

inin

g of

inta

ct s

kin,

may

dev

elop

ver

y fa

st. T

hese

dee

pw

ound

s of

ten

foun

d ov

er b

ony

prom

inen

ces

are

curr

ently

kno

wn

as p

ress

ure

indu

ced

Dee

p Ti

ssue

Inju

ry (D

TI).

The

rese

arch

in E

indh

oven

was

aim

ed a

t und

erst

andi

ng h

ow D

TI d

evel

ops

and

alth

ough

it is

kno

wn

that

fat a

sw

ell a

s m

uscl

e tis

sue

can

be im

plic

ated

in th

e ov

eral

l dam

age

proc

ess

the

focu

s w

as o

n sk

elet

al m

uscl

e. A

revi

ewof

the

curr

ent k

now

ledg

e ba

se w

ill b

e pr

esen

ted.

Met

hods

: A

mul

ti-sc

ale

appr

oach

usi

ng m

odel

sys

tem

s ra

ngin

g fr

om s

ingl

e ce

lls in

cul

ture

, tis

sue

engi

neer

ed m

uscl

e to

anim

al st

udie

s with

smal

l ani

mal

s was

use

d. In

all

mod

el sy

stem

s a c

ontr

olle

d m

echa

nica

l loa

d w

as a

pplie

d to

cel

lsor

tis

sues

and

the

effe

ct o

f tha

t lo

ad o

n th

e ce

ll or

tis

sue

resp

onse

was

mea

sure

d. In

ord

er t

o de

term

ine

the

hete

roge

neou

s int

erna

l mec

hani

cal s

tate

and

to in

terp

ret t

he e

xper

imen

tal d

ata,

the

intr

oduc

tion

of c

ompu

tatio

nal

mod

els

has

prov

ed in

valu

able

.

Resu

lts:

Th

is h

as le

d to

a c

lear

und

erst

andi

ng o

n tw

o da

mag

e m

echa

nism

s in

volv

ed in

the

dev

elop

men

t of

DTI

. Dire

ctde

form

atio

n da

mag

e re

sults

from

hig

h, b

ut p

hysi

olog

ical

ly re

leva

nt, s

trai

ns a

nd is

a p

roce

ss th

at le

ads

to th

e fir

stsi

gns o

f cel

l dam

age

in m

inut

es. I

scha

emic

dam

age

is c

ause

d by

occ

lusi

on o

f blo

od v

esse

ls, b

ut ta

kes s

ever

al h

ours

to d

evel

op.

Clin

ical

rele

vanc

e:La

rge

defo

rmat

ion

can

usua

lly b

e av

oide

d by

mea

ns o

f goo

d su

ppor

ting

surf

aces

and

aw

aren

ess f

.e. w

hen

patie

nts

are

mov

ed. I

scha

emic

dam

age

can

only

be

avoi

ded

by re

gula

r loa

d re

lieve

.

Refe

renc

es:

Oom

ens,

C.W

.J., B

ader

, D.L

., Lo

erak

ker,

S., B

aaije

ns, F

.P.T.

, Pre

ssur

e In

duce

d D

eep

Tiss

ue In

jury

Exp

lain

ed, A

nnal

s of

Biom

edic

al E

ngin

eerin

g ,4

3(2)

, 297

-305

, 201

5.

KS2

/1TH

E FU

TURE

OF

SUPP

ORT

SU

RFAC

ES A

ND

TEC

HN

OLO

GIE

SFO

R TI

SSU

E PR

OTE

CTI

ON

: WH

ERE

SHO

ULD

WE

GO

, AN

DW

HAT

SH

OU

LD W

E D

OAm

it G

efen

1

1Te

l Avi

v U

nive

rsity

The

futu

re o

f sup

port

sur

face

s an

d te

chno

logi

es fo

r tis

sue

prot

ectio

n: w

here

sho

uld

we

go, a

nd w

hat s

houl

d w

edo A

mit

Gef

en, P

hDPr

ofes

sor i

n Bi

omed

ical

Eng

inee

ring,

Dep

t. of

Bio

med

ical

Eng

inee

ring,

Fac

ulty

of E

ngin

eerin

g, Te

l Avi

v U

nive

rsity

,Te

l Avi

v 69

978,

Isra

el, E

-mai

l: ge

fen@

eng.

tau.

ac.il

Intr

oduc

tion

The

varie

ty o

f sup

port

sur

face

s is

con

fusi

ng e

ven

for t

he m

ost e

xper

ienc

ed c

linic

ians

. The

re a

re a

djus

tabl

e an

dno

n-ad

just

able

surf

aces

, and

pas

sive

ver

sus a

ctiv

e on

es, a

nd a

lso

com

bina

tions

. Non

-adj

usta

ble

surf

aces

are

sim

ple

and

the

leas

t exp

ensi

ve –

as i

n st

anda

rdis

ed h

ospi

tal f

oam

mat

tres

ses o

r whe

elch

air c

ushi

ons,

but t

hey

cann

ot b

e“fi

ne-t

uned

” to

adeq

uate

ly im

mer

se a

nd e

nvel

op t

he w

ide

varie

ty o

f pat

ient

bod

y ty

pes.

Adj

usta

ble

supp

orts

,pa

rtic

ular

ly a

ir-ce

ll-ba

sed

(ACB

) sup

port

s off

er s

uper

ior i

mm

ersi

on a

nd e

nvel

opm

ent w

hich

alle

viat

es lo

calis

edin

tern

al ti

ssue

load

s –

the

prim

ary

caus

e of

dee

p tis

sue

inju

ries.

Add

ition

al, c

ompl

emen

tary

pro

tect

ion

can

bepr

ovid

ed b

y m

eans

of s

peci

al d

ress

ings

on

vuln

erab

le b

ody

site

s to

furt

her r

educ

e in

tern

al ti

ssue

load

s.

Met

hods

Fi

nite

ele

men

t (F

E) m

odel

ling

is p

ower

ful

in e

valu

atin

g in

tern

al t

issu

e lo

ads

and

isol

atin

g th

e in

fluen

ce o

fbi

omec

hani

cal c

hara

cter

istic

s fro

m o

ther

pot

entia

l ris

k fa

ctor

s e.g

. im

paire

d ci

rcul

atio

n or

tiss

ue re

pair

capa

citie

s.Th

e us

e of

FE

in d

esig

n of

ort

hopa

edic

impl

ants

and

car

diov

ascu

lar d

evic

es h

as p

rove

n su

cces

sful

for m

any

year

s,an

d th

e w

ound

pre

vent

ion

indu

stry

is n

ow a

dopt

ing

FE fo

r eva

luat

ing

and

impr

ovin

g p

erfo

rman

ces

of s

uppo

rts

and

prop

hyla

ctic

dre

ssin

gs.

Resu

lts

Usi

ng F

E m

odel

ling,

imm

ersi

on a

nd e

nvel

opm

ent a

s w

ell a

s ad

just

abili

ty w

ere

iden

tified

as

key

feat

ures

of g

ood

supp

orts

. For

exa

mpl

e, A

CB c

ushi

ons p

rovi

ded

subs

tant

ially

gre

ater

imm

ersi

on a

nd h

ence

4 o

rder

s-of

-mag

nitu

delo

wer

mus

cle,

fat,

and

skin

tiss

ue st

ress

es c

ompa

red

to fl

at fo

am c

ushi

ons [

1]. T

he A

CB sy

stem

als

o pr

ovid

ed b

ette

rpr

otec

tion

agai

nst d

isus

e-re

late

d bo

ne sh

ape

adap

tatio

n, m

uscl

e at

roph

y, m

uscl

e sp

asm

s and

scar

s [1,

2]. L

ikew

ise,

use

of m

ulti-

laye

r hee

l dre

ssin

gs w

as s

how

n to

sub

stan

tially

redu

ce in

tern

al ti

ssue

load

s [3

]. D

iscu

ssio

n Th

e ab

ove

exam

ples

dep

ict t

wo

impo

rtan

t phe

nom

ena:

(1) g

row

ing

use

of F

E to

eva

luat

e bi

omec

hani

cal

effica

cies

of s

uppo

rts

and

(2) e

mph

asis

on

inte

rnal

tiss

ue lo

ads

as th

e m

easu

re o

f the

risk

for p

ress

ure

ulce

rs a

ndde

ep ti

ssue

inju

ries.

Clin

ical

Rel

evan

ce

The

futu

re h

olds

a p

rom

ise

for i

nteg

rativ

e 'p

ress

ure

ulce

r pro

tect

ion'

sol

utio

ns th

at w

ill e

ncom

pass

the

adeq

uate

supp

ort f

or th

e cl

ient

and

pos

sibl

e ad

ditio

nal u

se o

f dre

ssin

gs to

furt

her p

rote

ct ti

ssue

s at

spe

cific

site

s, ba

sed

onris

k as

sess

men

t of t

he in

divi

dual

.

Refe

renc

es[1

] Le

vy A

, Kop

plin

K, G

efen

A. J

Reh

abil

Res D

ev. 2

014;

51(8

):129

7-31

9.

[2]

Levy

A, K

oppl

in K

, Gef

en A

. J T

issu

e Vi

abili

ty. 2

014;

23(1

):13-

23.

[3]

Levy

A, F

rank

MB,

Gef

en A

. J T

issu

e Vi

abili

ty. 2

015;

24(1

):1-1

1.

KS2

/2



23

WO

UN

D H

EALI

NG

AN

D A

NG

IOG

ENES

ISLi

esbe

t Ger

is1

1 Bi

omec

hani

cs R

esea

rch

Uni

t, U

nive

rsity

of L

iège

, Bel

gium

Biom

echa

nics

Sec

tion,

KU

Leuv

en, B

elgi

umPr

omet

heus

, div

isio

n fo

r Ske

leta

l Tis

sue

Engi

neer

ing,

KU

Leuv

en, B

elgi

um

Intr

oduc

tion

: W

ound

hea

ling

is a

wel

l-org

anis

ed n

atur

al re

pair

proc

esse

s in

itiat

ed b

y tr

aum

a. T

his

repa

ir pr

oces

s co

vers

man

ytim

e an

d le

ngth

sca

le, r

angi

ng fr

om th

e su

bcel

lula

r lev

el u

p to

the

orga

n an

d ev

en s

yste

ms

leve

l. Pr

ogre

ss h

asbe

en m

ade

in d

escr

ibin

g an

d un

ders

tand

ing

wou

nd h

ealin

g at

eac

h of

thes

e di

ffere

nt le

vels

but

muc

h re

mai

ns to

be fo

und

out a

t the

diff

eren

t lev

els a

nd m

ost c

erta

inly

at t

he in

tera

ctio

n be

twee

n th

e di

ffere

nt le

vels

. D

urin

g th

ela

st d

ecad

es, m

any

mat

hem

atic

al m

odel

s ha

ve b

een

esta

blis

hed

to in

vest

igat

e as

pect

s of

the

repa

ir pr

oces

s in

anu

mer

ical

way

(in

silic

o), i

n ad

ditio

n to

ong

oing

exp

erim

enta

l wor

k.

Clin

ical

rele

vanc

e:

In re

cent

day

s, th

e fo

cus

of th

e m

athe

mat

ical

mod

els

has

shift

ed fr

om s

imul

atio

n of

the

heal

ing

proc

ess

tow

ards

sim

ulat

ion

of th

e im

paire

d he

alin

g pr

oces

s an

d th

e in

sili

co d

esig

n of

trea

tmen

t str

ateg

ies.

Dis

cuss

ions

: In

this

talk

I w

ill d

iscu

ss a

num

ber o

f exa

mpl

es o

f suc

h st

udie

s inv

olvi

ng c

ompu

tatio

nal m

odel

s. S

peci

al a

tten

tion

will

be

paid

to th

e pr

oces

s of a

ngio

gene

sis,

its im

port

ance

for w

ound

hea

ling

and

less

ons t

hat c

an b

e le

arne

d fr

omst

udyi

ng it

s ro

le in

oth

er re

gene

rativ

e an

d di

seas

e pr

oces

ses.

Refe

renc

es:

Ger

is L

., Sc

huga

rt R

., Va

n O

oste

rwyc

k H

. In

silic

o de

sign

of t

reat

men

t str

ateg

ies i

n w

ound

hea

ling

and

bone

frac

ture

heal

ing.

Phi

l. Tr

ans.

R. S

oc. A

(201

0) 3

68, 2

683–

2706

. doi

:10.

1098

/rst

a.20

10.0

056

KS2

/4BI

OM

ECH

AN

ICA

L M

OD

ELLI

NG

TO

PRE

VEN

T IS

CHIA

L A

ND

FOO

T PR

ESSU

RE U

LCER

SYo

han

Paya

n1

1 U

niv.

Gre

nobl

e Al

pes,

TIM

C-IM

AG, F

-380

00 G

reno

ble,

Fra

nce;

CN

RS, T

IMC-

IMAG

, F-3

8000

Gre

nobl

e, F

ranc

eYo

han.

Paya

n@im

ag.fr

Intr

oduc

tion

: M

easu

ring

surf

ace

pres

sure

s ca

n he

lp in

ale

rtin

g us

ers

agai

nst s

kin

inju

ries

(Pip

kin

and

Sprig

le, 2

008)

, but

thes

em

easu

rem

ents

can

not p

redi

ct d

ange

rous

inte

rnal

tiss

ue s

trai

ns (L

inde

r-G

anz

et a

l., 2

008)

resp

onsi

ble

for m

ost o

fth

e de

ep p

ress

ure

ulce

rs.

Met

hods

: To

qua

ntita

tivel

y es

timat

e th

e in

tern

al st

rain

s fro

m th

e in

terf

ace

pres

sure

s whi

le ta

king

into

acc

ount

the

anat

omic

alva

riabi

lity,

it is

nee

ded

(i) to

bui

ld a

pat

ient

-spe

cific

bio

mec

hani

cal m

odel

of t

he so

ft ti

ssue

s/bo

ny p

rom

inen

ce a

nd(ii

) to

use

this

num

eric

al m

odel

to c

ompu

te th

e in

tern

al s

trai

ns (E

lsne

r and

Gef

en, 2

008

; Loe

rakk

er e

t al.,

201

1 ;

Lubo

z et

al.,

201

4 &

201

5).

Resu

lts:

D

urin

g th

is in

vite

d le

ctur

e, I

will

rev

iew

the

mos

t re

cent

sim

ulat

ions

pro

vide

d by

our

gro

up a

s co

ncer

ns t

hees

timat

ions

of i

nter

nal s

trai

ns fo

r pat

ient

-spe

cific

ana

tom

ies

of th

e fo

ot, t

he h

eel/c

alf a

nd th

e bu

ttoc

ks.

Dis

cuss

ions

: W

e ha

ve p

ropo

sed

to lo

ok a

t wha

t we

call

“clu

ster

s” o

f max

imal

str

ains

, i.e

. vol

umes

of c

once

ntra

ted

high

str

ains

.Su

ch c

lust

ers

shou

ld h

elp

us to

iden

tify

whe

re a

re lo

caliz

ed th

e ris

ks fo

r pre

ssur

e ul

cers

.

Clin

ical

rele

vanc

e:

The

clin

ical

rele

vanc

e is

obv

ious

: unl

ess u

sabl

ebi

omar

kers

are

dis

cove

red

in t

he fu

ture

, we

have

no

ot

her

choi

ce

than

us

ing

abi

omec

hani

cal

mod

el t

o es

timat

e in

tern

alst

rain

s w

ith

the

corr

espo

ndin

g ris

ks

for

pres

sure

ulc

ers.

Figu

re 1

: Fin

ite E

lem

ent m

odel

of t

he b

utto

cks

(top)

with

the

estim

atio

n of

the

inte

rnal

stra

ins

(ε) c

lust

ers

(dow

n), f

rom

Lub

oz e

t al.,

201

4

Refe

renc

es:

Elsn

er, J

.J., a

nd G

efen

, A.,

2008

. Is o

besi

ty a

risk

fact

or fo

r dee

p tis

sue

inju

ry in

pat

ient

s with

spin

al co

rd in

jury

? Jou

rnal

of B

iom

echa

nics

,41

:332

2–33

31.

Lind

er-G

anz,

E.,

Shab

shin

, N.,

Itzch

ak, Y

., Yi

zhar

,Z.

, Sie

v-N

er, I

., an

d G

efen

, A.,

2008

. Str

ains

and

stre

sses

in su

b-de

rmal

tiss

ues o

f the

but

tock

sar

e gr

eate

r in

para

pleg

ics t

han

in h

ealth

ydu

ring

sitt

ing.

Jour

nal o

f Bio

mec

hani

cs, 4

1:56

7–58

0.Lo

erak

ker,

S., M

ande

rs, E

., St

rijke

rs, G

.J., N

icol

ay, K

., Ba

aije

ns, F

.P.T.

, Bad

er, D

.L.,

Oom

ens,

C.W

.J., 2

011.

The

effe

cts o

fde

form

atio

n, is

chae

mia

and

repe

rfus

ion

on th

e de

velo

pmen

t of m

uscl

e da

mag

e du

ring

prol

onge

d lo

adin

g. Jo

urna

l of

Appl

ied

Phys

iolo

gy, 1

11(4

): 11

68-1

177.

Lubo

z V.,

Petr

izel

li M

., Bu

cki M

., D

iot B

., Vu

iller

me

N. &

Pay

an Y

., 20

14. B

iom

echa

nica

l Mod

elin

g to

Pre

vent

Isch

ial

Pres

sure

Ulc

ers.

Jour

nal o

f Bio

mec

hani

cs, V

ol. 4

7, p

p. 2

231-

2236

.Lu

boz V

., Pe

rrie

r A.,

Buck

i M.,

Dio

t B.,

Cann

ard

F., V

uille

rme

N. &

Pay

an Y

., 20

15. I

nflue

nce

of th

e ca

lcan

eus s

hape

on

the

risk

of p

oste

rior h

eel u

lcer

usi

ng 3

D p

atie

nt-s

peci

fic b

iom

echa

nica

l mod

elin

g. A

nnal

s of B

iom

edic

al E

ngin

eerin

g, V

ol.

43(2

), pp

. 325

-335

.Pi

pkin

, L.,

and

Sprig

le, S

., 20

08. E

ffect

of m

odel

des

ign,

cus

hion

cons

truc

tion,

and

inte

rfac

e pr

essu

re m

ats o

n in

terf

ace

pres

sure

and

imm

ersi

on. J

ourn

al o

f Reh

abili

tatio

n Re

sear

ch &

Dev

elop

men

t, 45

:875

–882

.

KS2

/3



24

TACK

LIN

G B

IOFI

LMS

AN

D IN

FEC

TED

PRE

SSU

RE U

LCER

TREA

TMEN

TRo

n Le

gers

tee1

1Pe

@r R

evie

w

Intr

oduc

tion

: Th

e de

velo

pmen

t of a

pre

ssur

e ul

cer i

s con

tiguo

us b

y na

ture

(i.e

. the

mus

cle

beco

mes

dam

aged

and

nec

rotic

and

if th

e tis

sue

is n

ot re

lieve

d fr

om p

ress

ure,

the

next

adj

acen

t tis

sue

will

be

dam

aged

and

bec

ome

necr

otic

and

so

on) S

imila

rly, t

he fo

rmat

ion

of m

icro

bial

bio

film

s on

any

(moi

st) b

iolo

gica

l sub

stra

te is

a (b

io-)l

ogic

al c

onse

quen

ceof

wha

t oc

curr

ed p

revi

ousl

y1. B

acte

ria fi

nd t

heir

way

to

dam

aged

tis

sue

beca

use

they

“sen

se” t

he s

ubst

ance

spr

oduc

ed b

y da

mag

ed t

issu

e. M

any

mic

robi

al s

peci

es a

re e

quip

ped

with

pili

, fim

bria

e an

d/or

flag

ella

. The

sest

ruct

ures

are

use

d to

com

mun

icat

e am

ongs

t and

bet

wee

n sp

ecie

s or

mov

e th

e ba

cter

ia to

pla

ces

of in

tere

st. I

fth

e ci

rcum

stan

ces a

re su

itabl

e, se

vera

l spe

cies

, pre

sent

in a

wou

nd, c

an “t

eam

up”

and

mak

e lif

e m

ore

com

fort

able

for t

hem

selv

es, b

ut le

ss s

o fo

r the

hos

t2,3

. The

mic

robi

al a

ctiv

ities

in a

bio

film

rese

mbl

es th

at o

f a m

ulti-

cellu

lar

orga

nism

. A te

rm o

nce

men

tione

d: “s

lime

city

”4 s

eem

s qu

ite a

pt.

Met

hods

: In

vite

d le

ctur

e is

a p

rese

ntat

ion

of c

urre

nt k

now

ledg

e in

the

topi

c of

bio

film

s an

d in

fect

ion

in p

ress

ure

ulce

rs

Dis

cuss

ions

: If

the

patie

nt h

as th

e rig

ht to

NO

T de

velo

p a

pres

sure

ulc

er, t

hen

a pr

essu

re u

lcer

has

the

right

to N

OT

beco

me

infe

cted

, and

an

infe

cted

pre

ssur

e ul

cer h

as th

e rig

ht to

NO

T be

com

e co

mpl

icat

ed b

y bi

ofilm

form

atio

nCl

inic

al re

leva

nce:

Alth

ough

not

read

ily v

isib

le, b

iofil

ms

can

play

an

impo

rtan

t rol

e in

kee

ping

the

pres

sure

ulc

erfr

om h

ealin

g

Refe

renc

es:

1W

ilson

, 200

5, M

icro

bial

Inha

bita

nts o

f Hum

ans -

thei

r eco

logy

and

role

in h

ealth

and

dis

ease

, Ca

mbr

idge

Uni

vers

ity P

ress

,2

Perc

ival

, S.L

. & C

uttin

g, K

.F., 2

010,

Mic

robi

olog

y of

wou

nds,

CRC

Pres

s, Bo

ca R

aton

, Fl

3Co

oper

, R.A

., Bj

arns

holt,

T. &

Alh

ede,

M.,

2014

, Bio

film

s in

wou

nds:

a re

view

of p

rese

nt k

now

ledg

e, Jo

urna

l of

wou

nd ca

re, 2

3(11

), pp

. 570

, 572

-4, 5

76-8

0 pa

ssim

4

Cogh

lan

A 19

96, S

lime

City

: Chi

c, u

rban

e, so

phis

ticat

ed a

nd so

met

imes

dea

dly-

such

are

the

inha

bita

nts o

f the

wor

ld's

wei

rdes

t met

ropo

lis, N

ew S

cien

tist,

pp. 3

2-6”

KS3

/1TH

E A

SSO

CIAT

ION

BET

WEE

N M

ICRO

CLIM

ATE

AN

DPR

ESSU

RE U

LCER

DEV

ELO

PMEN

TJa

n Ko

ttne

r1

1Ch

arité

-Uni

vers

itäts

med

izin

Ber

lin, G

erm

any

Intr

oduc

tion

:M

icro

clim

ate

can

be d

efine

d as

a c

limat

e in

a lo

cal r

egio

n th

at d

iffer

s fr

om th

e cl

imat

e in

the

surr

ound

ing

regi

on.

In t

he c

onte

xt o

f sk

in a

nd t

issu

e in

tegr

ity,

the

clim

ate

clos

e to

the

ski

n su

rfac

e is

rel

evan

t. Th

e de

finin

gch

arac

teris

tics

are

tem

pera

ture

, hum

idity

and

airfl

ow.

Met

hods

: Th

e fa

ctor

s sk

in t

empe

ratu

re, h

umid

ity a

nd a

ir flo

w a

re c

hara

cter

ized

and

the

rel

evan

ce f

or p

ress

ure

ulce

rde

velo

pmen

t is

expl

aine

d.

Resu

lts:

D

urin

g an

d af

ter l

oadi

ng sk

in te

mpe

ratu

re in

crea

ses d

ue to

(par

tly) o

cclu

sion

and

cha

nges

in b

lood

flow

. Inc

reas

edte

mpe

ratu

re s

eem

s to

redu

ce th

e co

hesi

ve s

tren

gths

of t

he s

trat

um c

orne

um, o

f the

der

mo-

epid

erm

al ju

nctio

nan

d ot

her c

utan

eous

str

uctu

res.

Incr

ease

d sk

in s

urfa

ce h

umid

ity a

nd p

rolo

nged

con

tact

to ‘f

ree’

wat

er (w

etne

ss)

wea

kens

the

stra

tum

cor

neum

, inc

reas

es th

e ep

ider

mal

abs

orpt

ion

of p

ossi

ble

irrita

nts a

nd in

crea

ses t

he c

oeffi

cien

tof

fric

tion.

Bes

ides

ele

vate

d sh

ear s

tres

ses d

urin

g lo

adin

g in

dee

per t

issu

es, e

pide

rmal

bar

rier i

mpa

irmen

ts in

crea

seth

e ris

k fo

r infl

amm

atio

n an

d su

bseq

uent

ero

sion

s.

Dis

cuss

ions

: Th

ere

are

clea

r ass

ocia

tions

bet

wee

n th

e m

icro

clim

ate

prop

ertie

s tem

pera

ture

, hum

idity

, and

airfl

ow a

nd p

ress

ure

ulce

r ris

k. W

hen

cons

ider

ing

the

skin

are

a, d

urat

ion

and

inte

nsity

of l

oadi

ng a

nd o

ther

fact

ors

(e.g

. age

, dis

ease

)th

ese

asso

ciat

ions

are

com

plex

. Mic

rocl

imat

e pr

oper

ties

do n

ot a

ffect

the

skin

onl

y, b

ut a

lso

deep

er ti

ssue

s (e

.g.

heat

tran

sfer

).

Clin

ical

rele

vanc

e:

It is

reco

mm

ende

d to

kee

p th

e sk

in d

ry, a

void

loca

l war

min

g an

d oc

clus

ive

cond

ition

s. O

n th

e ot

her h

and,

ski

nbe

ing

too

dry

(xer

osis

cut

is) o

r too

coo

l is a

lso

at in

crea

sed

risk

to b

reak

-dow

n. T

hus,

an o

ptim

al b

alan

ce is

nee

ded

betw

een

both

ext

rem

es. A

ppro

pria

te s

kin

Publikace EPUAP 2015.qxp katalog velkż · 2020. 3. 17. · Publikace EPUAP 2015.qxp_katalog velký...

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Transcript of Publikace EPUAP 2015.qxp katalog velkż · 2020. 3. 17. · Publikace EPUAP 2015.qxp_katalog velký...