editorial
SECURE-ing device-related
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ISSN 0969-0700
Printed by Pensord Press Ltd,
Blackwood, NP12 2YA
pressure ulcer prevention
T
hank goodness January is finally over. Following the
Christmas break, January is the longest and bleakest month
of the year. Well it certainly feels that way, at least.
However, in that month we have been extremely busy
putting the final touches to a major new Journal of Wound
Care (JWC) consensus document, Device related pressure ulcers: SECURE
prevention.1 This has been a lengthy project, with the panel meeting
nearly a year ago, but with such an important area having little
guidance available it was critical we got this right.
The Panel Chair and JWC editorial board member, Amit Gefen,
explains in the foreword to the document that ‘greater awareness of
device-related pressure ulcers (DRPU) will lead to better adoption of
prevention protocols and much-needed new designs and technologies.’1
This leads me to the question of what is a DRPU? When the panel
convened, the subject of debate was medical-device related pressure Rachel Webb
PhD,
ulcers (MDRPU). However, very early on the discussion turned to other
Editor Journal of Wound Care
objects that can equally lead to a pressure ulcer. So along with the
medical devices that usually spring to mind when we think of MDRPU,
such as respiratory devices and feeding and nutrition tubes, health
professionals should also be aware of mobile/cell phones, jewellery, hearing aids,
glasses and remote controls. The panel defined a DRPU as:
‘A DRPU involves interaction with a device or object that is in direct or indirect contact
with skin ... or implanted under the skin, causing focal and localised forces that deform
the superficial and deep underlying tissues. A DRPU, which is caused by a device or
object, is distinct from a [pressure ulcer], which is caused primarily by body weight
forces. The localised nature of device forces results in the appearance of skin and deeper
tissue damage that mimics that of the device in shape and distribution.’1
The document discusses the devices associated with DRPUs and the biomechanical
reasons for the risks. A key aim of the panel was defining a mnemonic to aid in the
prevention of DRPU prevention, SECURE:
Skin/tissue: thorough assessment, daily or more frequently according to risk
Education: educate health professionals, the patient, carers, family and industry
Champion/collaborate: lead the adoption of evidence-based devices developed
through collaboration with manufacturers and health professionals
Understanding: develop a thorough understanding of the causes of DRPU,
patient assessment and correct product use
Report: ensure that DRPU are correctly reported in a timely manner
Evaluate: devices for their ability to minimise DRPU using support data and
conducting clinical evaluations.
Another innovative element of the panel’s work is the evaluation of engineering
concepts, and technologies can be used to protect the skin and deeper tissues and
assess if the tissue damage can be reversed. It also outlines strategies for changing the
mindsets of health professionals and policy-makers on the need for DRPU prevention,
including how to increase global awareness about its root causes and the scale of the
problem. The document is free to download from the JWC website and we will
have hard copies at WUWHS 2020 and many other conferences throughout the
year. It’s a must read! JWC
1 Gefen A, Alves P, Ciprandi G et al. Device related pressure ulcers: SECURE prevention. J Wound Care
2020; 29(Sup2a): S1–S52 https://doi.org/10.12968/jowc.2020.29.Sup2a.S1
JOURNAL OF WOUND CARE VOL 29, NO 2, FEBRUARY 2020 77
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