EUROPEAN PRESSURE ULCER ADVISORY PANEL

As a rule in agriculture, the acts of planting seeds, then caring for and growing crops are followed by a harvest. The natural rhythm of this perpetual movement is, at least in biblical terms, seven years. EPUAP has now existed for five years and it looks like harvest time is coming! The Pisa conference attracted more than 750 delegates and for the next meeting in Le Mans there are expected to be over 1000 attendees. Exultate jubilate one should perhaps say, but some concerns must be addressed. Quantity may not reflect quality, and for the EPUAP we must ensure that organising larger and larger meetings also means offering high quality exciting presentations. The Le Mans meeting later this year will, in part, focus upon the ongoing reports of the various EPUAP working groups. There are currently four main groups, tackling the evaluation of support surfaces, developing a European-level pressure ulcer prevalence survey, investigating the outcomes of those patients with a fractured neck of femur and finally a group exploring the use and abuse of pressure ulcer risk assessment. The support surface group is concentrating upon aspects of the scientific evaluation of devices. Until now most studies report absolute pressure-relieving characteristics solely represented using tissue-interface pressure, whereas it is unclear that these specific measures best reflect the likely effect of a support surface where the presence of shearing forces and moisture could be as, if not more, important. To date these latter parameters have rarely been addressed in support surface studies.

Risk assessment is also a major area of interest in pressure ulcer care. Correct identification of risk has major health care resource implications, for example a recent cost-analysis study conducted in The Netherlands has yet again highlighted that significant costs are incurred if a patient is incorrectly identified as being at high risk and so receives preventive interventions needlessly. Risk assessment tools, if they are to survive, must reflect the true factors that predispose people to developing pressure ulcers. Prospective studies of these tools are under way at this time and these we hope will be reported during the Le Mans meeting. It is quite possible that these studies will change daily care drastically.

In short: the EPUAP’s harvest is coming, and this harvest will produce a good vintage.

Jeen Haalboom
President