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From Decubitus and Pressure Ulcers to Pressure Injuries

Ayello, Elizabeth A., PhD, RN, CWON, ETN, MAPWCA, FAAN; Sibbald, R. Gary, MD, DSc (Hons), MEd, BSc, FRCPC (Med Derm), FAAD, MAPWCA, JM

Advances in Skin & Wound Care: March 2019 - Volume 32 - Issue 3 - p 101
doi: 10.1097/01.ASW.0000553114.57290.be
DEPARTMENTS: EDITORIAL
Free

Elizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAAN, is the co–Editor-in-Chief of Advances in Skin & Wound Care; Faculty, Excelsior College School of Nursing, Albany, New York; President, World Council of Enterostomal Therapists; President, Ayello Harris & Associates, Inc, Copake, New York; and President (1999), National Pressure Ulcer Advisory Panel. R. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med Derm), FAAD, MAPWCA, JM, is the co–Editor-in-Chief of Advances in Skin & Wound Care; Professor, Medicine and Public Health, University of Toronto, Toronto, Ontario, Canada; Director, International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care), Dalla Lana Faculty of Public Health, University of Toronto; and President (2008-2012), World Union of Wound Healing Societies.

Thirty-two years ago, the first issue of Decubitus (February 1988) was published. The founding editor, Dr Roberta Abruzzese, believed that the journal would be “a compendium of prevention and treatment of pressure ulcers.”1 Although the range of topics we cover has expanded significantly, the new co–editors-in-chief thought it would be important to mark the start of our 32nd year with a themed issue focused on pressure injuries. It was difficult to choose from the many wonderful articles, but we hope you will enjoy the ones we have included.

Marcel Proust said, “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.”2 With that in mind, it was interesting to reread that first issue and ponder why the journal was named Decubitus. Why was this “outdated” term used instead of “pressure ulcer?” At the time, there were passionate clinicians on both sides of the terminology debate; arguments for both terms were made at professional conferences and in the early issues of the journal. Once again, there is dialogue about terminology, this time between “pressure ulcer” and “pressure injury.” The article by Dr Delmore and colleagues provides some data from the global community about this change.

Another topic that Dr Abruzzese broached in her inaugural editorial was the lack of an accepted standard for pressure injury staging.1 She wrote that the journal should be a forum to discuss staging issues. To this end, we have included a commentary by Dr Jeffrey Levine covering both historical and recent insights into pressure injury staging.

Our founding editor also emphasized the importance of preventing pressure injuries and urged healthcare professionals to “become more sophisticated in prevention.”1 Because medical devices are a risk factor for pressure injuries, we wanted to share with you information about the Braden QD scale. The Braden Q tool, developed by Quigley and Curley in 1996 for use in pediatrics, is now revised and includes medical devices as an assessable variable.3,4 Visit the website for more information about the new “Braden QD,” to obtain permission to use it in your practice5 and to download the form.6 The Braden QD scale is available in English and Finnish, with other language translations to come.

Another concept that Dr Abruzzese explored was pressure injury incidence. Therefore, an article on pressure injury prevalence in the vulnerable spinal cord injury population was chosen to be part of this special issue. You may be surprised by their conclusions!

Perhaps most critically, Dr Abruzzese stipulated that current topics should be included in the journal to stimulate comments, questions, and dialogue in our community. This month’s CME article is one example of this; we hope it will serve as a call to action for clinicians and professional organizations to further clarify concepts and terminology around skin changes at end of life.

We can only hope that revisiting these concepts and reflecting on our practice experience will foster new insights from the latest literature and research. We invite your opinions on this issue’s content through a reader survey: www.surveymonkey.com/r/ASWC2019. The survey will be open until June 30, 2019. We plan to publish the results in a future issue of the journal for all to read.

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Elizabeth A. Ayello, PhD, RN, CWON, ETN, MAPWCA, FAAN

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R. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med Derm), FAAD, MAPWCA, JM

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REFERENCES

1. Abruzzese R. Editorial. Decubitus 1988;1(1)7.
2. Brainyquote.com. Marcel Proust Quotes. www.brainyquote.com/quotes/marcel_proust_107111. Last accessed December 13, 2018.
3. Curley MAQ, Hasbani NR, Quigley SM, et al. Predicting pressure injury risk in pediatric patients; the Braden QD Scale. J Pediatrics 2018;192:189–95.
4. Chamblee TB, Pasel TA, Caillouette CN, et al. How to predict pediatric pressure injury risk with the Braden QD Scale. Am J Nurs 2018;118(11):34–43.
5. Curley MAQ, Hasbani NR, Quigley SM, et al. Braden QD Scale for assessment of immobility and device-related pressure ulcer risk in your pediatric population. www.marthaaqcurley.com/braden-qd.html. Last accessed December 13, 2018.
6. Curley MAQ. Braden QD form. www.marthaaqcurley.com/uploads/8/9/8/6/8986925/braden_qd_tool.pdf. Last accessed December 13, 2018.
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