Abstract
Pressure injuries are a serious risk for patients admitted to hospital and are thought to result from a number of forces operating on skin tissue (pressure, shear and friction). Most research on interface pressure (IP) has taken place using healthy volunteers or mannequins. Little is currently known about the relationship between pressure injury risk and IP for hospital patients.
This relationship was investigated with a sample of 121 adult hospital patients. Pressure injury risk was evaluated using the Waterlow Risk Assessment Tool (WRAT) and IP was measured at the sacrum using a Tekscan ClinSeat™ IP sensor mat. Other factors considered were body mass index (BMI), blood pressure, reason for hospital admission, comorbidities and admission route to hospital. Patients were classified according to WRAT categories (‘low risk’, ‘at risk’, ‘high risk’, ‘very high risk’) and then remained still on a standard hospital mattress for 10 minutes while IP was measured.
Participants in the ‘low risk’ group were significantly younger than all other groups (p<O.OO1) and there were some group differences in BMI. IP readings were compared between the ‘low risk’ group and all of the participants at greater risk. The ‘low risk’ group had significantly lower IP at the sacrum on a standard hospital mattress than those at greater risk (p=O.002). Those at greater risk tended to have IP readings at the low end of the compromised IP range.
This study is significant because it describes a new, clinically relevant methodology and presents findings that challenge clinician assumptions about the relationships between pressure injury risk assessment and IP.

Abstract
Many authors are questioning the need to cleanse every wound, yet despite limited investigation on the topic, wound cleansing can reach ceremonial proportions and remains an integral element of wound management. Recent systematic reviews have examined physiological elements of wound cleansing and concluded that few practices are able to be definitively supported or refuted. The results of several influential studies that have been inducted into wound cleansing legend are marred by poor methodology, raising questions about their conclusions. While many authors dismiss wound cleansing practices as ritualistic, few studies have considered how nurses actually cleanse wounds. No studies have yet examined the psychological, cultural and socioeconomic aspects of wound cleansing and considered patient expectations and preferences.
This discussion paper examines nursing literature to consider the purpose of wound cleansing, to discover how nurses are actually cleansing wounds, to consider non-physiological elements of wound cleansing and to summarise recently published recommendations. This paper concludes that there is little evidence to guide wound cleansing practices and that there is an urgent need to further examine all aspects of this topic.

Abstract
Leg ulcerations are a chronic and debilitating condition that predominantly affects older adults. The management of leg ulcers consumes a substantial amount of financial and human resources in acute, chronic and community health settings. This literature review examines the prevalence of leg ulcers and their impact on the individual and on Australia’s healthcare system. The review considers the need for comprehensive client and wound assessment to determine appropriate management options, and discusses the potential contribution that community leg ulcer clinics can make in the management of chronic lower extremity ulcerations.

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