Abstract
This study was undertaken to describe the patients treated by the Austin Health High Risk Foot Clinic for diabetes related foot ulcers and to illustrate the evolution of data collection within this service, highlighting specific data for inclusion. Prospective collection of data for all patients with diabetes and a foot ulcer attending the High Risk Foot Clinic between January 2000 and February 2005 were reviewed retrospectively. During this period 162 patients with a foot ulcer related to diabetes were seen and referral was predominantly from the outpatient clinic of the hospital. Over 70% of patients were aged >60 years and almost two thirds were men. Over 75% were diagnosed with diabetes for <25 years. In those where location of ulceration was noted, over 50% developed in the forefoot. Peripheral neuropathy was present in just over 75% of cases. The majority of management included pressure redistribution and wound treatment. Initial data captured basic demographic information. It has become clear that new data should include information about aetiology of ulceration and healing rates, to allow the practitioners to assess the efficacy of current management practices. The process of meaningful data collection requires ongoing evaluation and change in order to keep information relevant and up to date. Our experience reveals the clear need for objectives to be set prior to collecting data, with regular assessment of data to ensure that the targeted outcomes are being captured.

Abstract
Pressure redistributing support surfaces, designed to prevent and treat pressure ulceration, are generally based on one of two modalities; constant low pressure (foam, gel, low air loss etc) or alternating pressure. Despite appearing similar, these systems work in very different ways and require different techniques for measuring interface pressure. While such measurements are a useful and increasingly accessible adjunct to the design and evaluation of pressure redistributing support surfaces, when used alone they should not be considered a surrogate for clinical outcome studies. This review discusses why interface pressure measurements are undertaken, the methodologies, the factors that affect data reliability, and whether by making use of innovative Doppler techniques, interface pressure will be superseded by contemporary and perhaps more relevant performance indices such as tissue perfusion. The clinician who can critically appraise interface pressure data will be able to make informed decisions relevant to individual clinical practice.

Abstract
Pressure ulcers affect large numbers of patients within health services. Preventive measures need to be implemented early in a patient hospital stay and at all levels of hospital care. A successful ulcer prevention program will address contributing factors such as pressure, shear forces, friction and moisture. This paper reports the results of a ‘quality activity’ undertaken to assess the role of an anatomical heel dressing, Allevyn Heel (Smith & Nephew), as part of a preventive pressure-area management strategy in at-risk patients in a hospital emergency department. Allevyn Heel dressings were applied to one hundred patients assessed as being at moderate to high risk of developing a pressure ulcer after presenting to Box Hill Hospital emergency department in Victoria, Australia. A random audit of twenty patient histories was performed at the end of the quality activity to determine how many patients, if any, developed a pressure ulcer. All twenty patient histories randomly audited at the end of the two-week period had no documentation of evidence of a pressure ulcer. Allevyn Heel was reported to be easy to use and comfortable for patients. This quality activity was successful in bringing pressure area management to the fore of emergency care consideration. The results of this activity show that emergency departments can successfully participate in the prevention of pressure ulcers by instituting preventive measures from the time a patient first presents to hospital, thereby helping to facilitate better long-term health outcomes.

Abstract
Skin tears are reported to be a common occurrence in the elderly 1 because of age related skin changes and associated disease processes. The depth of literature with regard to skin tears is indeed limited, yet skin tears may cause pain and suffering to the individual as well as monetary cost to the individual, hospital and community. In some cases, skin tears may become infected and require surgical intervention, or become chronic wounds and the occurrence of skin tears may present as an indicator of the quality of care in healthcare facilities. However, there is no consensus for the prevention and management of skin tears, and evidence based protocols are limited, with many of the existing protocols generated by dressing product manufacturers.

Abstract