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Abstract
Background: Older people residing in residential aged care (RAC) facilities are becoming more dependent, have higher rates of chronic disease and are at risk for skin injuries and developing chronic wounds. The importance of evidence-based and sustainable wound programmes in RAC facilities to prevent and manage wounds is essential.
Aim: To establish the composition and effect of wound-related programmes, implementation strategies, resident and clinical staff outcomes and programme sustainability in RAC facilities.
Method: Fifty-one studies met the inclusion and exclusion criteria and were then appraised according to the grading criteria; this resulted in 11 observational or descriptive studies included in the review. Heterogeneity across the studies meant pooling of data could not be performed; hence this systematic review is presented in narrative form.
Results: Three syntheses emerged: educational outcomes; implementation strategies; and organisational culture. Results indicated pressure injury programmes could improve knowledge and care processes to reduce pressure injury rates. Recommendations to help implement programmes into RAC facilities are provided.
Conclusion: Pressure injury programmes can reduce pressure injury rates and improve management for residents residing in RAC. Data is limited to provide conclusions for wound programmes other than for pressure injuries and is an area for future research.

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Abstract
The Australian Wound Management Association (AWMA) has had an integral involvement in the development of two recent clinical guidelines on the prevention and management of pressure injuries: the Pan Pacific Clinical Practice Guideline for the Prevention and Management of Pressure Injury (2012) and Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline (2014). This paper outlines a comparison of the guideline methodologies, and discusses emerging issues in pressure injury research. Both the guidelines remain relevant to prevention and management of pressure injuries in Australian healthcare settings.

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Abstract
Background: Venous leg ulcers (VLUs) are a common problem that impact on quality of life and are a costly health care burden. Cost-effective strategies to heal and prevent recurrence are required to address this growing burden. Whilst compression therapy has the potential to heal some ulcers, new treatments are needed to address those wounds that are more challenging to heal. Targeting the inflammatory processes underlying venous ulcers is a possible strategy. Limited evidence suggests that low-dose aspirin may be an effective adjunct to aid ulcer healing and reduce recurrence. The Aspirin in Venous Leg Ulcer study (ASPiVLU) will seek to investigate if daily low-dose aspirin improves time to healing. Design: This randomised, double-blinded, multicentre, placebo-controlled clinical trial will recruit 268 participants with a chronic VLU from wound clinics across Australia. Participants will be randomised to receive either daily oral aspirin (300 mg) or placebo, in addition to best practice compression therapy. Discussion: This study will provide a robust evaluation of the benefits and harms of aspirin as an adjunct therapy to compression in the management of VLUs. Recruitment commenced in March 2015 and study completion is anticipated in June 2018.

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Abstract
Cleansers and moisturisers are used every day for maintaining our skin in good health, and while they may seem like simple products, our choice of product can have a major impact on the health and healing of our skin. A quality moisturiser should combine emollients, humectants and occludents to simulate the skin’s natural approach to maintaining good hydration, while a quality cleanser should use gentle surfactants and moisturisers to cleanse the skin and leave the natural oils intact. Product pH also plays a large role in the health of our skin, with high pH products having many adverse effects on the skin’s ability to stay hydrated. When recommending a cleanser or moisturiser, it’s important to keep the patient’s preferences in mind, as compliance will increase if the patient is happy to use the product.

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Clinicians assess the periwound of venous leg ulcers (VLUs) to optimise their management and treatment. Yet, there has been little research on whether undesirable periwound conditions such as maceration, dehydration and erythema are associated with VLU chronicity and non- healing. This study addressed the gaps in the literature by exploring associations between clinician visual periwound assessment, objective periwound assessment using a skin diagnostic device and VLU chronicity. This study also explored the agreement between clinician assessment and objective measurements of periwound status. In total, 16 VLU periwound were assessed. No association was found between undesirable periwound conditions such as maceration, dehydration or erythema and longer wound duration and wound size. This study identified a significant relationship between clinician and objective assessment of dehydration suggesting that current visual assessment of periwound dehydration may accurately reflect VLU periwound dryness. However, it is recognised that mechanisms underlying periwound redness are complex and there is difficulty ascertaining if periwound redness is truly detrimental for wound healing. Overall this study provides a preliminary insight into the relationships between periwound hydration and erythema and VLU chronicity and can inform future research to improve wound assessment and management.

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QUESTION
What is the best available evidence on bioimpedance spectroscopy to assess lymphoedema?

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QUESTION
What is the best available evidence on perometry to assess lymphoedema?

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