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HYDROGELS AND FOAM DRESSINGS IN COMBINATION CONTROLLING BLEEDING IN FUNGATING WOUNDS HYDROSTATIC LEG ULCERS COMMUNITY LEG ULCER CLINICS.

SPINAL INJURY AND PRESSURE SORE PREVENTION TREATMENT FOR OVERGRANULATION.

MEDIEVAL ULCER MANAGEMENT SCIENTIFIC PAPERS SPECIAL EQUIPMENT IN NURSING HOMES TWO BANDAGING SYSTEMS SELECTION OF DRESSINGS FOR DIABETIC FOOT ULCERS.

The masterclass reports in this issue (page 398) raise serious questions about our understanding and practice of the management of pressure sores.

The 'silver' book, Pressure Area Care for the City and Hackney Health Authority, produced in 1988, probably takes second place in the development of pressure area care in the UK only to the 'blue book', An Investigation of Geriatric Nursing Problems in Hospital, published in 1962. Although Hibbs's work was intended only as a local service manual, it rapidly generated a much wider demand, with revision and updating in 1992. Hibbs herself says it is now out of date, but it is worth examining the precepts which formed the basis of modern pressure sore prevention.

MAGGOTS - A PERSONAL EXPERIENCE ABPI TECHNIQUES VAPOUR-PERMEABLE DRESSINGS PRESSURE SORES AND SPINAL CORD INJURY DANGERS OF TOWEL CLIPS.

Intensive care wards have a high incidence of pressure sores. This trial, in an eight-bed unit, aimed to compare the cost-effectiveness of constant-low-pressure and alternating-pressure support systems for preventing pressure sores. Patients without sores with a Norton risk score of < 13 were allocated to either alternating- or constant-low-pressure supports according to their hospital number. The cheapest supports were used initially, and changed for more sophisticated types if the patient's pressure areas deteriorated. None of the 23 patients using low-cost alternating-pressure supports developed open sores and only one had to be transferred to a more sophisticated mattress because of persistent erythema. Eleven out of 20 patients on constant-low-pressure mattresses or overlays developed either persistent erythema (three) or sores (eight). Ten were transferred to more expensive support systems. The mean cost of supports per patient in the alternating-pressure group was 44.50 pounds and in the constant-low-pressure group 86.20 pounds.