No new proposals sought at this time. Research from previously funded projects will continue to translate findings into practice.

The following list represents the ranked priority for pressure injury research in Australia, as identified by 16 Australian pressure injury experts:

1. Strategies to assess the skin and tissues.

2. Consensus on appropriate outcome measures for indicators of pressure injury healing and recurrence.

3. Studies exploring heel pressure off-loading and shear reduction strategies.

4. The economic cost of pressure injuries and strategies for their prevention and treatment.

5. Effectiveness of skin moisturisers and barrier products in preventing pressure injuries.

6. Effectiveness of early mobilisation interventions in preventing and treating pressure injuries.

7. Strategies to prevent and treat medical device related pressure injuries.

8. Frequency and content of consumer education for sustained knowledge and best practice in pressure injury prevention and treatment.

9. Comparison of high specification reactive surfaces with active surfaces (e.g. low-air- loss, alternating pressure) for preventing pressure injuries.

10. Effectiveness of different strategies for positioning and offloading the heels in the operating room.

11. Efficacy of polyurethane foam dressing compared with other prophylactic dressings.

12. Comparison of high specification reactive surfaces with active surfaces (e.g. low-air- loss, alternating pressure) for treating pressure injuries.

13. Strategies to relieve pressure in seated individuals.

14. Efficacy and cost-effectiveness of using prophylactic dressing in populations and clinical settings other than critical care (e.g. aged care, paediatrics, spinal cord injury).

15. Prevention of pressure injuries in the acute phase of spinal cord injury.

Key research questions:

Prevention of diabetic foot complications including a reduction in amputations, improved healing of diabetic foot ulcers, translation of best practice into aged care, hospitals and the community.

Linkages to high risk groups such as aboriginal (rural and remote) or migrant communities will be well regarded.

Education and training for health practitioners, carers, patients including eHealth.

Public and government awareness including policy development, health economics and reimbursement.

Therapies, dressings and devices for foot injury prevention and offloading with particular reference to technologies for self-monitoring and management.

Dressings, therapies and devices will need to be well advanced in the development pipeline with data demonstrating some level of efficacy and safety and have a strong intellectual property position.

Key Research Questions:

Strategies to ameliorate complications with acute/surgical wounds and surgical site infections with a focus on risk

assessment, monitoring and translation of best practice into hospitals and community health care.

Dressings and devices for surgical scar reduction, wound dehiscence and infection prevention.

Dressings, therapies and devices will need to be well advanced in the development pipeline with data demonstrating some level of efficacy and safety and have a strong intellectual property position.

Key Research Questions:

Implementation of healing and prevention strategies, translation of best practice into aged care, hospitals and the community.

Education and training for health practitioners, carers and patients including eHealth.

Public and government awareness including policy development, health economics and reimbursement.

Therapies, dressings and devices for compression therapy, debridement or infection control.

Dressings, therapies and devices will need to be well advanced in the development pipeline with data demonstrating some level of efficacy and safety and have a strong intellectual property position.

This project aims to identify biomarkers for the prediction of paediatric burn wound severity. The ability to predict which patients may develop scars or who are more prone to poor wound healing will improve clinical decision making within the critical early phase following burn injuries.

This project generated an information portfolio on biomarkers identified in earlier CRC funded projects and engaged with wound healing and product development leaders to determine the commercial value of these biomarkers as diagnostic and prognostic tools for wound management.

This project aims to develop a rapid, robust and inexpensive DNA test that can be used routinely by wound clinicians to assess wound infection risk

This project aimed to develop novel surface coating technologies to be applied to bandages and three dimensional scaffolds for rapid wound closure and wound infection control. The central hypothesis was that coating dressing materials with chemically defined surfaces will improve their performance by encouraging cell migration to promote healing.

The use of gaseous atmospheric plasma is an emerging medical technology. The purpose of this study is to determine the optimal plasma composition, dose and reactive species for the promotion of wound healing and design a portable gas plasma device as a new therapy.

This project aimed to review the existing research evidence to identify the threshold values for diabetic foot injuries to provide real time patient feedback by a smart phone to prevent ulceration.

This project is developing novel hyperspectral imaging system that can monitor and predict wound healing and can assist with the diagnosis and early detection of infection in wounds.

This project developed new materials to improve open abdomen wound closure following surgery. The new materials will maintain their height but contract laterally under negative pressure to close the wound without using invasive mechanical devices.

This project will study the microbial diversity of burn wounds to determine the connection between bacterial colonisation and scarring. Results will inform new ways of managing burn wounds to minimise scarring.

In this study a number of factors that have previously been shown to be associated with the phase of healing of venous leg ulcers were evaluated. The study assessed whether there was sufficient separation in the levels between healing and non-healing phases of wound healing for these factors to be of value as diagnostic tests.

In collaboration with AWMA this project aimed to increase awareness of government authorities, the general public and health professionals on the incidence of patients suffering from venous leg ulceration.

Skin tears are reported to be the most common preventable wound found amongst older adults.  This project consisted of three separate studies focused on skin tear risk assessment and prevention in community nursing and aged care.

This project determined the cause and impact of skin tears in a Hospital setting. Based on the results of the study, education and training strategies were developed to minimise the number of skin tears occurring.

Chronic wounds reduce health among many individuals and impose large economic costs, but the profile of this health issue is lower than for other conditions like diabetes, cancer and cardiovascular disease. This project provided valid estimates of the economic burden of chronic wounds in Australia.

Surgical wound dehiscence is the separation of stapled or sutured wounds following surgery. This project is identifying the risk factors for surgical and post caesarean wound dehiscence and will develop risk assessment tools to guide clinicians in preventative strategies.

The objective of the Cooperative Wound Clinic project is to increase evidence-based wound management in GP clinics and aged care by improving the confidence and capability of clinicians and staff with evidence based resources and a training and coaching model focused on sustainability.

In collaboration with AWMA this project aimed to increase awareness of government authorities, the general public and health professionals on the incidence of patients suffering from venous leg ulceration.

The project aimed to identify the current gaps in pressure injury research and make recommendations to target areas of national and international importance.

This project determined the feasibility of a national sustainable service to improve wound prevention and wound management.

In this project Diabetic Foot Australia (DFA) will be established as a sustainable national body. DFA will promote evidence based clinical practice with the aim of reducing Australia’s diabetes related amputation rates by 20% within 5 years.

This project will determine the types of wounds managed in the community, the average time and cost to healing and make predictions of the population level health services burden of the cost of treating these wounds.

Flii is a negative regulator of the wound healing process and anti-Flii antibodies have shown significant promise as a healing agent for wounds. This project aims to use biodegradable drug delivery vehicles to provide sustained delivery of Flii antibodies to improve wound repair.

This project  conducted a randomised controlled trial to determine the effectiveness of hyperbaric oxygen therapy for patients with non-healing venous leg ulcers.

Valid and reliable evidence is a fundamental requirement for the development of clinical practice guidelines. The objective of this project is to provide clinicians with access to evidence summaries and recommended practices which are current, valid, reliable and easy to translate into practice.

Based on results from earlier WMI CRC studies this project reduced the incidence of skin tears in older patients in hospital with the application of twice daily moisturiser.

The application of twice daily moisturiser was shown to halve the number of skin tears for residents in aged care (CRC project: 3.06 Skin Tear Risk Assessment and Prevention). In this follow on project a strategy for national dissemination of the skin tear prevention information for consumers and health care providers, agencies and government bodies is being developed.

This project provided support for the ongoing collection of wound fluid and clinical data for WMI CRC research projects.

Surgical wound dehiscence is the separation of stapled or sutured wounds following surgery. This project will conduct a randomised controlled trial to determine the effectiveness of topical negative pressure as a prevention therapy.

This project profiled the biological changes in chronic wounds through the use of state-of-the art proteomic and metabolic analyses across sequential wound fluid samples. This information was used for the identification of biochemical markers for use in wound management and for the identification of therapeutic targets for treating chronic wounds.

This project developed new and improved models for assessing wound targets, therapies and skin integrity products. As part of this project a new cell line and a 3 dimensional human skin equivalent model was developed.

An external review of the commercial viability of a testing service using a human skin equivalent and other in vitro assays was conducted.

This project aimed to identify novel gene variations associated with venous ulcers and excessive scar formation after burn injury with the aim of preventing chronic wounds and improving scar outcomes with interventions based on individual risk.

This project generated advanced sensing technologies to monitor temperature and pH in the wound environment with the aim of informing practitioners and aid in wound management decision making.

This project developed methods for the application of novel antibacterial and anti-inflammatory molecules. Work in this project focused on designing and implementing methodologies for delivering compounds sourced from the parallel CRC WMI “Plant compounds for wound healing” project.

The chemical diversity of plant metabolites is a rich source of compounds with pharmaceutical potential.  This project identified plant compounds possessing anti-inflammatory, anti-bacterial and/or cell migratory stimulant activity for application in wound management.

Wound fluid was collected for use in research projects.

This project developed risk assessment tools to identify patients who are likely to suffer from non-healing venous leg ulcers or have recurrent venous leg ulcers. The risk assessment tools will guide wound management and prevention strategies.

In collaboration with AWMA this project aimed to increase awareness of government authorities, the general public and health professionals on the incidence of patients suffering from venous leg ulceration.

This project is addressing the problem of wound care in rural and remote areas of Australia by improving wound education using online materials and by developing a telehealth wound advisory service.

Education regarding the conduct of Good Clinical Practice (GCP) for clinical trials was provided.

It is common practice for dressing products to be opened, a portion used, and then the remainder stored in its original pack for use at a later date. This study determined the degree of microbial contamination in open but unused portions of wound dressings and developed recommendations for storage, handling and use of wound dressings in home settings.

This project  audited the available wound management information to determine the education and training needs of health consumers and the relevant health workforce. The project also established Cooperative Wound Clinics to aid in the education and provision of best practice.

A WMI CRC project (3.06 Skin Tear Risk Assessment and Prevention) showed that the application of twice daily moisturiser reduced the incidence and severity of skin tear injuries in aged care. As a follow on to these findings this project will determine whether the same reduction in skin tear incidence can be obtained with the use of a moisturising cleanser during routine bathing.

The objective of this project is to provide expertise and to conduct research to evaluate the cost of wounds to the Australian economy. The project will then determine the economic benefits of improved service delivery in this field with a view to informing better policy decisions.

This project will develop medical compression devices. The technology utilises a patented biosensor material integrated with a wireless detection technology.

This project will develop an insole for diabetic ulcer management. The technology utilises a patented biosensor material and wireless technology to map the pressure distribution and alert the wearer if “hotspots” are detected.

A pilot project determined the technical, legal and governance requirements for a National Wound Registry to inform health economic modelling and policy and funding, which was implemented in this project.

This project will assess the financial sustainability and demand for commercial wound services in Residential Aged Care including education of staff, accreditation and monitoring, product recommendations and wound management support via case studies and telehealth services.

The project aims to build on the models and outcomes of the Education and training project (3.12) and the Cooperative Wound Clinic and Residential Aged Care Education Pilot Project (3.21), and will deliver a comprehensive Wound Management Capability Framework and an Education Resource Map.