Here - EWMA 2013

ORAL PRESENTATIONS
93
Free Paper Session: Pressure Ulcers
Exposures to Pressure injuries, a prospective cohorte study
Anne-Birgitte Vogelsang 1
1 Aarhus Universitetshospital (Aarhus, Denmark).
Objective: To identify intrinsic and extrinsic exposures that increase the risk of patients
developing a pressure injury (PI) during hospitalisation, and to estimate the relative risk
(RR) associated with PI development.
Method: Design: A prospective cohort study. Setting: an intensive care unit, a medical
and a surgical unit. Observation period from the 28 March –11 April 2011, including 134
patients.
Outcome: PI prevalence and incidence. Exposures: Demographic, intrinsic and extrinsic
risk factors. Statistics: were performed by Chi-squared test, Fischer’s exact test or
Student’s t-test.
Results: The incidence of PI was 26.7%, the prevalence of PI 2.2%, and overall
occurrence of PI was 28.4%. The dichotomized exposures that increased the risk of
having a PI was found to be, pressure on the same part of the body for more than 1½
running hours during the past or next 24 hours RR 14.6 (2.08;102.9), limitation in activity
performance the day after admission RR 12.6 (1.79;88.2), lack of willingness and/or
ability to mobility RR 5.70 (1.86;17.6), systolic hypotension RR 3.88 (2.89;5.20),
exposure to shear or friction when moved and/ or re-positioned and RR 3.80 (1.59;9.10),
oedema RR 2.65 (1.60;4.38), sores or damaged skin 2.23 (1.33;3.73), skin exposed to
moisture RR 2.16 (1.23;3.79), respiratory insufficiency or lung symptoms RR 2.17
(1.27;3.69), partly conscious/unconscious RR 2.07 (1.22;3.53),
Conclusion: The exposures that increased the risk of having a PI the most were all
related to patient activity and mobility. The most important preventive step seems be
insurance of changing position of the patient often enough.
ETRS GUEST SESSION: WOUND HEALING AND WOUND RESEARCH
94
ETRS Guest Session: Wound Healing and Wound Research
Cell therapy and tissue remodeling: fibroblast or fibroblast?
Bernard Coulomb 1
1 Institut national de la santé et de la recherche médicale, Centre de Recherche
Cardiovasculaire (Paris, France)
Tissue repair is a priority for any tissue or organ for recovering functional properties after
injury. In contrast to embryo of several animal species in which the healing is perfect
without any sequels, the wound healing in adults is generally associated with
consequences (scar) that may lead to functional defects (e.g. hypertrophic scar in
burns).
In fact, efficiency of healing is depending on the tissue, and one can observe that
gingival healing in adult can be considered as embryo-like. This is due to the ability of
gingival fibroblasts to restore ad integrum the tissue without scar formation and fibrosis.
We thus aimed to validate the concept of using gingival fibroblast healing properties in
another tissue. The proof of this concept was first demonstrated in the context of arterial
remodeling, both in vitro and in vivo in animal. This concept was also found valid to
improve healing of irradiated burn lesions.
As an example, in an experimental aneurysm model induced in rabbit carotid artery by
elastase incubation, gingival fibroblasts cell therapy reduces the size of the aneurisms
and restore the elastic network. In parallel, MMP-9 activity is decreased and TIMP-1
secretion increased. Gingival fibroblasts persist at least three months within the arterial
wall and are able to proliferate. None of these effects are obtained with dermal
fibroblasts, illustrating the specific efficiency of gingival fibroblasts in tissue repair.
This strategy is thus a promising approach to treat defects for which the current
treatments do not treat the pathophysiology.
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