EPUAP Review 5/2 RIP - European Pressure Ulcer Advisory Panel

epuap 

Mission Statement 

Executive Committee Members: 

Trustees: 

EPUAP Business Office: 

EUROPEAN PRESSURE ULCER ADVISORY PANEL 

Trustees of the European Pressure Ulcer Advisory Panel 

The European Pressure Ulcer Advisory Panel’s objective is to provide the 

relief of persons suffering from, or at risk of pressure ulcers, in particular 

through research and the education of the public. 

Marco Romanelli: President (Italy) 

Michael Clark: Recorder (Wales) 

Jeen Haalboom: Past President (Netherlands) 

George Cherry: Secretary/Treasurer (England) 

Christine Cherry: Business Administrator (England) 

Denis Colin (France) 

Christina Lindholm (Sweden) 

Joan-Enric Torra i Bou (Spain) 

Sue Bale (Wales) 

Brigitte Barrois (France) 

Andrea Bellingeri (Italy) 

Mark Collier (England) 

Theo Dassen (Germany) 

Carol Dealey (England) 

Tom Defloor (Belgium) 

Jacqui Fletcher (England) 

Katia Furtado (Portugal) 

Finn Gottrup (Denmark) 

Laszlo Gulacsi (Hungary) 

Ruud Halfens (Netherlands) 

Helvi Hietanen (Finland) 

Maarten Lubbers (Netherlands) 

Sylvie Meaume (France) 

Zena Moore (Eire) 

Elia Ricci (Italy) 

Anne Witherow (Northern Ireland) 

Wound Healing Institute 

Department of Dermatology 

The Churchill Hospital, Old Road 

Headington, Oxford, OX3 7LJ, UK 

Tel: +44 (0)1865 228264 

Fax: +44 (0)1865 228233 

E-mail: EuropeanPressureUlcerAdvisPanel@compuserve.com 

Volume 5, Number 2, 2003 45

46 

epuap 

Dr Michael Clark 


Letter from the Editor 

EDITORIAL 

Ihad been looking forward to writing this introduction to the issue of 

the EPUAP Review that is distributed at the time of our Annual Open 

Meeting. There is always something pleasing about being able to welcome 

EPUAP members and those (hopefully) soon to be members to the 

conference. However, this year sees EPUAP approach the Tampere conference 

in sombre mood. The recent death of Gerry Bennett, our first Recorder 

has been a great shock to the EPUAP ‘family’ members. Gerry’s contribution 

to the development of EPUAP was immense – as our first Recorder he 

was responsible to the scientific programme at the seminal EPUAP conferences. 

As his successor in the post of Recorder, I was personally grateful for 

his advice and support during the Budapest conference last year. However, 

Gerry did much more than organise the conference programme, this issue 

of the EPUAP Review contains the draft text of a new EPUAP guideline on the 

role of nutrition in pressure ulcer prevention and treatment. This project 

was instigated by Gerry Bennett last year during the Budapest conference 

and he was responsible for bringing together the team that worked on the 

guideline text. I hope that the material we developed reflects Gerry’s enthusiasm 

for understanding pressure ulceration, while all members of the guideline 

group would like to thank him for his comments upon the various drafts 

we produced. The EPUAP has lost one of its strongest supporters, we will 

miss him for Gerry helped to build EPUAP into today’s vibrant organization. 

Looking ahead from this sombre time, we must continue to develop EPUAP 

and strengthen its influence. A growing, respected and influential EPUAP 

would indeed be a fitting tribute. 

This issue of the EPUAP Review also contains the first section from the 

recent pressure ulcer guidelines published in the Netherlands last year. This 

is the first part of an on-going series of articles that set out the content of this 

important evidence-based guideline. EPUAP became aware of this guideline 

through our members from the Netherlands, it would be excellent if EPUAP 

could develop a library of pressure ulcer guidelines from across Europe. 

Could I ask members to send the EPUAP Business Office copies of national 

pressure ulcer guidelines or links to web sites where the documents could be 

accessed. 

Looking forward to seeing you in Tampere. 

Michael Clark 

Editor 

Volume 5, Number 2, 2003

epuap Letter 

Dr Marco Romanelli 


from the President 

Dear Readers, 

THIS is my last contribution as the President of EPUAP and I would 

like to begin by remembering our colleague, Professor Gerry Bennett. 

Gerry will be remembered by EPUAP both for his accomplishments 

as a professional and for his sterling qualities as a person. He was an outstanding 

physician and an effective teacher who enriched all of us with his 

activity in the field of pressure ulcers. Even though I was not a close friend or 

even a close colleague, I, like many others admired him greatly. Since the 

foundation of EPUAP he expressed an eclectic interest in the progression of 

the society, with his most recent contribution being the suggestion to develop 

the nutrition guidelines which will be presented at our next annual 

meeting in Tampere. In my interactions with Gerry he had a delightful, subtle 

sense of humour that was expressed in the playful way in which he related 

to those with whom he was familiar. The memory of Professor Gerry Bennett 

will be held forever in inestimable esteem by each of us who were privileged 

to know him. 

The success and improvement of the EPUAP Review depends on the material 

available to the production team, and this availability depends not 

only on our trustees, but also on our many members. During my two years of 

presidency a large number of contributions were submitted and many of 

these were from different countries, reflecting the international readership 

and widespread interest in pressure ulcer prevention and management. My 

personal thanks go to Mike Clark for his invaluable hard work and continued 

support of the Review. Thanks also to the Business Office in Oxford, Dr 

and Mrs Cherry and Jane Green, who actively strive to keep improving the 

EPUAP Review. 

I look forward to working with the EPUAP in the future; helping to improve 

future activities and also in making the EPUAP Review a valuable read 

for all interested in research, prevention and management of pressure ulcers. 

Marco Romanelli 

President of the EPUAP 


48 

epuap Letter 

NEWS FROM EPUAP 

THE annual meeting of the EPUAP this year in 

Tampere, Finland is, as in the past, the major activity 

of our organization. It is appropriate that we are 

holding it in Finland this year, especially in view of the support 

that our Finnish members have given the EPUAP since 

its inception, and I would particularly like to thank Helvi 

Hietanen for her energetic contribution as a leader of the 

local organizing committee. 

Helvi Hietanen 

The meeting is organized by the Business Office with 

the input of the scientific committee chaired by Michael 

Clark. This year we have had more than eighty-five excellent 

abstracts received for presentation on pressure ulcers. 

In the programme there are slots for twenty-eight oral presentations; 

the number was limited in order that the majority 

of delegates could attend the main sessions. There will 

be more than fifty poster presentations with the authors 

presenting at special breakfast and tea sessions near the 

posters in order to allow them to discuss their work with 

attendees. The posters are a major feature of the EPUAP 

Annual Meeting and they contribute a wealth of knowledge 

on pressure ulcers as well as allowing time for in-depth discussion 

between the authors and delegates. 

Following the success of the satellite symposia at our 

meeting last year in Budapest, this year (on Thursday morning) 

we have four sponsored symposia which have been arranged 

by ConvaTec, Johnson & Johnson, KCI and Smith 

& Nephew. Two of these will take place before coffee and 

two before lunch, before the opening of the main meeting. 

We hope that you will support these excellent sessions in 

which the subjects are all related to pressure ulcer prevention 

and management, with well known and knowledgeable 


from the Business Office 

speakers in each of the symposia’s programmes. Details of 

the symposia are in the programme abstract booklet. 

If you are a paid-up member of the EPUAP I would encourage 

you to attend this year’s annual general meeting 

on Friday, at lunch time, as a number of administrative 

changes need to be ratified, particularly those concerning 

becoming Trustees of the EPUAP. 

You will find an invitation in this issue of the Review to 

attend a celebration of Gerry Bennett’s life and work, which 

is to be held in London on 21 September 2003. Please note 

that if you wish to attend, please contact the Warden’s Office 

at the address on the invitation. 

Next year our annual meeting will be held in Paris at 

the Palais des Congres during the World Union of Wound 

Healing Societies meeting 8–13 July 2004. EPUAP is a cohosting 

society of this meeting and is part of the programme 

planning committee with regard to pressure ulcers. 

The members of the Business Office look forward to seeing 

you all in Tampere at the EPUAP stand. 

Dr George W. Cherry 

Secretary/Treasurer 

George Cherry 



50 

epuap Report 


from the Guideline Development Group 

EPUAP GUIDELINES 

On the Role of Nutrition in Pressure Ulcer Prevention and Management 

THIS issue of the EPUAP Review reproduces the draft 

text of a new EPUAP guideline covering the role of 

nutrition in pressure ulcer prevention and management. 

This guideline was initiated by the late Professor Gerry 

Bennett during the EPUAP Open Meeting held in Budapest 

last year. Since September 2002, the guideline development 

group (members listed below) met in Amsterdam 

in February 2003 with subsequent revisions to the draft text 

made via e-mail. This draft guideline will be presented for 

discussion during the EPUAP Open Meeting to be held in 

Tampere. All comments received during this presentation 

will be considered by the guideline development group and 

the text revised where appropriate. If you have any comments 

regarding the content of this draft guideline please 

send them to the EPUAP Business Office by the end of 

October 2003. We have also reproduced the list of references 

on pressure ulcers and nutrition considered by the 

guideline development group. 

Membership of the Guideline Development Group 

Professor Gerry Bennett (UK) 

Dr Michael Clark (Facilitator, UK) 

Dr Joseph Schols (Netherlands) 

Dr Giuseppe Benati (Italy) 

Mr Gero Langer (Germany) 

Mrs Pam Jackson (UK) 

Mrs Bernadette Kerry (Ireland) 

Draft for Discussion – Version 4 

European Pressure Ulcer Advisory Panel 

Guideline on nutrition in pressure ulcer 

prevention and treatment. 

Clinical Need for this Guideline 

Pressure ulcers are the result of a complex interplay between 

myriad extrinsic and intrinsic risk factors – excessive 

mechanical loading, immobility, incontinence, advanced 

age among many others. While the consequences of immobility 

are often viewed as the key predisposing factors in 

prompting the development of a pressure ulcer, it is often 

assumed that there is also a direct causal relationship between 

nutrition and pressure ulcer development. The scientific 

basis for this assumption is unclear with as yet no 

sound studies linking impaired nutrition and an increased 

incidence of pressure ulcers. However, it is possible that 

impaired nutrition may influence tissue vulnerability to 

extrinsic factors such as pressure. It is important to note 

that only a few risk factors can be influenced by our actions 

– tissue loading and nutrition being two key issues we can 

address. The perceived importance of malnutrition in pressure 

ulcer development and management is briefly considered 

within existing EPUAP guidelines; for example: 

• a full risk assessment in patients to include: General 

skin condition, skin assessment, mobility, moistness 

and incontinence, nutrition and pain, 

• following assessment nutritionally compromised 

individuals should have a plan of appropriate support 

and/or supplementation that meets individual needs 

and is consistent with overall goals of therapy, 

• ensure adequate dietary intake to prevent malnutrition 

to the extent that this is compatible with the 

individual’s wishes or condition. 

The purpose of this guideline is to expand upon the 

references to malnutrition within existing EPUAP guidelines 

and provide clinicians with specific guidance upon 

nutritional screening and assessment and following assessment, 

appropriate intervention. It is intended that the 

guidelines be appropriate for all care settings although it is 

recognized that the access to specific tools such as weighing 

scales and personnel such as dieticians may be limited 

in some sectors. 

The recommendations offered in this guideline have 

been graded using the following systems: 


Source of Evidence that underpins the recommendation 

I Evidence from systematic review or meta-analysis of 

randomised controlled trials or at least one 

randomised controlled trial. 

II Evidence from at least one controlled trial without 

randomisation or at least one other type of quasiexperimental 

study. 

III Evidence from non-experimental descriptive studies, 

such as comparative studies, correlation studies and 

case-control studies. 

IV Evidence from expert committee reports or opinions 

and/or clinical experience of respected authorities. 

Recommendation Grading 

A Directly based on category I evidence. 

B Directly based on category II evidence or extrapolated 

recommendation from category I evidence. 

C Directly based on category III evidence or extrapolated 

recommendation from category I or II evidence. 

D Directly based on category IV evidence or extrapolated 

recommendation from category I, II or III 

evidence. 

Both grading systems were adapted from Eccles M, Mason J 

(2001). How to develop cost-conscious guidelines. Health 

Technology Assessment 5: 8. 

Structure of the Guideline 

The recommendations of this guideline are considered to 

apply to both the prevention and management of pressure 

ulcers. Where guidance relates solely to pressure ulcer treatment 

this will be highlighted in the text. It should also be 

noted that the EPUAP considers all recommendations to 

be equally valid regardless of the grade of evidence upon 

which they are based. In the following recommendations 

where a source and level of evidence is not explicit, the 

recommendation should be considered as a level IV, D recommendation. 

Screening and Assessment of Nutritional Status 

Screening and assessment of an individual’s nutritional status 

can be performed using a number of measures ranging 

from tools such as the Subjective Global Assessment (Detsky 

et al., 1987) to relatively simple measures of height and 

weight (combined as Body Mass Index). However, some 

measurements (height, laboratory tests, skin fold thickness) 

may not be readily available in all care settings. Undesired 

weight loss (>10% of normal body weight in the past six 

months, or >5% in the past month) may provide an indication 

of malnutrition although where possible reasons for 

this unintentional weight loss should be explored with the 

individual patient. 

Accurate measurement of body weight and height, and 

hence Body Mass Index, may be problematical in many settings 

through lack of available equipment or challenges in 

measuring body length among some patient groups. While 

BMI has been found to be less valid in some patient groups, 

such as children and the very elderly, due to an altered/ 

different fat/lean body mass ratio. 

Nutritional assessment may also include nutritional in- 

REPORT FROM THE GUIDELINE DEVELOPMENT GROUP 

take over the past 1, 3 or 7 days; this information may be 

gathered using 24-hour recall, self or carer reported food 

intake records or through the involvement of a dietician, 

where available. It is important to consider why the intake 

of food and fluids is at the reported level. 

Biochemical measurements such as serum albumin, 

hemoglobin and potassium may be helpful when considering 

the nutritional status of the ill although these indicators 

may provide more information upon chronic, rather 

than acute depletion of specific nutrients. In general it is 

unlikely that biochemical measurements will provide more 

information than other indicators such as undesired weight 

loss although a number of studies cite an association between 

albumin and pressure ulcers. 

The use of nutritional screening or assessment tools 

appears to be becoming more prevalent in managing patients 

at risk of/with pressure ulcers. These tools require to 

be validated and reliable, and like general risk assessment 

tools should not replace clinical judgement. However, the 

use of validated nutritional assessment tools may help to 

foster attention upon the need to consider nutrition when 

assessing vulnerability to pressure ulcer development. 

Nutritional status should be re-assessed regularly following 

an individualized assessment plan which includes an 

evaluation date. The frequency of assessment should be 

based upon the condition of the individual and should occur 

following specific events such as surgery and any development 

of infections or other catabolic processes likely to 

stress the nutritional status of the individual. 

While looking at the individual patient the clinical judgement 

of appropriately trained health professionals may provide 

sound evaluations of probable nutritional status, it 

should be acknowledged that excess of body weight may 

mask nutritional deficiencies – for example morbidly obese 

individuals may still be malnourished. 

Nutritional Intervention 

Where an assessment or screening of nutritional status indicates 

that malnutrition may be present, nutritional intervention 

should be considered. The primary goal of nutritional 

intervention is generally to correct protein-energy 

malnutrition ideally through oral feeding. When considering 

any limitations on normal food and fluid intake, consider 

the local environment such as ease of access to food, 

social and functional issues along with the texture of the 

diet. Changes in these aspects may encourage or facilitate 

increased oral intake. Overall the goal should be to consider 

the quality and energy-density of the food intake rather 

than its quantity. Considering fluid intake quantity is equally 

important as quality. 

Where enhanced normal feeding is not possible, protein-energy 

rich oral supplements may be considered (Recommendation 

1, B; Benati et al., 2001, Bourdel-Marchasson 

et al., 2000, Breslow et al., 1993, Chernoff et al., 1990, Delmi 

et al., 1990). The value of vitamin and trace element supplementation 

in pressure ulcer prevention is unclear (Recommendation 

1, B; Taylor et al., 1974, ter Riet et al., 1995). 

Where normal feeding and oral supplementation fail 

to resolve apparent malnutrition then other routes (for 

example tube-feeding) may be undertaken although the 

risks associated with these interventions should be considered. 



While the amount of supplementation required by individuals 

will vary, general guidance can be offered where 

an individual may require a minimum of 30–35 kcal per kg 

body weight per day, with 1 to 1.5 g/kg/day protein required 

and 1ml per kcal per day of fluid intake. 

Specific guidance on energy expenditure may be provided 

through the use of standard equations such as the 

Harris-Benedict or Schofield formulae although it is recommended 

that advice on their use and interpretation be 

sought from a dietician (where available) or the multidisciplinary 

care team. 

The success of nutritional intervention should be reviewed 

within the on-going regular nutritional assessments 

and may be indicated by outcomes such as increased weight 

or improved functional ability and/or enhanced healthrelated 

quality of life. Successful nutritional intervention 

may also be marked by a reduced incidence of new pressure 

ulcers and the healing of established pressure ulcers. 

Regular evaluation of the effects of nutritional interventions 

is required but it should be borne in mind that where 

individuals are malnourished the effects of feeding and/or 

supplementation may not be immediately apparent, probably 

because there first needs to be a restoration of already 

depleted reserves. 

Where patients have established pressure ulcers then a 

similar strategy of nutritional intervention should normally 

be considered (normal feeding, then oral supplements and 

finally tube-feeding) although the demands may be greater. 

There are a number of observations upon the role of nutritional 

deficiencies and pressure ulcer healing that can be 

extracted from controlled trials – protein and calorie supplementation, 

along with the use of arginine, vitamins and 

trace elements with antioxidant effects appear to have a 

positive effect on healing (Recommendation 1, B; Benati 

et al., 2001, Bourdel-Marchasson et al., 2000, Breslow et al., 

1993, Chernoff et al., 1990, Delmi et al., 1990). The evidence 

for the value of ascorbic acid supplementation is equivocal 

(Recommendation 1, B; Taylor et al., 1974, ter Riet et al., 

1995), and the evidence for zinc supplementation is weak 

(Recommendation 1, B; Norris 1971). 

Specific issues may need to be resolved if normal feeding 

is to be enhanced – for example control of wound odour, 

altered body image, pain associated with the pressure ulcer 

and loss of self-esteem because these issues can reduce nutritional 

intake. 

Where individual patients present with severe pressure 

ulcers (Grades 3 and 4) then the multidisciplinary team 

should consider their basal energy expenditure and pay 

particular attention to the increased fluid loss through such 

wounds. 

The nutritional requirements of specific groups may be 

different from those outlined in these guidelines, for example 

the spinal cord injured. 

Nutritional assessment and intervention should of 

course be combined with all other appropriate interventions 

including pressure management. 

These guidelines have not addressed several specific issues 

– nutritional assessment and intervention in neonates 

and paediatrics, the role of parenteral nutrition and specific 

needs of individual patient groups such as the immunosuppressed, 

those with cancers, orthopaedic, trauma and 

surgical patients and those who have experienced burns. 

52 

Pharmacological interventions such as the use of anabolic 

steroids also are not included. 

In all of the preceding recommendations regarding nutritional 

assessment and supplementation all decisions 

should be taken with regard to patient choice and in light 

of the overall goals of treatment. 

Education 

There is a requirement for all staff (including but not limited 

to health professionals, untrained staff, catering and 

porters) to be aware of the importance of nutrition and to 

understand their role in improving the nutritional status of 

patients. This education will range from the performance 

of nutritional screening and assessment, the preparation 

of attractive, appetizing meals and the delivery and presentation 

of meals dependent upon the needs of individual 

staff members. There is a need to establish a nutritional 

culture within healthcare prompting the appropriate availability 

and presentation of meals through to continuity of 

nutritional care across departments and care settings. 

Summary of Recommendations 

The EPUAP recommends that as a minimum, assessment 

of nutritional status should include regular weighing of 

patients, skin assessment, documentation of food and fluid 

intake. Additional procedures including anthropometric 

measurements and laboratory tests may also be performed 

although these may best be viewed as more advanced assessment 

techniques. Nutritional intervention should focus 

upon improving the individual’s intake of food and fluids – 

through consideration of the quality of what is offered along 

with removing physical or social barriers to its consumption. 

Nutritional supplementation may be considered where 

it is not possible to enhance the individual’s own consumption 

of food and fluids. 

References used in the Development of this Guideline 

American Society for Parenteral and Enteral Nutrition 

Board of Directors. Definition of terms used in 

ASPEN guidelines and standards. JPEN 1995; 19: 1–2. 

Benati G, Delvecchio S, Cilla D, & Pedone V. Impact on 

pressure ulcer healing of an arginine enriched 

nutritional solution in patients with severe cognitive 

impairment. Arch Gerontol Geriatr, 2001, 33 Suppl 1, 

43–47. 

Bourdel-Marchasson I, Barateau M, Rondeau V, Dequae- 

Merchadou L, Salles-Montaudon N, Emeriau JP, 

Manciet G, & Dartigues JF. A multicenter trial of the 

effects of oral nutritional supplementation in critically 

ill older inpatients. GAGE Group. Groupe Aquitain 

Geriatrique d’Evaluation. Nutrition, 2000, 16(1), 1–5. 

Breslow RA, Hallfrisch J, Guy DG, Crawley B, & Goldberg 

AP. The importance of dietary protein in healing 

pressure ulcers. J Am Geriatr Soc, 1993, 41(4), 357–362. 

Chernoff RS, Milton KY, & Lipschitz DA. The effect of a 

very high protein liquid formula on decubitus ulcers 

healing in longterm tubefed institutionalised patients. 

J Am Diet Assoc,1990, 90, A–130. 

Delmi M, Rapin CH, Bengoa JM, Delmas PD, Vasey H, & 

Bonjour JP. Dietary supplementation in elderly 


patients with fractured neck of the femur. Lancet, 

1990, 335(8696), 1013–1016. 

Detsky AS, McLaughlin JR, Baker JP, Johnston N, 

Whittaker S, Mendelson RA, Jeejeebhoy KN. What is 

subjective global assessment of nutritional status? J. 

Parenter. Enteral Nutr., 1987, 11: 8–13 

Gray-Donald K, Payette H, Boutier V. Randomized clinical 

trial of nutritional supplementation shows little effect 

on nutritional status among free-living frail elderly. J 

Nutr., 1995; 125(12): 2965–71 

Green CJ. Existence, causes and consequences of disease 

related malnutrition in the hospital and the community, 

and clinical and financial benefits of nutritional 

intervention. Clinical Nutrition 1999; 18(Supp 2):3–28. 

Keele AM, Bray MJ, Emery PW et al. Two phase 

randomized controlled clinical trial of postoperative 

oral dietary supplements in surgical patients. Gut 

1997; 40: 393–399. 

Lipschitz DA, Mitchell CO, Steele RW et al. Nutritional 

evaluation and supplementation of elderly subjects 

participating in a ‘meals on wheels’ program. JPEN 

1985; 9: 343–7 

Mathus-Vliegen EMH. Nutritional status, Nutrition and 

Pressure Ulcers. Nutrition in Clinical Practice 2001; 16: 

286–291. 

Professor 

Gerry Bennett 

RSVP 

The Warden’s Office, 

Barts and the London Queen Mary School of Medicine and Dentistry 

Turner Street, London, E1 2AD 

J.Dance@qmul.ac.uk 

Norris JR & Reynolds RE. The effect of oral zinc sulfate 

therapy on decubitus ulcers. J Am Geriatr Soc, 1971, 19, 

793–797. 

Robinson G, Goldstein M, Levine GM. Impact of nutritional 

status on DRG length stay. JPEN 1987; 11: 49–52 

Taylor TV, Rimmer S, Day B, Butcher J, & Dymock IW. 

Ascorbic acid supplementation in the treatment of 

pressuresores. Lancet, 1974, 2(7880), 544–546. 

ter Riet G, Kessels AG, & Knipschild PG. Randomized 

clinical trial of ascorbic acid in the treatment of 

pressure ulcers. J Clin Epidemiol, 1995, 48(12), 1453– 

1460. 

The EPUAP would suggest that a sound starting point for 

further exploration of the links between nutrition and 

pressure ulcers would be the publication: 

Mathus-Vliegen EMH. Nutritional status, Nutrition and 

Pressure Ulcers. Nutrition in Clinical Practice 2001; 16: 

286–291. 

Draft prepared by Michael Clark 

on behalf of the Guideline Development Group 

13 May 2003 

Gerald Bennett 

A Wonderful Life 

You are invited to 

a meeting to celebrate the life and work of 

Gerry Bennett 

REPORT FROM THE GUIDELINE DEVELOPMENT GROUP 

On Sunday 21 September 2003 

2.00-3.30pm, followed by a reception 

in the Great Hall of the People’s Palace, 

Queen Mary University of London, Mile End, London E1 4NS 


54 

epuap Guideline 


Development Group 

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31]. ONS Nursing Scan in Oncology 1992; 1(4): Nov–Dec. 

Winslow MNB. A study on the prevention of pressure 

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Wirtz KM, La Favor KM, Ang R. Managing chronic spinal 

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1997; 43(7): 28–32. 

Yager DR, Zhang LY, Liang HX, Diegelmann RF, Cohen IK. 

Wound fluids from human pressure ulcers contain 

elevated matrix metalloproteinase levels and activity 

compared to surgical wound fluids. J of Investigative 

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Yarkony GM, Matthews Kirk P, Carlson C, Roth EJ, Lovell L, 

Heinemann A, et al. Classification of pressure ulcers. 

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Fabris F. [Acute confusion in the geriatric patient]. 

Recenti Progressi in Medicina. 1998; 89(5): 229–34. 

Zhou XJ, Vaziri ND, Segal JL, Winer RL, Eltorai I, 

Brunnemann SR. Effects of chronic spinal cord injury 

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[comment]. J of the American Paraplegia Society. 1993; 

16(1): 9–13. 

Zulkowski K. A conceptual model of pressure ulcer 

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Geriatrics 1999; 1(2): 144–147. 


64 

epuap News 


from the Netherlands 

A NEW EVIDENCE-BASED PRACTICE GUIDELINE 

ON PRESSURE ULCER PREVENTION AND MANAGEMENT 

IN 2002 new guidelines on pressure ulcer prevention 

and management were released in the Netherlands. 

These evidence-based guidelines built upon the literature 

review conducted during the development of the 

United States Agency for Health Care Policy and Research 

(AHCPR) pressure ulcer guidelines issued in the early 1990s. 

As such the new Dutch guidelines offer new insights into 

the management of pressure ulcer prevention and management 

given their foundation upon new research studies 

and an awareness of literature published in languages other 

than English. The European Pressure Ulcer Advisory Panel 

would like to acknowledge CBO, Dutch Institute for Quality 

in Health Care (Kwaliteitsinstituut voor de Gezondheidszorg) 

CBO, PO Box 20064, 3502 LB Utrecht, the Netherlands 

for their kind permission to present an edited version 

of these new guidelines within the EPUAP Review. In 

this issue we cover the methodological issues related to the 

development of the new guidelines. 

Why was the new guideline developed? 

Recent years have seen greater focus upon the problem of 

pressure ulcers in the Netherlands at a political and economic 

level. For example political initiatives have included 

a report on pressure ulceration to the Secretary of Health 

and the Health Council. 1 This report was followed by a written 

reply to the report’s conclusions submitted by the Health 

Minister to the Dutch House of Commons. In parallel with 

these political issues there has been a growth in the availability 

of national epidemiological data 2 along with a 

stronger awareness of the economic impact of pressure ulcers. 

3–18 In the Netherlands approximately 13% of all patients 

in teaching hospitals have pressure ulcers, the prevalence 

then rises in home care (17%), general hospitals 

(23%) and to about 30% in nursing homes 2 while the annual 

spend on pressure ulcer care is about 600 million Euros 

with a total population of 16 million. 16–17 These developments 

have not occurred in a vacuum; Dutch demography 

has changed over the past ten years with greater numbers 

of elderly people, while the scientific basis for pressure ulcer 

prevention and management has also advanced. Taken 

together there was perceived to be a need to revise earlier 

consensus texts developed in the Netherlands during the 

mid 1980s, and to update the US AHCPR guidelines that 

date from 1992. This update of the guideline was commissioned 

by the CBO (Dutch quality organization for health 

care) with all relevant interest groups represented in the 

working group established to direct the guideline update. 

What is the purpose of the new guideline? 

Essentially the guideline must be appropriate for use in daily 

medical, nursing and paramedical practice giving sound recommendations 

and practical advice. All patient groups and 

care settings are to be covered by the guideline’s recommendations 

– both those with an elevated risk of developing 

pressure ulcers and those with established pressure ulcers. 

One important consideration was that the guideline 

should seek to facilitate the co-ordination of care both within 

and between institutions. 

Definition of pressure ulceration used 

throughout the guideline 

In this guideline, ‘pressure ulcer’ should be considered to 

refer to any tissue damage caused by mechanical loading 

(pressure, shear and friction alone or in combination). 

Developing the guideline 

In 2000 a Working Group was formed to lead the development 

of the new guideline (See Appendix 1 for composition 

of the group) formed of society representatives and 

active researchers. In particular this latter group comprised 

of post-doctoral fellows drawn from the Netherlands and 

Belgium and collectively known as the European Pressure 

Ulcer Research Interest Group (EPURIG). 

The working group first met on 11 May 2000 and separated 

the guideline development into two phases – development 

of the recommendations, and commentary from 

appropriate stake-holders. The EPURIG members were 

tasked to identify the relevant literature, review it and form 

draft recommendations. The primary role of the scientific 

society representatives was to provide comment upon these 

draft recommendations. Studies to be included in the review 

were to have been published since the AHCPR pressure 

ulcer prevention guideline issued in 1992. Initially it 

was anticipated that the latest date of publication to be covered 

by the review was Summer 2000 but this process extended 

to include new publications for a further twelve 

months (Summer 2001). Throughout the review process 

close co-operation was sought with relevant Dutch steering 

committees and European and North American pressure 

ulcer organizations (EPUAP and NPUAP). 

During the initial meeting, the chair of the working 

group proposed the guideline be divided into five sections 

covering: 


• risk assessment 

• prevention 

• pressure ulcer assessment 

• treatment and complications 

• organizational issues and specific care-setting 

situations 

This structure was subsequently adopted during the development 

of the guideline. 

Search strategy 

Relevant literature was identified through a combination 

of searches of electronic data bases and hand-searching of 

reference lists and other available evidence-based guidelines. 

The electronic search covered four key data-bases – 

the Cochrane Library, CINAHL, EMBASE and MEDLINE. 

Each data-base was searched using the following key-words; 

pressure ulcer, pressure ulcers, pressure sore, pressure sores 

and decubitus. Studies retrieved with the last key-word were 

rejected from the review if they referred to the decubitus 

position. The search was refined using a variety of study 

designs as additional key-words; randomized clinical trials, 

cohort studies, retrospective studies, prospective studies, 

case control studies and case studies. Eligible studies had 

to be published between 1992 until July 2001. Members of 

the working group also submitted publications out with 

those included on the electronic data-bases while further 

publications were identified from reference lists and other 

evidence-based guidelines. In total over 400 publications 

were considered in this review. Each publication was then 

reviewed and graded using the following criteria: 

Where publications reported the use of interventions for 

either pressure ulcer prevention or treatment; 

A1 systematic reviews that included some studies of 

A2 level, with consistent results across the individual 

studies, 

A2 appropriately designed and conducted 

randomized controlled trials, 

B low quality randomized controlled trials or nonrandomized 

comparative cohort studies or 

patient-controlled studies, 

C non-comparative studies, 

D expert opinion. 

And in cases where publications reported upon diagnostic 

procedures for example risk assessment; 

A1 several prospective studies (including some at A2 

level) with minimal loss to follow-up within 

specified patient groups that reported clinical 

outcomes achieved after implementing a specified 

diagnostic procedure, 

A2 studies comparing the results from a diagnostic 

procedure against previously agreed ‘gold standard’ 

reference procedure, with appropriate 

statistical analyses, 

B studies comparing the results from a diagnostic 

procedure against a reference procedure, may not 

have appropriate statistical analyses, 

C non comparative studies, 

D expert opinion. 

Throughout the process of reviewing and grading studies 

the working group would like to thank the Belgian Pressure 

Ulcer Guideline Committee for the assistance they provided. 

Having graded the sources of evidence, the recommendations 

in the new guideline were also weighted as follows: 

1 Recommendation based on one systematic review 

(A1), or at least two independent studies on level A1 

or A2, 

2 Based on at least two independently executed studies 

on level B, 

3 Based on one study at level A2 or B, or studies on 

level C, 

4 Based on expert opinion. 

Each recommendation is supported by its scientific basis, 

representing a summary of the studies that underpin 

the recommendation. The key studies and weighting (level 

1 to 4) are illustrated for each of the given recommendations. 

Where recommendations were in part based on information 

outside the scientific studies (for example patient 

preferences, cost, equitable access throughout all care 

settings) the non-scientific aspects are listed as ‘other considerations’. 

Adopting this procedure for presenting recommendations 

was considered to increase the transparency 

and implementation of the guideline while also facilitating 

discussion within the working group! 

Legal implications of the guideline 

Clinical guidelines are not laws, but rather offer insights 

based on the available evidence that would assist caregivers 

to deliver ‘good’ care. These insights are based on the average 

or typical patient and when faced with a heterogeneous 

patient population it is likely that caregivers may exercise 

their professional judgement and decide to deviate from 

the guideline. Such deviations should be noted in the patients 

medical record. 

Updating the guideline 

NEWS FROM THE NETHERLANDS 

The CBO will update the guideline no later than 2007 although 

earlier review may be required dependent upon 

advancves in scientific knowledge and clinical practices. 

References 

1. Gezondheidsraad: Decubitus.Den Haag: Gezondheidsraad, 

1999. Publicatie nr 1999/23, blz.13. 

2. Bours, G. and Halfens R. ‘Decubitus komt nog veel te 

veel voor.’ TVZ 1999; (20): 608–611. 

3. Hey, S. Pressure sores care and cure (letter). Lancet 

1996; 348: 1511.D 

4. Haalboom JRE. Pressure Ulcers. Lancet 1998; 352: 

581. 

5. Hu TW, Stotts NA, Fogarty TE and Bergstrom B. Cost 

analysis for guideline implementation in prevention 

and early treatment of pressure ulcers. Decubitus 1993; 

6: 42–46. 

6. Frantz R, Bergquist S and Specht J. The cost of 

treating pressure ulcers following implementation of 

a research-based skin care protocol in a long term 



care facility. Adv Wound Care 1995; 8: 36–45. 

7. Lapsley HM and Vogels R. (1996) Cost and prevention 

of pressure ulcers in an acute teaching hospital. 

Int J Qual Health Care 8: 61–66. 

8. Haalboom JRE. (1991) De kosten van decubitus. Ned 

Tijdschr Geneesk 135: 606–609. 

9. Xakellis GC, Frantz R and Lewis A. Cost of pressure 

ulcer prevention in long term care. J Am Geriatr Soc 

1995; 43: 496–501. 

10. Xakellis GC and Frantz R. The cost of healing 

pressure ulcers across multiple health care settings. 

Adv Wound Care 1996; 9: 18–22. 

11. Allman RM, Damiano AM and Strauss MJ. Pressure 

ulcers, hospital complications, and disease severity: 

impact on hospital costs and length of stay. Adv Wound 

Care 1996; 9: 22–30. 

12. Allman RM, Damiano AM and Strauss MJ. Pressure 

ulcer status and post-discharge health care resource 

utilization among older adults with activity limitations. 

Adv Wound Care 1996; 9: 38–44. 

13. Richardson GM, Gardner S and Frantz RA. Nursing 

assessment: impact on type and cost of interventions 

to prevent pressure ulcers. J WOCN 1998; 25: 273–280. 

14. Xakellis GC, Frantz RA, Lewis, A and Harvey P. Costeffectiveness 

of an intensive pressure ulcer prevention 

protocol in long term care. Adv Wound Care 1998; 11: 

22–29. 

15. Severens JL. A Kosten van decubitus in Nederland. 

Afdeling MTA, Universitair Medisch Centrum St. 

Radboud, Nijmegen. 1999. 

16. Severens JL Habraken JM, Frederiks CMA, 

Duivenvoorden S van. Kosten van decubitus in 

Nederland; een inventarisatie op basis van expertopinion. 

Woundcare Consultant Society Nieuws 2000; 16: 

20–25. 

17. Severens JL, Habraken JM, Duivenvoorden S van, 

Frederiks CMA. The cost-of-illness of pressure ulcers 

in the Netherlands. Adv Skin & Wound Care (2001). 

18. Rutten FFH, Ineveld BM van, Ommen R van, Hout 

BA van and Huijsman R (1993). Kostenberekening bij 

gezondheidszorgonderzoek; richtlijnen voor de praktijk 

Utrecht: Uitgeverij Jan van Arkel. 

Appendix 1 

Members of the Guideline Development Group 

JRE Haalboom MD PhD, University Hospital Utrecht, 

Royal College of Physicians, president 

R Ettema BSc, CBO Utrecht, recorder 

FWA van Asbeck MD PhD, rehabilitation centre, De 

Hoogstraat, Utrecht, Dutch Society for Rahabilitation and 

Physical Medicine 

66 

TA van Barneveld PhD, epidemiologist, CBO Utrecht 

GJJW Bours BSc, Dept of Nursing Research, University of 

Maastricht 

IC Buss, BSc, Dept of Nursing Research, University of 

Maastricht 

FJ van Buuren, occupational therapist, Dutch Society for 

Occupational Therapy 

M Casteleijn RN, nurse-specialist, Dutch Organization for 

Home Care 

B Derre RN BSc, nursing researcher, Dept of Nursing 

Research, University of Gent (Belgium), 

T Defloor RN PhD, nursing researcher, Dept of Nursing 

Research, University of Gent (Belgium), 

PH Germs MD, general practitioner, Dutch Society of 

General Practitioners 

HW Groen MD, nursing home specialist, Dutch Society of 

Nursing Home Specialists 

WM van Hengel, dietician, Dutch Society of Dieticians 

BPJA Keller MD, physician-researcher, University Hospital 

Utrecht, 

MNS Koek RN, dermatologic-nurse-specialist, Wound 

Consultant Society 

BGM Kolnaar, general practitioner, Dutch Society of General 

Practitioners 

HEW de Laat, BSc, Dept of Nursing Research, University 

of Nijmegen 

MJ Lubbers MD, surgeon, University Hospital Amsterdam, 

Royal Dutch College of Surgeons 

RJ van Marum MD PhD, clinical geriatrician, Dutch Society 

for Clinical Geriatry 

E Mathus-Vliegen MD PhD, professor of clinical nutrition, 

University Hospital Amsterdam 

JCL Neyens, physiotherapist, Dutch Society for Physiotherapy 

JU Piersma, pressure ulcer nurse, Dutch Network Decubitus 

Consultants 

ME Pieterse PhD, senior researcher, Dutch Institute for 

Health Care Education NIGZ 

CJG Sanders MD, dermatologist, University Hospital 

Utrecht, Dutch Society for Dermatology and Venereology 

L Schoonhoven RN BSc, assistant researcher, University 

Hospital Utrecht 

JTM Westsrate MSc, Erasmus University Rotterdam 

JT Zeilstra, pressure ulcer nurse, University Hospital 

Groningen, Dutch Society of Dermatology Nurses 


epuap 

SEPTEMBER 2003 

3 – 6 7th European Pressure Ulcer Advisory Panel 

Open Meeting 

Tampere, Finland 

EPUAP Business Office 

E-mail: EuropeanPressureUlcerAdvisPanel@ 

compuserve.com 

10 4th Scottish Wound Care Conference 

Glasgow Royal Concert Hall 

Contact: Vi Guyan, Dalmore Associates, 

Prospect House, 8 Prospect Terrace, 

Aberdeen, AB11 7TD, Scotland 

Tel: 01224 582355 Fax: 01224 570296 

E-mail: vguyan@aol.com 

19 – 20 7th Annual European Conference of Scientists 

and Plastic Surgeons 

ECSAPS c/o PD Dr Brigitte Pittet 

Division of Plastic and Reconstructive Surgery 

University of Geneva Hospitals 

25 Rue Micheli-du-Crest 

CH-1211, Geneva 14, Switzerland 

E-mail: brigitte.pittet-cuenod@hcuge.ch 

www.chirurgie-geneve.ch/ecsaps2003 

20 – 21 Tissue Sealants and Adhesives Meeting 

American Academy of Facial Plastic & 

Reconstructive Surgery 

Walt Disney’s Swan and Dolphin Hotel, 

Orlando, Florida, USA 

Tel: 001 703 299-9291 extension 237 

www.aafprs.org 

24 – 25 7th National Wound Management Conference 

Wound Management Association of Ireland 

Rochester Park Hotel, Cork, Ireland 

Conference Secretary: Lucette Murray 

10 Beaumont Avenue, Ballintemple, Cork, Ireland 

Tel: 021 429 3918, Fax: 021 429 3930 

E-mail: Lucette@iol.ie 

24 – 25 New Directions in Tissue Repair and 

Regeneration – Scientific Discussion Meeting 

The Royal Society, London 

Contact: Suzi White 

Science Communication Section 

The Royal Society, 6–9 Carlton House Terrace 

London, SW1Y 5AG 

Tel: +44 (0)20 7451 2581, Fax: +44 (0)20 7451 2693 

E-mail: discussion.meeting@royalsoc.ac.uk 


Future Meetings 

SEPTEMBER / OCTOBER 2003 

29 Sept Tissue Engineering and Cell Therapy 

1 Oct Queens’ College, Cambridge, UK 

Organiser: Dr G. Subramanian 

Contact: Conference Secretariat 

60b Jubilee Road, 

Littlebourne, Kent, CT3 1TP, UK 

Tel: +44 (0)1227 720819, Fax: +44 (0)1227 722700 

E-mail: gsub@globalnet.co.uk 

NOVEMBER 2003 

11 – 12 Wounds UK 2003 

Harrrogate International Conference Centre 

http://www.wounds-uk.com Tel: 01224 582 355 

17 – 19 The Fourth Annual Conference on 

Regenerative Medicine 

Renaissance Washington, D.C. Hotel 

Conference Chair: William A Haseltine PhD 

Chairman and CEO, Human Genome Sciences 

Contact: BioConferences International Inc. 

2 Madison Avenue, Larchmont, NY 10538 

800 – 5 BIOCON (outside NY) (914) 834 3100 

Website: www.bioconferences.com/ebio 

DECEMBER 2003 

5 – 6 Scientific Symposium Honoring 

Thomas K. Hunt MD 

Contact: Lois Hagstrom, 

c/o Adrian Barbul Dept of Surgery, 

Sinai Hospital of Baltimore, MD–21215, USA 

JULY 2004 

8 – 13 2nd World Union of Wound Healing Societies 

Meeting · Paris, France 

MF Congress, Contact: Mr Bia 

8 rue Tronchet, 75008 Paris, France 

Tel: +33 140 07 11 21 Fax: +33 140 07 10 94 

Web: http://www.wuwhs.org 


Executive Trustees 

68 

epuap Membership 


List 

Dr Marco Romanelli, President 

Department of Dermatology, University of Pisa, Via Roma 67, 

56126 Pisa, Italy. 

Tel: 00 390 50 992 436 or 50 533 387, Fax: 00 390 50 551 124 

Dr Michael Clark, Recorder 

Wound Healing Research Unit, Medicentre, University of Wales 

College of Medicine, Heath Park, Cardiff, CF4 4XN, Wales. 

Tel: 02920 689703, Fax: 02920 754217 

Dr George W Cherry, Secretary/Treasurer 

Chairman, Wound Healing Institute, Department of Dermatology, 

The Churchill Hospital, Headington, Oxford, OX3 7LJ, England. 

Tel: 01865 228269, Fax: 01865 228233 

Mrs Christine Cherry, Business Administrator 

EPUAP Business Administror, Wound Healiing Institute, Dept of 

Dermatology, The Churchill Hospital, Headington, Oxford, OX3 

7LJ, England. Tel: 01865 228264, Fax: 01865 228233 

Dr Denis Colin, Centre de l’Arche 72650, Saint Saturnin, France 

Tel: +33 243 51 72 57, Fax: +33 243 51 72 67 

Denis.Colin2@wanadoo.fr 

Dr Jeen R E Haalboom, Past President 

Associate Professor of Internal Medicine, Dept of Internal Medicine, 

University Hospital, PO Box 85500, 3508 GA Utrecht, The 

Netherlands. Tel: 00 31 30 250 6214, Fax: 00 31 30 253 9060 

e-mail: Haalboom@med.ruu.ml 

Professor Keith Harding, Past President 

Director of Wound Healing Research Unit, University Department of 

Surgery, Cardiff Medicentre, Heath Park, Cardiff, CF4 4XN, Wales. 

Tel: 02920 689703, Fax: 02920 745217, e-mail: wsrkgh@cf.ac.uk 

Dr Christina Lindholm, Nattarovagen 42, 13234 Saltsjo-Boo, Sweden 

Tel: 00 46 8 715 6263, Fax: 00 46 8 715 4442 

Mr Joan-Enric Torra i Bou, Consorci Sanitari de Terrassa, Hospital de 

Terrassa, Carretera de Terrassa s/n, 08227 Terrassa, Barcelona, Spain 

Tel: 00 34 93 731 00 07 (ext 2291), Fax: 00 34 93 731 44 51 

Trustees 

Mrs Sue Bale, Director of Nursing Research, Wound Healing Research Unit, 

University Department of Surgery, UWCM, Heath Park, Cardiff, CF4 4XN, 

UK. Tel: 02920 689703, Fax: 02920 745299 

Dr Brigitte Barrois, 32 Rue Roger Lemaire, Aulnay/s/Bois 93600 France 

Tel: +33 1 3453 2085 Fax: +33 1 3453 2481 bbarrois@ch-gonesse.fr 

Mr Mark Collier, 61 Sparrowhawk Way, Hartford, Huntingdon, Cambridgeshire, 

PE18 7XE, England. Tel: 020 8280 5020, Fax: 01480 434100 

Mrs Carol Dealey, 32 Serpentine Road, Harbourne, Birmingham, 

West Midlands, B17 9RE, UK. Tel/fax: 0121 426 5674 

Mr Tom Defloor, Nursing Sciences, Univ. of Gent, U.2. Block A 2 o V, De 

Pintelaan 185, 9000 Gent, Belgium. Tel/fax: 00 32 50 36 24 38 

tom.defloor@urgent.be 

Ms Jacqui Fletcher, Principal Lecturer, Univ of Hertfordshire, Hatfield 

Campus, College Lane, Hatfield, AL10 9AB, England. Tel: 01707 284000, 

Fax: 01707 284954 j.fletcher@herts.ac.uk 

Ms Katia Furtado, Rua Viturino Nemesio, No 2 – 7 Esquerdo, 1750–307 

Lisbon, Portugal Tel: +351 21 758 8288, Fax: +351 21 313 36434 

kfurtado@ip.pt 

Professor Finn Gottrup, University Center of Wound Healing, Dept of Plastic 

Reconstructive Surgery, Odense University Hospital, Sdr Boulevard 29, DK– 

5000 Odense, Denmark. Tel: +45 6542 3903, Mob: +45 4030 3390 

Fax: +45 6542 3904 finn.gottrup@ouh.fyns-amt.dk 

Dr Laszlo Gulacsi, Bem ter 8, H-4026 Debrecen, Hungary 

Tel: +36 52 423 264 

Dr Ruud J G Halfens, Vakgroep Verplegingswetenschap, University of 

Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands. 

Tel: 00 31 43 388 2222, Fax: 00 31 43 367 1004 

Ms Helvi Hietanen, Head Nurse, HUCH, Toolo Hospital, Dept of Plastic 

Surgery, Box 266, 00029 HYKS, Finland 

Tel: +358 9 47 17 228, Fax: +358 9 47 17 260 

Mr. Maarten Lubbers, Meibergdraas 9, 1100 A2, Amsterdam, The 

Netherlands. Tel: 00 31 20 56 69 111, Fax: 00 31 20 69 72 988 

Dr Sylvie Meaume, Hopital Charles Foix, 7 Avenue de la Republique, Ivry sur 

Seine, 94205, France Tel: 00 33 149 594 504, Fax: 00 33 149 594 524 

Zena Moore, The Adelaide & Meath Hospital, Dublin, Eire. 

Tel: 003531 414200 (bleep 7190), Fax: 003531 4143576 

Prof Elia Ricci, Via P. Crotta 8, 10010 Cascinette d’Ivrea, (TO) Italy 

Tel: +39 011 544 747, Fax: +39 011 533 649, eliaricci@tin.it 

Anne Witherow, 36 Cappagh Grove, Portstewart, Derry, Northern Ireland. 

Tel: 02871 345171 (ext. 3602). 

Paying Members 

Ms Jolanda Alblas, Boveny Ziekenhuis, Statenjachtstraat 1, 1034 CS, Amsterdam, 

The Netherlands. Tel: +31 20 634 6346, Fax: +31 20 634 6730 

Mr Bill Allan, Smith & Nephew Medical Ltd, PO Box 81, Hessle Road, Hull, 

HU3 2BN, England. Tel: 01482 225181, Fax: 01482 328326 

Mrs Patrizia Amione, Vulnera C50, Matteotti 35, Turin 10121, Italy. 

Tel: +39 011 544 747, Fax: +39 011 533 649 padmion@tin.it 

Mrs Irene Anderson, Senior Lecturer, Tissue Viability, Univ of Hertfordshire, Dept 

of Nursing & Midwifery, College Lane, Hatfield, Herts, AL10 9AB, England. 

Tel: +44 (0)1707 285233 i.1.anderson@herts.ac.uk 

Mrs Annelie Andersson, Box 13080, 402 52 Göteborg, Sweden. 

Tel: +46 31 722 3105, Fax: +46 31 722 3409, annelie.andersson@molnlycke.net 

Mrs Anneke Andriessen, Zwenkgras 25, Malden 6581–RK, The Netherlands. 

Tel: +31 24 358 7086, Fax: +31 24 388 0155, anneke.a@ntiscali.nl 

Dr Bauk Apotheker, James Stewart Str 125, Almere-Stad, 1325–JC, The Netherlands. 

Mrs Leticia Arreytunandia, Lab Knoll SA, Av Burgos 91, Madrid 28050, Spain. 

Tel: 00 34 1 334 3900, Fax: 00 34 1 383 1676 

Ms Jacqui Ashton, Tissue Viability CNS, Lever Chambers Centre for Health, 

Ashburner Street, Bolton, BL1 1SQ 

Mrs Shirley Aspin, Whithnell Health Centre, Railway Road, Whithnell, Chorley, 

PR6 8UA, England. Tel: 07826 501385, Fax: 01254 832846 

Associacao Portuguesa Tratamento de Feridas, Rua Alvares Cabral, 137–Sala 14, 

4050–041 Porto, Portugal. Tel: +351 222 026 725, Fax: +351 222 007 890 

Ms Stefania Astolfi, Vulnera C50, Matteotti 35, Turin, 10121 Italy. 

Tel: 00 39 011 544 747, Fax: 00 39 011 533 649 r.cassino@sicurdata.it 

Miss Sally Atkin, Smith & Nephew Medical, PO Box 81, Hessle Road, Hull, 

HU3 2BN, England 


Prof Elizabeth Ayello, New York University, Division of Nursing, 346 Green Street, 

New York, NY 10003, USA Tel: +212 998 5311, Fax: +212 995 4302 

elizabeth.ayello@nyu.edu 

Ms Carina Baath, Karlstad University, Division for Health and Caring Sciences, 

Dept of Nursing, SE–65188 Karlstad, Sweden Tel: +46 54 700 2089 

carina.baath@kau.se 

Mrs Sue Bale, Dir of Nursing Research, Wound Healing Research Unit, UWCM, 

The Medi Centre, Heath Park, Cardiff, CF14 4UJ, Wales 

Tel: 02920 682 187, Fax: 02920 754 217 

Mr Graham Ball, Jacksons, 8 Mill Field, Barnston, Essex, CM6 1LH, England 

Tel: 01371 872 097 graham@roberlimited.com 

Ms Katrin Balzer, Zikadenweg 21, 70439 Stuttgart, Germany 

Tel: +49 7 11 1882 – 1159 katrin.balzer@kohlhammer.de 

Prof Joseph Barbenel, 151 Maxwell Drive, Glasgow, G41 5AE, Scotland 

Tel: 0141 427 0705 j.c.barbenel@strath.ac.uk 

Ms Maria Barbierto, Via ca’ Brazzo 44, 35020 Arre, Padova, Italy. 

Tel: +39 49 538 4324, Fax: +39 49 821 2423 mbarbiertom@libero.it 

Dr Richard Barnett, Hill–Rom, 4349 Corporate Road, Charleston, South Carolina, 

29405, USA 

Ms Sharon Baranoski, 24724 W Park River LN, Shorewood, IL 60431 U.S.A. 

Tel: 001 815 740 1078, sbaranoski@silvercross.org 

Dr Brigitte Barrois, 32 Rue Roger Lemaire, Aulnay/s/Bois, 93600 France 

Tel: +33 1 3453 2085, Fax: +33 1 3453 2481, bbarrois@ch-gonesse.fr 

Mr Neil Bashforth, SSL International plc, Canute Court, Toft Road, Knutsford, 

WA16 0NL, England. Tel: +44 (0)1565 625192 

neil.bashforth@ssl-international.com 

Dr Paggi Battistimo, St Priv MK Gandhi 3, Cameri 28062, Italy battpa@tin.it 

Dr Andrea Bellingeri, Via Flarer 6, Pavia 27100, Italy. Tel: +39 038 422 133, 

Fax: +39 038 523 203 ebellingeri@venus.it 

Mrs Maureen Benbow, 20 Cloverfields, Haslington, Cheshire, CW1 5AL, England. 

Tel: 01270 251833, Fax: 01270 612041 

Mr Paul Bennis, Training Manager & Nursing Specialist, Redactron International 

b.v., Lange Voren 18, 5521 DD Eersel, The Netherlands. 

Tel: +31 497 516895 Fax: +31 497 516833 r.bennis@redactron.com 

Mrs S Benton-Jones, The Nuffield Orthopaedic Centre, Windmill Road, 

Headington, Oxford, OX3 7LD, UK. 

Mr Joseph Berman, Dept of Physical Therapy, 346 WSC Marqhette University, PO 

Box 1881, Milwaukee, Wisconsin, 53201-1881, USA 

Tel: 001 414 288 3363, Fax: 001 414 288 5987 

Dr Laurent Bernier, Le Green, rue des Granges, Dommartin, 69380 France. 

Tel: 00 33 478 435 127, Fax: 00 33 478 435 172 lbernier@plaies.com 

Mrs Elaine Bethell, c/o Nursing Admin, City Hospital, Dudley Road, Birmingham, 

B18 7QH, UK. Tel: +44 (0)121 554 3801, Fax: +44 (0)121 507 5610 

elaine.bethell@swbh.nhs.uk 

Mrs Victoria Betteridge, Pressure Damage Lead Nurse, Tissue Viability Service, 

Abingdon Hospital, Marcham Rd, Abingdon, OX14 1AG, England 

Tel: 01235 205789, Fax: 01235 205788 

Mr Bert Billen, The ROHO Group, Peter Valentinuslaan 4, B–3500 Hasselt, 

Belgium Tel: 00 31 1128 4359, Fax: 00 31 1128 1517, bbillen@attglobal.net 

Mr Itzak Binderman, School of Dental Medicine, Tel-Aviv University, Ramat Aviv, 

69978 Tel Aviv, Israel Tel: +972 3 695 1835, Fax: +972 3 640 9250 

binderma@post.tau.ac.il 

Miss Lynne Birchall, Dept of Nursing, Metchley Lane, Edgbaston, Birmingham, 

B15 4TH, England Tel: 0121 472 1311 

Miss Rachael Blewett, 27 Eskmont Ridge, Upper Norwood, London, SE19 3PZ, 

England Tel: 020 8700 0232 Fax: 020 8653 3597 rachael_blewett@hotmail.com 

Dr Mary Bliss, Oaklea, Badgers Mount, Sevenoaks, Kent, TN14 7AY, England 

Tel: +44 (0)1959 534278 

Mr Johe Bominaar, ConvaTec, Ujzelmolenlaan 9, AM Woerden, 3440 gx, 

The Netherlands. Tel: +31 348 436950, Fax: +31 348 423084 

johe.bominaar@BMS.com 

Helen Boon, Wallsend Health Centre, The Green, Wallsend, Tyne and Wear, 

NE28 7PD, England Tel: 0191 220 5991, 0191 220 5943 

helen.boon@northumbria-healthcare.nhs.uk 

Mrs Th CM Bots, Silversteyn 64, 3621 PD Breukelen, The Netherlands. 

Tel: +31 346 264 208, Fax: +31 346 264 163 postbus@thbots.demon.nl 

Dr R T Boumans, TNO Prevention & Health, PO Box 2215, Leiden 2301 CE, 

The Netherlands. 

Dr Gerrie Bours, Maastricht Univ, Dept Nursing Science, PO Box 616, Maastricht 

6200 MD, The Netherlands. Tel: +31 43 388 1279, Fax: +31 43 388 4162 

G.Bours@zw.unimaas.nl 

Dr Carlijn Bouten, Eindhoven University of Technology, Department of Biomedical 

Engineering, PO Box 513, 5600 MB, Eindhoven, The Netherlands. 

Tel: 00 31 40 247 3006, Fax: 00 31 40 244 7355 c.v.c.Bouten@tue.nl 

Mr Jon Bredal, Semsveien 150, 1384 Asker, Norway. Tel: +47 661 05610, 

Fax: +47 669 05611 bred@online.no 

Joost L. Broerse, Postbus 60165, 1320 AE Almere, The Netherlands. 

Tel: 00 31 36 533 5588, Fax: 00 31 36 547 5074 J-Broerse@huntleighhealthcare.nl 

Mr C.H. Bronner, PO Box 616, 6200 MD, Maastricht, The Netherlands. 

Tel: +33 43 388 1544, Fax: +33 43 388 4162 c.bronner@zw.unimaal,nl 

Miss Jill Brooks, Abingdon Hospital, Marcham Road, Abindon, Oxford, 

OX14 1AG, England. Tel: 01993 774126, Fax: 01992 706947 

jill.brooks@oxch-tr.anglox.nhs.uk 

Mr Harry Brouwer, c/o Sterreboslaan 2, Bloemendaal, 2061 VV, The Netherlands. 

Tel: +31 6 53 66 3583 

Dr Roel Brull, Huntleigh Healthcare, Flevolaan 8, 1382 JZ Weesp, The Netherlands 

Dr Enrica Buonagurio, via A. Manzoni 6, Vimodrone, Milan 20090, Italy. 

Tel: +39 022 650 062, Fax: +39 022 502 546 ebuonagurio@libero.it 

Ms Annette Buschka, Mölnlycke Health Care AB, PO Box 13080, SE 40252, 

Sweden. Tel: 00 46 31 722 8121, Fax: 00 46 31 722 3409 

Mr Edwin Buttfield, Talley Group Ltd, Premier Way, Abbey Park Industrial Estate, 

Romsey, Hants, SO51 9AQ, England. Tel: 01794 503557, Fax: 01794 503555 

Mr Cesar Calderon, Beiersdorf Portugesa, Rus Soeiro Pereira Gomes, 59 – Queluz 

de Baixo, 2746–952, Portugal. Tel: 00 351 21 436 8500, Fax: 00 351 21 436 2874 

Miss Rosemarie Callaghan, Evesham Community Hospital, Waterside, Evesham, 

WR11 6JT, England callaghankids1@hotmail.com 

Dr Gianna Rita Carella, ‘C Golgi’ Geriatric Institute, Piazza Golgi 11, Abbiategrasso 

(Milan) 20081, Italy. Tel: +39 029 466 771 Fax: +39 029 496 808 

Ms Lucy Carroll, 30 Larkfield Grove, Harolds Cross, Dublin 6W, Ireland. 

Tel: +353 1 492 3194 lkcarroll@eircom.net 

Dr Roberto Cassino, Vulnera-Corso, Matteotti 35, Torino 10121, Italy. 

Tel: +39 011 544 747, Fax: +39 011 533 649 r.cassino@sicurdata.it 

EPUAP MEMBERS 

Ms Andrea Cavicchioli, Via Siligardi 14, 41100 Modena, Italy Tel: +39 059 440124, 

Fax: +39 059 399210 cavicchioliandrea@hotmail.com 

Mrs Tina Chambers, 5 Wren Close, Ringwood, Hants BN24 3RF, England. 

Tel: 01425 471291, Fax: 01962 824826 tina.chambers@weht.swest.nhs.uk 

Dr Michael Clark, Wound Healing Research Unit, UWCM, The Medi Centre, 

Heath Park, Cardiff, CF14 4UJ, Wales. Tel: 02920 682 191, Fax: 02920 754 217 

Ms Nicky Clark, Tissue Viability Nurse, Queen Elizabeth Hospital, Metchley Park 

Road, Edgbaston, Birmingham, B15 2TQ, England 

Mrs Ann Cobb, Harrogate District Hospital, Lancaster Park, Harrogate, North 

Yorks, GH2 7SX, England. Tel: 01423 881604, Fax: 01423 553624 

ann@cobb51-fsnet.co.uk 

Dr Denis Colin, Medical Director, Centre de l’Arche, 72650 Saint Saturnin, 

Le Mans, France. Tel: +33 243 51 72 67, Fax: +33 243 51 72 57 

denis.colin@antivirus.oleane.com 

Mr Mark Collier, The Old Dairy, Byards Leap Farm, Cranwell, Sleaford, Lincs, 

NG43 8EY, England. Tel: 07785 297663 mark.collier@ulh.nhs.uk 

Mrs Fiona Collins, 25 Hyde Gardens, Eastbourne, East Sussex, BN21 4PX, 

England. Tel: 01323 735588, Fax: 01323 737132 fiona@trcs.cc 

Ms Catherine Considine, 2 The Drive, Melrose Park, Swords, Co. Dublin, Ireland 

Tel: +353 1 886 0953 / 840 7792, Fax: +353 1 836 3813 



Mrs Joanne Conway, The Royal Oldham Hospital, Room 14, Chalmers Keddre 

Building, Rochdale Road, Oldham, OL1 2JM, England Tel: +44 (0)161 627 8423, 

Fax: +44 (0)161 627 8554 joanne.conway@oldham-tr.nwest.nhs.uk 

Miss Pamela Cooper, Clinical Nurse Specialist, Dept of Tissue Viability, Foresthill, 

Grampion University Hospital, AB25 2ZN, Scotland. 

Tel: 01224 554621, Fax: 01224 849139 

Miss Fiona Coull, c/o Nursing Directorate, Royal Free Hospital, Pond Street, 

London, NW3 2QG, England Tel: 020 7472 6439, Fax: 020 7830 2961 

fiona.coull@rfh,nthanes.nhs.uk 

Ms Gerardine Craig, Broadmeadow, Drumshallow, Grangebellen, Drogheda, Co. 

Leith, Ireland Tel: +353 41 988 1515 

Mrs Barbara Craven, Disability Services, Walton Hospital, Whitecotes Lane, 

Chesterfield, Derbyshire, S40 3HW, England. Tel: +44 (0)1246 552917 (ext 5707) 

Fax: +44 (0)1246 557958 barbara.craven@nederbypct.nhs.uk 

Ms Jean Cregg, 9 Goddards Lane, Aldbourne, Marlborough, Wilts, SN8 2DZ, 

England. Tel: 01282 432072, Fax: 01282 421597 

Ms Ann Daenekindt, Stapelplein 70, Gent 9000, Belgium. Tel: +32 9 265 8770, 

Fax: +32 9 265 8771 ann.daenekindt@huntleigh-healthcare.be 

Dr Sarah Daniels, Harrington House, Milton Road, Ickenham, Uxbridge, 

Middlesex, UB10 8PU, England. Tel: 01895 628395, Fax: 01895 628338 

Prof Theo Dassen, Albrechtstrasse 15, 10117 Berlin–Mitte, Germany 

Tel: +49 30 450 529 092, Fax: +49 30 450 529 900 theo.dassen@charitl.de 

Mrs Carol Dealey, Research Dev. Team, University Hospital Birmingham NHS 

Trust, 4th Floor, Nuffield House, QEMC, Birminham, B15 2TH, England. 

Tel: (and Fax:) 0121 426 5674 carol.dealey@uhb.nhs.uk 

Dr Tom Defloor, Kerklaan 58, Brugge 8310, Belgium 

Tel: 00 32 50 36 24 38, Fax: 00 32 50 36 24 38 tom.defloor@urgent.be 

Dr Maaike De Jager, Postbus 1, 2700 MA Zoetormeer, The Netherlands. 

Tel: +31 79 353 9673, Fax: +31 79 353 9730 Maaike.dejager@nutricia.nl 

Mr Germain de Keyser, Kapucijnenvoer 35, 3000 Leuven, Belgium 

Tel: 00 32 1633 2211, 00 32 1922 8349 germain.dekeyser@pandora.be 

Dr Erik de Laat, University Medical Centre Nijmegen, 111 Staf Zorg, PO Box 9101, 

6500 HB Nijmegen, The Netherlands Tel: +31 24 361 6560, 

Fax: +31 24 354 1456 e.delaat@zorg.azn.nl 

Mr Fredrik Delas, Bryggenveien 42, 1747 Skjeberg, Norway 

Tel: +47 930 22 712, Fax: +47 69 33 6606 fd@alurehab.com 

Dr Bart Derre, Aartstraat 210, Ronse, B-9600, Belgium. Tel: 00 32 55 20 6948 

Mr Dirk De Wolf, Prinsenmeers 9, Dendermonde, B–9200 Belgium. 

Tel: +31 52 21 5872 dirk.de.wolf@pi.be 

Miss Meike Dewin, Academisch Ziekenhuis, Directir Vorpleging, Laarbeecklaan 

101, 1090 Brussels, Belgium. Tel: +31 2 477 5577, Fax: +31 2 477 5593 

dirndwnm@azwb.ac.be 

Mr Peter Diesing, Buchbinder Weg 55, 12355 Berlin, Germany 

Tel: +49 30 664 61709, Fax: +49 30 664 61708 peter.diesing@gmx.de 

Dr Andy Dobrzeniecki, Torsana A/S, Skosborg Strandvej 156, DK-2942 Skodsborg, 

Denmark 

Ms Valerie Dowley, Practice Development Specialist, Pegasus Limited, Waterberry 

Drive, Waterlooville, Hants, PO7 7XX, England 

Dr Inge Duimel-Peeters, Wirixstraat 22, Tongeren, 3700 Belgium 

Tel: +31 43 388 1557, Fax: +31 43 388 4162 i.duimel@xw.unimaas.nl 

Dr Sonia Dumit-Minkel, 1231 E. Donges Crt, Bayside, Wisconsin 53217, USA 

Tel: (and Fax:) 001 414 228 0101 duminkel@yahoo.com 

Mrs Cheryl Dunford, School of Nursing and Midwifery, Nightingale Building, 

University Road, Highfield, Southampton, SO17 1BJ, England 

Dr Ana Durao, R Replia Horsensia de Castro, No 2 – 8oD to, Colina do Sol, 2700 

Amadora, Portugal. Tel: +351 21 474 8559, anadurao@net.sapo.pt 

Mrs Jane Edwards, 17 Windrush Way, Abingdon, Oxon, OX14 3SX, England. 

Tel: 01865 227312 (work) Fax: 01865 742348 jane.l.edwards@noc.anglox.nhs.uk 

Mrs Lynfa Edwards, 135 Kenyngton Drive, Sunbury, Middlesex, TW16 7RU, 

England. Tel: 01932 789022 

Mrs Sandra Ellis, 14 Pinewood Road, Eaglescliffe, Cleveland, TS16 0AH, England 

Tel: 01642 791558, Fax: 01642 624165 

70 

Ms Jacqui Elst, Weide 93, 5103 HT Dongen, The Netherlands 

jacam.elst@wanadoo.nl 

Mrs Wendy Eve, Saiyang, 30 Torton Hill Rd, Arundel, West Sussex, BN18 9HL, 

England Tel: 01243 623661, Fax: 01243 623664 wendyeve@u.genie.co.uk 

Mrs Leone Ewings, Tissue Viability CNS, Nurse Practice Development Unit, 

Beaumont Hospital, Beaumont, Dublin 9, Ireland. Tel: +353 1 809 2533 

leone.ewings@beaumont.ie 

Ms Caterina Falce, 109 Barnet Road, Potters Bar, Herts, EN6 2RN, England 

Tel: +44 (0)1707 859153, Fax: +44 (0)1707 664889 caterinafalce@yahoo.co.uk 

Carlos Ferrer, Smith & Nephew SA, Fructuos Gelabert 2 y 4, 08970 Sant Juan 

Despi, Barcelona, Spain Tel: +34 93 373 7301, Fax: +34 93 373 7453 

Ms Johanna Feuchtinger, St-Agatha-Weg 5, 79108 Freiburg, Germany 

Tel: +49 7665 938093 Fax: +49 7612 706153 johanna.feuchtinger@gmx.de 

Dr Rosy Fittipaldi, Via Ticinello No. 34, Pavia, 27100 Italy 

Tel: +39 333 9452041 rosi.fittipaldi@libero.it 

Ms Cynthia Fleck, The ROHO Group, 100 North Florida Avenue, Belleville, 

Illinois, 62221, USA Tel: +618 277 9173, Fax: +618 277 9561 

cynthiaf@therohogroup.com 

Mrs Jacqui Fletcher, University of Hertfordshire, Hatfield Campus, College Lane, 

Hatfield, Herts, AL10 9AB, England Tel: +44 (0)1707 285266, 

(home: 01462 850495), Fax: +44 (0)1707 284954 j.fletcher@herts.ac.uk 

Mr Håkan Freijd, MedTec Nordic AB, Vinbarsvagen 14, S–734 31 Hallstahammar, 

Sweden. Tel: +46 220 126 23, Fax: +46 220 126 23 medtecnordic@netscape.net 

Mr John Furness, Vital Base AS, Myravegen 2, Hareid, NO–6060, Norway 

Tel: +47 700 95959, Fax: +47 700 95951 john@vitalbase.no 

Ms Katia Furtado, Rua Viturino Nemesio, No.2–7 Esquerdo, 1750-307 Lisbon, 

Portugal. Tel: +351 21 758 8288, Fax: +351 21 313 36434 Kaxfurtado@clix.pt 

Mr Lucas Garabet, GerroMed GmbH, Fangdieckstra 75B, Hamburg 22547, 

Germany. Tel: +49 40 547 3030, Fax: +49 40 547 30331 GarabetL@Gerromed.de 

Ms Tracy Gardner, Professional Development Specialist, Pegasus Limited, 

Waterberry Drive, Waterlooville, Hants, PO7 7XX, England Tel: 02392 784200 

Prof Stefano Gasperini, Via V Maroso, 50, c/o Bristol Myers Squibb, Div. ConvaTec, 

Roma 00142, Italy. Tel: +39 6 50 396378 stefano.gasperini@bms.com 

Kjetil Gausel, Dreierhagen 21, Sandnes, 4321 Norway 

Tel: +47 9 805 1111, Fax: +47 5 158 1889, kg@alurehab.com 

Mr Krzysztof Gebhardt, PUPT, Room 0.195, Ground Floor, Lanesborough Wing, 

St George’s Hospital, Blackshaw Road, London, SW5 0AH, England. 

Tel: 020 8725 2230, Fax: 020 8725 1071 chris.gebhardt@stgeorges.nhs.uk 

Dr Walter Gianni, via Appennini 38, Rome 00198, Italy 

Tel: +39 06 3034 2690, wgianni@tiscalinet.it 

Mrs Elaine Gibson, 21 St Mary’s Green, Kennington, Ashford, Kent, TN24 9HP, 

England. Tel: 01233 626837 gibse@btinternet.com 

Me Anabela Gomes, Rua Teofilo Braga, 154–1o, 4435–461 Rio Tinto, Portugal. 

Tel: +351 224 889 791 

Mrs Ann Goodhead, Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, 


Ms Marguerite Gordon, 7 Hampstead Park, The Rise, Glasnevin, Dublin 9, Ireland. 

Tel: +353 1 836 0875, Fax: +353 1 848 7821 

Dr Davina Goswell, 1733 Elm Drive, Kent, 44240 Ohio, USA 

Tel: 001 330 672 3777, Fax: 001 330 672 2433 dgoswell@kent.edu 

Dr Allison Graham, 75 Mellstock Road, Aylesbury, Bucks, HP21 7NX, England 

Tel: 01296 315851, Fax: 01296 315867 

Dr Jeffrey Graham, Dept of Health, Room LG24, Wellington House, Walterloo 

Road, London, SE1 8UG, England Tel: 020 7972 4710, Fax: 020 7972 4405 

Mr Mark Green, 1 Greenwood Avenue, Horwich, BL6 6FA, UK. 

Dr Laszlo Gulacsi, Bem ter 8, H–4026 Debrecent, Hungary. 

Mrs Lena Gunningberg, Department of Nursing Research and Development, 

University Hospital, 75185 Uppsala, Sweden. Tel: +46 18 611 3194, 

Fax: +46 18 611 3025 lena.gunningberg@adm.uas.lul.se 

M Susan Gwynne, C.I. Adulti, Ospedale G Pasquinucci, via Aurelia Sud 1, Massa 

54100, Italy. 


Dr Jeen RE Haalboom, Dept. of Internal Medicine, University Hospital, 

Heidelberglaan 100, Utrecht 3508, The Netherlands. 

Tel: 00 31 30 250 6214, Fax: 00 31 30 253 9060 

Dr Satsue Hagisawa, Nagoya City University, School of Nursing, Kawasumi 1, 

Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Tel: +81 52 853 8074 

Mr Kurt Halbwachs, Smith & Nephew GmbH, Concorde Business Park D2/Top 

11, 2320 Schwechat, Austria. 

Dr Ruud Halfens, Praaglaan 123, 6229 HR Maastricht, The Netherlands. 

Ms Samantha Hall, Acordis Speciality Fibre Ltd. Lockhurst Lane, Coventry, 

CV6 5RS, England. 

Ms Tracey Hamlyn, 61 Lydford Park Road, Peverell, Plymouth, PL3 4LQ, England 

Tel: 01752 670601 

Mr Mark Hammonds, Coronary Care Unit, James Cook University Hospital, 

Marton Road, Middlesborough, TS4 3BW, England 

Tel: 01642 854801, Tel: 01642 854196 

Miss Jane Hampton, 25 Trentham St, Southfields, London, SW18 5AS England. 

Tel: 020 8846 6544, Fax: 020 8846 6543 

Dr Carita Hansson, Dept of Dermatology, Wound Healing Centre, Sahlgrenska 

University Hospital, 41345 Göteborg, Sweden 

Tel: +46 31 342 1000, Fax: +46 31 821 1871 

Prof Keith Harding, Director, Wound Healing Research Unit, UWCM, 

Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, Wales, UK 

Tel: 02920 682 176, Fax: 02920 754 217 HardingKG@whru.co.uk 

Ms Elizabeth Hardy, Northumbria Healthcare NHS Trust, Wallsend Health Centre, 

The Green, Wallsend, Tyne and Wear NE28 7PD England. 

Tel: 0191 220 5928, Fax: 0191 220 5943 

Ms Diane Hargrove, Seton Healthcare, Tubiton House, Medlock Street, Oldham, 

OL1 3HS, England. Tel: 0161 652 2222, Fax: 0161 621 2627 

Ms Judy Harker, Room 15 Chalmers Keddie Building, Royal Oldham Hospital, 

Rochdale Road, Oldham, OL1 2JH, England Tel: 0161 627 8701, 

Fax: 0161 627 8554, judy.harker@oldham-tr.nwest.nhs.uk 

Mrs Lucy Harper, 50 Somersall Street, Mansfield, Notts., NG19 6EP, England. 

Tel: 01623 456063 lucy@ntlworld,com 

Ms Joy Harris, Smith & Nephew Medical Ltd, PO Box 81, Hessle Rd, Hull, HU3 

2BN, UK. Tel: 01482 225181 (x 2645), 01482 673106 

Mr Kenny Harris, Davenant, 18a Lordsgate Lane, Burscough, Ormskirk, L40 7ST, 

England 

Mr William Haughton, 211 Spital Road, Bromborough, Wirral, Merseyside, 

CH62 2AF, England. Tel: 0151 334 8461 

Mrs Linda Haywood, 25 Avalanche Road, Southwell, Portland, Dorset, DT5 2DT, 

England. Tel: 01305 252812 

Ms Arja Heikinheimo, Kuntokatu 8, 15900 Lahti, Finland 

Tel: +358 3 819 4857, Fax: +358 3 819 7850 arja.heikinheimo@phks.fi 

Ms Jussi Heikkila, Kuoppatie 4, PO Box 25, Helsinki, 00731 Finland 

Tel: +358 9 346 2574, Fax: +358 9 346 2576 jussi.heikila@icfgroup.fi 

Dr Eva-Lisa Heinrichs, ConvaTec Ltd, Harrington House, Milton Rd, Ickenham, 

Uxbridge, Middlesex, UB10 8PU, England. 

Tel: 01895 628330, Fax: 01895 628332 eva-lisa.heinrichs@bms.com 

Ms Taina Hemmila, Kuoppatie 4, PO Box 25, Helsinki, 00731 Finland 

Tel: +358 9 346 2574, Fax: +358 9 346 2576 taina.hemmila@icfgroup.fi 

Ms Val Henderson, Tissue Viability Nurse, Joint Equipment Loan Store, 43 

Colbourne Crescent, Nelson Industrial Estate, Cramlingham, Northumberland, 

England 

Mr Jan Hermkens, Weymar Straat 8, Maasbree, 5993 CT, The Netherlands. 

Tel: +31 77 465 2676, Fax: +31 77 465 1599 jan.hermkens@wxs.nl 

Ms Hilde Heyman, Karel VD, Woestynelaan 40, 2630 Aartselaar, Belgium 

Tel: +31 3 289 4087 

Ms Helvi Hietanen, Tonttumuorinkija 1, 02200 Espoo, Finland. 

Tel: +35 85 001 02947, Fax: +35 89 412 5074 hetu.hietanen@magabaud.fi 

Ms Raija Hietikko, Karhusyuontie 14, Fin–02810 Espoo, Finland. 

Tel: +358 50 344 7127, raija.hietikko@hus.fi 

Mrs Monica Hofmann-Rosener, HNE Healthcare, Im Hulsenfeld 19, 40721 

Hilden, Germany. Tel: +49 2013 97110 Fax: +49 2013 971146 

hne.hofrose@t-online.de 

Mrs Helen Hollinworth, 10 Cages Way, Melton, Woodbridge, Suffolk, IP121TE, 

England Tel: 01473 296557 

Ms Alison Hopkins, 8 Plas Taliesin, Penarth Marina, Penarth, CF64 1TN, Wales, 

UK hopkins72@yahoo.com 

Ms Ansa Iivanainen, Potnolankatu 5, Mikkeli, 50120 Finland. 

Tel: +358 15 150 632, Fax: +358 15 355 6686 ansa.iivanainen@mikkeliamk.fi 

Prof Agnes Jacquerye, Clinique Universitaires de Brusselles, Route de Lemik 808, 

1070 Brusselles, Belgium. Tel: +32 2 555 4567, Fax: +32 2 555 3665 

Sister Sian James, Wound Healing Office, East 5, Whitchurch Hospital, Park Road, 

Whitchurch, Cardiff CF4 7XB, UK 

Mr Torsten Johansen, Smith & Nephew A/S, Naerum Hovedgade 2, 2850 Haerum, 

Denmark 

Ms Julie Jordan-O’Brien, Tissue Viability CNS, Nurse Practice Development Unit, 

Beaumont Hospital, Beaumont, Dublin 9, Ireland. 

Tel: +353 1 809 2533 julie.jordanobrien@beaumont.ie 

Dr Wilhelm Jung, Global Category Manager–Debridement, Smith & Nephew 

Medical Ltd, PO Box 81, Hessle Rd, Hull, HU3 2BN, England. 

Tel: 01482 673030, Fax: 01482 673307, willi.jung@smith-nephew.com 

Dr Vesa Juutilainen, Pitkankalliontie 14 B 11, Espoo, 02170 Finland 

vesa.juutilainen@kolumbus.fi 

T. Kaldijk, Academisch Ziekenhuis Maastricht, Postbus 5800, 6202 AZ, Maastricht, 

The Netherlands. Tel: +31 43 387 5912, Fax: +31 43 387 5142 tka@frev.azm.nl 

Mr Raija Kanniainen, Perkionkuja 5B, 01670 Vantaa 67, Finland. 

Tel: +358 9 270 92793, Fax: +358 9 270 92798 raijakanniainen@hotmail.com 

Greger Karlsson, Smith & Nephew AB, Textilvagen 7, 3tr, S–120 30 Stockholm, 

Sweden. 

Dr Paul Keller, University Medical Centre, Utrecht, 3508 GA, The Netherlands 

Tel: +31 30 250 8075 

Ms Helena Kelly, Keaney Medical Ltd, Clinitron House, 6 Greenhills Business Park, 

Talloght, Dublin 24, Ireland. Tel: +353 1 459 6585, Fax: +353 1 459 6634 

Mrs Anne Keogh, 8 Glenavon Road, Kings Heath, Birmingham, B14 5BL, 

England. Tel: 0121 604 2287, Fax: 0121 697 8377 

Mrs Bernadette Kerry, Lahinch, Durrow, Tullamore, Co. Offaly, Ireland 

Tel: +353 506 28075, Fax: +353 506 31175 bernie.kerry@mhb.ie 

Dr Morris Kerstein, 1214 Valley Road, Villanova, PA 19085–2124, USA 

Tel: 001 610 527 4316, Fax: 001 610 520 9293 LK1122@prodigy.net 


Mrs Penny Keynton-Hook, Department of Professional Studies, Sussex Weald and 

Downs NHS Trust, 9 College Lane, Chichester, PO19 4FX, England. 

Tel: 01203 815336 (0402 891835), Fax: 01203 815413 

Mrs Joyce Khoulowa, c/o Ward 23, York District Hospital, Wiggington Road, York, 

YO31 8HE, England. Tel: 01904 725966 

Mrs Brenda King, 12 Beckton Ave, Waterthorpe, Sheffield, S20 7NA, England. 

Tel: 0114 271 6416, Fax: 0114 271 6417, brenda.king@virgin.net 

Prof Luther Kloth, Dept of Physical Therapy, Marquette University, PO Box 1881, 

Milwaukee, WI 53201-1881 USA. Tel: 001 414 288 3381, Fax: 001 414 288 5987 

Mrs Cathy Knowles, Tissue Viability Specialist, Royal Devon and Exeter Hospital , 

Barrack Road, Exeter, EX2 5DW, England. 

Tel: 01392 402846, Fax: 01392 402774 

Mr E. Koopman, Deventer Ziekenh Stg, Fesevurstraat 7, 7415 CM Deventer, The 

Netherlands. Tel: +31 (0)570 646 078 koopman@dz.nl 

Me Eva Krahenbuhl, Ardo Medical AG, Gewerbestrasse 19, 6314 Unterageri, 

Switzerland. Tel: +41 417 57 70 70, Fax: +41 417 57 70 71 

eva.krahenbuhl@ardo.ch 

Mr Samuel Krahenbuhl, ARDO Medical AG, Gewerbestrasse 19, 6314 Unterageri, 

Switzerland. Tel: +41 417 54 70 70, Fax: +41 417 54 70 71 

samuel.krahenbuhl@ardo.ch 

Prof. Andrzej Kubler, Chalublinskiego 1A, Wroclan, 50368 Poland. 

Tel: +48 71 328 1534, Fax: +48 71 328 5087 andrzej.kubler@anest.am.wroc.pl 

Mr Erik Küppers, HNE Healthcare, Im Hulsenfeld 19, 40721 Hilden, Germany. 

Tel: +49 2013 97110 Fax: +49 2013 971146 hne.kueppers@t-online.de 



Mr Jan van Laere, Smith & Nephew SA, Avenue du Four a Briques 3B, 1140 

Bruxelles, Belgium. 

Mr Nils Lahmann, Ziegelstr 5, D–10117 Berlin, Germany 

Tel: +49 30 450 529066, Fax: +49 30 450 529900 nils.lahmann@charite.de 

Ms Catriona Lally, Clinical Specialist, Kaymed, Bluebell Industrial Estate, Naas 

Road, Dublin 12, Ireland Tel: +353 1 419 2938, Fax: +353 1 460 2574 

lallyc@kayfoam.com 

Mr Larry Lankard, 8550 Balboa Boulevard, No. 214, Northridge, CA 91325, USA 

Tel: 001 818 894 0744, Fax: 001 818 894 7972 larry.lankard@bgind.com 

Mr Bernier Laurent, Asymptote, Le Green – Rue des Granges, Dommartin, 69380 

France. Tel: +33 478 435 127, Fax: +33 478 435 172 

Ms J Leenman, Albert Cuyplaan 17, Woudenberg LD 3931, The Netherlands. 

Tel: 00 31 33 286 2303, Fax: 00 31 33 693 2740 

Miss Sylvia Leonard, 7 Brackendale Grove, Luton, Beds, LU3 2LT, England 

Tel: 01582 495036 lem65@tiscali.co.uk 

Miss Ruth Lester, 64 Wellington Road, Edgbaston, Birmingham, B15 2ET, UK 

Tel: 0121440 4937, Fax: 0121 440 7708 ruthlester@compuserve.com 

Mr Nigel Lewis, Smith & Nephew Healthcare Ltd, Healthcare House, Goulton 

Street, Hull, HU3 4DJ, England. 

Ms Sarah Lewis, 14 Lancaster Road, Walthamstow, London, E17 6AJ, England. 

Tel: 020 8503 3921 sarah.lewis@uclh.org 

Ms Doris Liddy, Tissue Viability Nurse, UCHG, Newcastle Road, Galway City, 

Ireland. Tel: +353 (0)91 542115, doris.liddy@hsi.ie 

Mrs Pirjo Lietzen, Jonsaksenpolku 1 A 22, Fin–01600 Vantaa, Finland 

Tel: +358 50 372 0280, Fax: +358 9 310 50330 pirjo.lietzen@luukku.com 

Dr Christina Lindholm, Director Clinical Research, Karolinska Hospital, S–171 76 

Stockholm, Sweden. Tel: +46 8 517 798 82, Fax: +46 8 517 799 68 

christina.lindholm@ks.se 

Mr Wouter Lioen, Sampli NV, Schamperij 9, B–9667 Horebeue, Belgium. 

Tel: 00 32 55 45 5867, Fax: 00 32 55 45 6986 

Mr Armin Littek, Box 14435, Kilkirnie, Wellington, New Zealand 

Tel: +64 4 383 5790, Fax: +64 4 383 5797 armin@med-dev.co.nz 

Mrs Menna Lloyd-Jones, Beechwood House, Bridge Street, Dolgellau, LL40 1AU, 

Gwynedd, Wales, UK Tel: +44 (0)1341 421412, Fax: +44 (0)1341 422059, 

menna.jones@nww-tr.wales.nhs.uk 

Ms Pille Loit, Tammsaane 61–9, 13715 Tallinn, Estonia 

Tel: +372 51 84008, Fax: +372 67 11509 

Mr Reinier J. Lorist, Oude Waal t.o.10, 1011 CG, Amsterdam, The 

Netherlands Tel: +31 20 62 02962, Fax: +31 20 599 2299 r.j.lorist@olvg.nl 

Dr Maarten Lubbers, Surgeon AMC, Meibergdreef 9 1105 AZ, Amsterdam, The 

Netherlands. Tel: 00 31 20 566 9111, Fax: 00 31 20 697 2988 

Ms Elja Luotola, Hakalantanhua 15, Fin–29100 Luvia, Finland 

Tel: +358 2 558 3300, eija.luotola@jippii.ji 

Ms Yvonne Lutgens, Nieuwe Uilenburgerstraat 10B, 10011 LP Amsterdam, The 

Netherlands. Tel: +31 20 566 9111 Fax: +31 20 566 9568 

y.h.lutgens@amc.uva.nl 

Ms Gysesl Machteld, De Domk 4, Mortsel, B–2640, Belgium 

Tel: 00 32 3455 2660 Fax: 00 32 3457 3419 

Ms Gwendolyn Macintyre, 153 Kilpatrick Gardens, Clarkston, Glasgow, G76 7RN, 

Scotland, UK Tel: +44 (0)141 638 0360 billmacintyre@yahoo.co.uk 

Mrs Helga Magnusson, Mölnlycke Health Care, PO Box 13080, 40503 Göteborg, 

Sweden 

Ms Lybda Mapplebeck, Tissue Viability Specialist, Kingsley Grove Clinic, Grimsby, 

Lincs, DN33 1NL, England 

Mr George Maroutsis, 24 Filellinon Street, Halandri, GR–152, 32 Athens, Greece 

Tel: +30 168 12 522, Fax: +30 168 16 706 gmaroutsis@msjacovides.com 

Mr Andrew Cox Martin, Dept of Medical Engineering, Salisbury District Hospital, 

Salisbury, Wilts, SP2 8BJ, England. Tel: 01722 425138 Fax: 01722 416227 

bill@medengsdh.demon.co.uk 

Mrs Laura Martin, 6 Parkgate Road, Temple Patrick, Ballyclare, BT39 0DF, 

Northern Ireland. Tel: 028 9443 2667 laura@martinparkgate.freeserve.co.uk 

72 

Dr Marco Masina, Via Andrea Costa 5, S Giorgio Di Piano (BO), 40016 Italy 

Tel: +39 339 305 1053, Fax: +39 051 66 44491 marc_mas@yahoo.com 

Mr John Masso, 412 Hancock Place, Fairview, New Jersey, 07022–1810, USA 

Tel: 001 201 941 8493, Fax: 001 201 943 1726 chichimambo@ix.netcom.com 

Mrs Peta Matthews, Southern Cottage, Jenkins Lane, St Leonards, Tring, Herts, 

HP23 6NW, England. Tel: 01494 758751 

Dr Stella Maurizio, Burn Unit/CTO, via Zuretti 29, Torino, 10137 Italy. 

Tel: +39 11 693 3423/5, Fax: +39 11 693 3425 

Mr Anton Mayrhauser, Ketzergasse 39 (FA Sunmed), 1232 Vienna, Austria 

Tel: +43 1699 2299 Fax: +43 1699 2299-1 mayrhauser@ sunmed.at 

Dr Alistair McLeod, Huntleigh Technology PLC, 310-312 Dallow Road, Luton, 

LU1 1TD, England. Tel: 01582 745768, Fax: 01582 745862 

Ms Mary McMahon, St Joseph’s Ward, Cappagh National Orthopaedic Hospital, 

Finglas, Dublin 11, Ireland. 

Mr Kevin Mearns, Tally Group Limited, Premier Way, Abbey Park Industrial Estate, 

Romsey, Hants, SO51 9AQ, England. Tel: 01794 503557, Fax: 01794 503555 

Dr Sylvie Meaume, Hopital Charles Foix, 7 Avenue de la Republique, Ivry sur 

Seine, 94205, France Tel: 00 33 149 594 504, Fax: 00 33 149 594 524 

sylvie.meaume@cfx.ap-hop-paris.fr 

Dr Elke Mertens, Wielandstr 24, 12159 Berlin, Germany 

Tel: +49 30 859 1136, Fax: +49 30 450 529 900 elke.mertens@charite.de 

Mrs Janine Michaelides, The Cyprus Ass. of Cancer Patients and Friends, 6 Pindou 

Street, Limassol 3035, Cyprus. Tel: +357 574 7750, Fax: +357 574 7668 

janinemichaelides@yahoo.com 

Mrs Christina Miguens, R Rangel de Lima, No. 12, 3320–229 Pampilhosa Da Serra, 

Portugal miguens.gouveia@clix.pt 

Dr Julian Minns, Dept of Medical Physics, Dryburn Hosp, Durham, DH1 5TW, 


jminns@compuserve.com 

Ulla Moe, Product Manager, Huntleigh Healthcare, Hejreskouvej 18a, 3490 

Kvistgard, Denmark. Tel: 00 45 49 138 486, Fax: 00 45 49 138 487 

Dr Fabrizio Moffa, Vulnera C50, Matteotti 35, Turin 10121, Italy. 

Tel: +39 011 544 747, Fax: +39 011 533 649 fmoffa@tin.it 

Ms Sue Moody, Smith & Nephew Medical Ltd, PO Box 81, Hessle Rd, Hull, HU3 

2BN, England. 

Mrs Zena Moore, Kuldana, 11 Beech Park Avenue, Castleknock, Dublin 1, Ireland. 

Tel: +353 1 821 6775, Fax: +353 1 414 3576 zena.moore@amnch.ie 

Ms Margaret Moriaty, Tissue Viability Specialist, Dartford, Gravesend and Swanley 

PCT, Gravesend Hospital, Ward M4, Bath Street, Gravesend, Kent, DA1 0DG, 

England. Tel: 01474 564333 

Ms Louise Morris, 9 Fen Close, Kidderminster, Worcs, DY10 2HR, England. 

Tel: 01562 741331, louise_morris@btinternet.com 

Mr Will Morris, Pinfold House, Pinfold Lane, Alltami Mold, Flintshire, CH7 6NZ, 


willmorris@nightingalebeds.co.uk 

Mr Olavi Murros, Kuoppatie 4, PO Box 25, 00731 Helsinki, Finland. 

Tel: +358 9 346 2574, Fax: +358 9 346 2576 olavi.murros@icfgroup.fi 

Mrs Anne Myer, 22951 Femes, Mission Viejo, California, 92692–1424, USA 

Tel: +1 949 770 9316 Fax: +1 949 767 5998 woundcare@cox.net 

Mrs Jeanette Nelson, Vibro-Pulse Ltd, Colomendy Industrial Estate, Denbigh, 

LL16 5TS, N Wales, UK Tel: 01745 811200, Fax: 01745 817142 

epetern@aol.com 

Mrs Marilyn-Agnes Ngoh, 11 Maxwell Court, Dulwich Common, London, SE22 

8NT, England Tel (+Fax): +44 (0)20 8299 6690 mangoh2001@aol.com 

Ms Kaoru Nishide, Smith & Nephew KK, Shiba-Nikkei-Yuraku Bld, 1-10-13 Shiba, 

Minato-ku, Tokyo 105-0014, Japan. Tel: 00 81 3544 35721, 

Fax: 00 81 3544 35722 kaoru.nishide@smith-nephew.com 

Mrs Jane Nixon, Centre for Evidence Based Health Care, University of Huddersfield, 

Harold Wilson Building, Queensgate, Huddersfield, HD1 3DH, England. 

Tel: 01484 473645 j.nixon@hud.ac.uk 

Ms Birgit Nordlund, Salamapujankatu 18, F 41, Fin–65370 Vaasa, Finland 

Tel: +358 6 316 9617 birgit.nordlund@vshp.fi 


Mrs Pirjo Nurminen, Simpukkakie 14, Fin–48310 Kotka, Finland 

Tel: +358 5 2604 181 (or +358 40 7409 709) pirjo.nurminen@kymshp.fi 

Mrs Pia Obank, Lane End Surgery, Finings Road, Lane End, Bucks, HP14 3ES, 

England Tel: 01494 883364 

Miss Louise O’Connor, 37 Clough House Drive, Leigh, Lancashire, WN7 2GD, 

England. Tel: 0161 291 3227 louise.oconnor@smunt.nwest.nhs.uk 

Mrs Linda O’Flynn, Holly Lodge, 57 London Road, Datchet, Berks, SL3 9JY, 

England Tel: 01753 545640, Fax: 01753 860441 

linda-oflynn@btinternet.com 

Dr Takehiko Ohura, Kojinkai Pressure Ulcer Wound Healing Res. Center, 

7F, H&B Plaza Bld 1-1, West 2, South 3, Chuo-ku, Sapporo, 060–0063 Japan 

Tel: +81 11 232 2208, Fax: +81 11 232 5181 t.ohura@mb.snowman.ne.jp 

Dr Cathy O’Neill, Huntleigh Healthcare, 312 Dallow Road, Luton, LU1 1TD, 

England. Tel: 01582 745736, Fax: 01582 459100 cathy.oneill@hunhcare.co.uk 

Mrs Nwando Onugha, 3 Wood Close, Salfords, Redhill, Surrey, RH1 5EE, England. 

Tel: 01293 823176 

Dr Cees Oomens, Eindhoven Univ of Technology, Mech Eng Dept, PO Box 513, 

5600 MB, Eindhoven, The Netherlands. Tel: +31 40 247 2818, 

Fax: +31 40 244 7355 oomens@wfw.wtb.tue.nl 

Dr Forma Ormella, Via Carlo Porte 3, Voltorre di Gavirate, Varese 21026, Italy 

Tel: +39 033 2828 443 or 730372 pamisua@tin.it 

Ms Sandra O’Shaughnessy, 32 Kilbane Golf Links Road, Castletroy, Limerick City, 

Ireland Tel: +353 61 331153, Fax: +353 61 331179 

sandra.o’shaughnessy@smith-nephew.com 

Ms Sarah Pankhurst, Wollaton Vale Health Centre, Wollaton, Nottingham, NG8 

2GR, England. Tel: 0115 928 8861, 0590 

Ms Angela Parlane, Flat 59, 135 Warwick Road, London, W14 8NJ, England. 

Tel: 07810 026534, angelapsyd@hotmail.com 

Ms Claudia Parnell, Tissue Viability Specialist, Hawthorn Road Clinic, Hawthorn 

Rd, Strood, Kent, ME2 2HU, England 

Mrs Elaine Penn, Kent House, Princess Marina Hospital, Upton, Northampton, 

NN5 6UH, England Tel: +44 (0)1604 595215 elaine.penn@nht.nhs.uk 

Dr Jeanne Perla, 10 Center Road, Orchard Park, New York 14217, USA 

Tel: +1 716 662 8662, Fax: +1 716 662 8624 jperla@gaymar.com 

Mrs Anne-Marie Perrin, 13 Pettitts Lane, Dry Drayton, Cambs, CB3 8BT, England. 

Tel: 01954 780467, Fax: 01954 789729 annemarieperrin@aol.com 

Ms Ulla Perttilahti, Cook Ireland Ltd, O’Halloran Road, National Technological 

Park, Limerick, Ireland Tel: +353 62 334440, Fax: +353 61 334441 

Dr Maria Pietropaolo, via val Trompia 56, Rome 00141, Italy 

Tel: +39 06 871 92 983, Fax: +39 06 494 0594 

Dr Elaine Pina, Comissao de Controlo de Infeccao, Hopital sto Antonio dos 

Capuchos, Alameda sto Antonio, Dos Capuchos, 1150 Lisbon, Portugal. 

Mrs Monica Pittarello, Vulnera-Corso, Matteotti 35, Torino, 10121 Italy. 

Tel: +39 011 544 747, Fax: +39 011 533 649 monica.pittarello@tiscalinet.it 

Dr Chryssanthi Plati, Univ of Athens, Fragokklissias 12 Str, 15125 Marousi, Athens, 

Greece. Tel/Fax: +301 61 98 619 

Mrs Fiona Preece, Staff Development Education Centre, Worcester Royal 

Infirmary NHS Trust, Ronkswood Branch, Newtown Rd, Worcester, WR5 1HN, 


Mrs Maria Priami, Univ of Athens, Fragokklissias 12 Str, Marousi, 15125 Athens, 

Greece. Tel/Fax: +301 61 98 619 

Dr Patricia Price, Wound Healing Research Unit, Cardiff Medicentre, Heath Park, 

Cardiff, CF14 4UJ, Wales, UK Tel: 02920 682 179, Fax: 02920 754 217 

pricepe@whru.co.uk 

Mr Terence Price, Seers Bough, Wilton Lane, Jordans, Beaconsfield, HP9 2RG, 

England. Tel: 01494 874 589 

Mr Nigel Quinn, Pinfold House, Pinfold Lane, Alltami Mold, Flintshire, CH7 6NZ, 


nigelquinn@nightingalebeds.co.uk 

Mr Marcus Raphael, B Braun Medical Ltd, Thorncliffe Park, Sheffield, S35 2PW, 


marcus.raphael@bbraun.com 

Dr Steven Reger, Cleveland Clinic Foundation – C21, Dept of Physical Medicine 

Rehabilitation, Cleveland, 44195 Ohio, USA 

Tel: +1 216 444 1801, Fax: +1 216 445 7000 regers@ccf.org 

Mr Claude Regnier, 204 Avenue du Marechal Juin, Boulogne 92104, France. 

Tel: +33 141 10 53 00, Fax: +33 144 84 08 44 claude.regnier@bbraun.com 

Brukhard Reis, Smith & Nephew GmbH, Medical Division, Max-Planck-Strasse 1–3, 

D–34253 Lohfelden, Germany 

Prof Elia Ricci, Via P. Crotta 8, 10010 Cascinette d’Ivrea, (TO) Italy 

Tel: +39 011 544 747, Fax: +39 011 533 649 eliaricci@tin.it 

Dr Shyam Rithalia, School of Healthcare Professionals, University of Salford, Brian 

Blatchford Building, Salford, M6 6PU, England Tel: 0161 295 2286, 

Fax: 0161 295 2302 s.rithalia@salford.ac.uk 

Dr Marina Ritter, Polyheal Ltd, 44 Bar Jehuda Str, Nesher, 20300 Israel 

Tel: +972 4 820 7917, Fax: +972 4 820 7919 marina@polyheal.co.il 

Dr Vladimire Ritter, Polyheal Ltd, 44 Bar Jehuda Str, Nesher, 20300 Israel 

Tel: +972 4 820 7917, Fax: +972 4 820 7919 

Mr Stefan Roales-Welsch, An der Hauptstr 36, 35287 Amoneburg, Germany 

Tel: +49 (0)6421 286 2739 srowe@gmx.de 

Dr Marco Romanelli, Department of Dermatology, University of Pisa, Via Roma 67, 

56126 Pisa, Italy. Tel: +39 050 992 436, Fax: +39 050 551 124 

Ms Marianne Rosager, Brunzevej 1–8, 3060 Espergaerde, Denmark 

Tel: +45 49 11 11 11 dkmro@coloplast.com 

Prof Lior Rosenberg, 13 Harduf Street, Omer 84965, Israel 

Tel: +972 764 00880, Fax: +972 764 03033 proflior@netvision.net.il 

Mr Keith Rowland, Cook Ireland Ltd, O’Halloran Road, National Technological 

Park, Limerick, Ireland Tel: +353 62 334440, Fax: +353 61 334441 

Mr Joao Carlos Rua Rangel de Lima,12 Pampilhosa Da Serra, 3320–229 Portugal 

Tel: +351 235 594 728 miguens.gouveia@clix.pt 

Dr Vincenzo Ruggiero, Clinica villa Bianca Martina, Franca Taranto Italie, 74100 

Taranto, Italy. Tel: +39 080 449 0234 

Mrs Linda Russell, Queens Hospital, Burton Hospitals NHS Trust, Belvedere Road, 

Burton on Trent, Staffs, DE13 0RB, England. Tel: 01283 511511 (x 2272) 

Dr David Ryan, GITU Freeman Hospital, Newcastle upon Tyne, NE7 7DN, 

England. Tel: +44 (0)191 284311 (x 26423), Fax: +44 (0)191 223401 

David.Ryan@nuth.northy.nhs.uk 

Prof Terence Ryan, Wound Healing Institute, Department of Dermatology, 

Churchill Hospital, Headington, Oxford, OX3 7LJ, England. 

Tel: 01865 228269, Fax: 01865 228233 

Dr Paini Salminen-Peltola, Kuusaankuja 2, Jarvenpaa, 04430 Finland 

paivi.salminen-peltola@hus.fi 

Ms Margarita Sanchez, CI Cacandvas 27/31 SN, Corbera de Llobregat, 08757 

Barcelona, Spain. msanchez@icnpharm.com 

Andre Santos, Smith & Nephew Lda, Galerias do Alto da Barra, Av. Das 

Descobertas, Piso 3 No 59, Alto da Barra – 2780 Oeiras, Portugal. 

Ms Salla Sappanen, Kaarikatu 32, Fin–86300 Culainen, Finland 

Tel: +358 50 320 6832 Fax: +358 8 479 3432 salla.sappanen@pp.inet.fi 

Miss Susam Sayer, 4 Earlston Place, Edinburgh, EH7 5SU, Scotland 

Tel: +44 (0)131 661 4931 suesayer33@hotmail.com 

Dr J.M.G.A. Schols, Vlaaikensstraat 2, 4944 XL Raamsdonk, The Netherlands 

Tel: +31 162 52 0464 jmga.schols@worldonline.nl 

Ms Lisette Schoonhoven, University Medical Center Radboud, Verplegingsweterschap 

229, PO Box 9101, 6500 HB Nijmegen, The Netherlands. 

Tel: +31 24 361 0458, l.schoonhoven@wok.umcb.nl 

Dr Wayne Schroeder, 8023 Vantage Dr, PO Box 659508, San Antonio, 78265-9508 

Texas, USA. Tel: 001 210 554 5396, Fax: 001 210 255 6988 schroedw@kci1.com 

Mrs Eileen Scott, Prof. Unit of Surgery, North Tees & Hartlepool NHS Trust, 

Stockton on Tees, TS19 8PE, England. Tel: 01642 624087, Fax: 01642 624165 

Mr Tony Seaney, Niaraga Holdings plc, 88a High Street, Shoreham-by-Sea, West 

Sussex, BN43 5DB, England. 

Dr Joseph Selkon, 4 Ethelred Court, Oxford, OX3 9DA, England. 

Tel: 01865 764098, Fax: 01865 764098 




Dr Zina Serafim, R.D. Estefania 5–3° D, Lisboa, Portugal. 1150–120. 

Tel: +351 1 354 9154 

Mrs Catherine Sharp, 3 Salisbury Street, South Hurstville, Sydney 2221, Australia 

Tel. & Fax: +61 2 958 50393 Tel: +61 2 938 53588 

Fax: +61 2 938 51086 catherine 410@hotmail.com 

Miss Helen Shearer, 164 Scalby Road, Scarborough, North Yorkshire, TO12 6TB, 

England Tel: 01723 3754525 hcs164@hotmail.com 

Mr Andy Smallwood, NHS Purchasing & Supply Agency, 80 Lightfoot Street, 

Chester, CH2 3AD, England. Tel: 01244 586807 Fax: 01244 586828 

andy.smallwood@doh.gsi.gov.uk 

Ms Helen Smyth, Anglia Polytechnic University, School of Healthcare Practice, 

24 Park Road, Chelmsford, Essex CM1 1LL, England 

Tel: 01245 493131 (x 4142), Fax: 01245 250368 h.smyth@apu.ac.uk 

Mr Javier Soldevilla, Agreda Avda de Navarra, 8-10, 4-D, Logrono, 26001, Spain. 

Tel: +34 41 251 392, Fax: +34 41 22 03 44 

Dr James Spahn, EHOB Inc, 250 North Belmont Avenue, Indianapolis, Indiana 

46222, USA. Tel: 001 317 972 4600 (ext 108), Fax: 001 317 972 4625 

james.spahn@ehob.com 

Mr Steve Spurgin, Smith & Nephew Medical Ltd, PO Box 81, Hessle Road, Hull, 

HU3 2BN, England. Tel: 01482-673742, Fax: 01482-673106 

Mrs Julie Stevens, 11 Portland Road, Ashford, Middlesex, TW15 3BU, England. 

Tel: 01784 242312, Work: 020 8321 2435, Fax: 020 8321 2272 

Ms Jackie Stephen-Haynes, Stourport Health Centre, Worcester Street, Stourport 

on Severn, Worcs, DY13 8EH, England. Tel: +44 (0)1299 827131 

jackies_h@btopenworld.com 

Mrs Fiona Stephens, 16 Strangford Rd, Tankerton, Whitstable, Kent, CT5 2EP, 

England. Tel: 07711 479668 fiona.stephens@rcn.org.uk 

Dr Thomas Stewart, Gaymar Industries Inc, 10 Center Drive, Orchard Park, 

NY-14127, USA 

Mrs Lesley Stockton, Department of Allied Health Professionals, OT Division, 

University of Liverpool, Thompson Yate Building, Brownlow Hill, Liverpool, 

L69 3GB, England Tel: +44 (0)151 794 5722, Fax: +44 (0)151 794 5719, 

lesley2@liv.ac.uk 

Mr Alan Sullivan, Meditec Medical Ltd, Unit 7, Ida Business Centre, Whiteltown 

Industrial Estate, Tallaght, Dublin 24, Ireland 

Mrs Varda Swager, Hoshav Serufa Doan Nah, Hof Ha Carmel, 30850, Israel. 

Tel: +972 4984 2928 Fax: +972 4854 2750 

Dr Ian Swain, Dept of Medical Physics and Bio. Engineering, Salisbury District 

Hospital, Salisbury, SP2 8BJ, England. Tel: 01722 336262 (x 4065), 01722 425263 

Ms Anna-Britta Tallberg, Vaksala Svia, 75594 Uppsala, Sweden, Tel: +46 18 31 

7412, Fax: +46 18 611 2460 anna-britta-tallberg@kirurgi.uas.lul.se 

Ms Anu Tammemae, Sytiste Str 19, North Estonian Regional Hospital, 13419 

Tallinn, Estonia Tel: +372 697 1371, Fax: +372 697 1200 

Ms Antje Tannen, Stresowplatz 1, 13597 Berlin, Germany. Tel: +49 30 529 066, 

Fax: +49 30 529 900 antje.tannen@charite.de 

Dr M Barden ter Haar, BES Rehab Ltd, 9 Cow Lane, Fulbourn, Cambridge, 

CB1 5HB, England. Tel: 01223 882105, Fax: 01223 882105 

b.e.s.rehab@btconnect.com 

Mr Andrew Thelwell, 2 Royal Farm Mews, Edgewell Lane, Eaton, Tarporley, 

Cheshire, CW6 9XE, England Tel: +44 (0)1244 584330 

Fax: +44 (0)1244 548311 andrew.thelwell@bms.com 

Mrs Susan Thomas, 3 Tylston Meadow, Liphook, Hants, GU30 7YB, England. 

Tel: 01420 488999, Fax: 01420 489009 clinical@crownmed.co.uk 

Mr Geoff Thompson, Specialist Nurse Manager, Equipment Resource Centre, 

Heartlands Hospital, Bordsley Green, Birmingham B9 5SS, England 

Ms Jean Thomson, 9 Goddards Lane, Aldbourne, Marlborough, Wilts, SN8 2DZ, 

England. 

Tissue Viability Team, Room 15, Chalmers Keddie Building, The Royal Oldham 

Hospital, Rochdale Road, Oldham, OL1 2JH, England Tel: +44 (0)161 627 8701 

Mr Tore Tomter, Tordivelen 20, Hamar, N-2316 Norway. Tel: +47 625 26272, 

Fax: +47 625 21211 tore@togemo.no 

74 

Dr Joan Enric Torra i Bou, Galle 5. Bis, Barcelona, 08021, Spain. 

Tel: +34 3731 0474 

Mrs Ulla-Maija, Tuuliranta, Purokatu 15B, Fin–40600, Finland. 

Tel: +358 14 244 885 mikko.tuuliranta@kolumbus.fi 

Ms Geri Usberg, 2 L Punsep St, Tartu University Clinics, Tartu, 51003 Estonia 

Tel: +372 566 32818 gerli67@hot.u 

Dr Dirk van de Looverbosch, Turnhoutseraan 111, 2100 Deurne, Belgium 

Tel: +31 3 325 0965 medresearch@wanadoo.be 

Mr Bart Van der Heyden, Houtstraat 74, 9070 Destelbergen, Belgium. 

Tel: +32 (0)9356 7222, Fax: +32 (0)9356 6915 bvanderheyden@attyglobal.net 

Mr Han van der Mijn, Niewe Achtergracht 100, Amsterdam, 1018 WT, The 

Netherlands. Tel: +31 20 624 3079, Fax: +31 20 638 7960 

hbjvdmijn@fbadam.nl 

Dr Katrien Vanderwee, Ghent University, uz Gent – Blok A 2de V, De Pintelaan 

185, Gent, 9000 Belgium. Tel: (and Fax:) +32 9 1240 3694 

katrien.vanderwee@rug.ac.be 

Mr Edwin Van der Zee, Krommekamp 232, Harderwijk, 3848 DT, The Netherlands 

Tel: +31 341 4189214, Fax: +31 341 422957 vanderzee@globalxs.nl 

Mrs Tracy Vernon, Doncaster Royal Infirmary, Armthorpe Road, Doncaster, Yorks, 

DN2 5LT, England. Tel: 01302 366666 (ext. 3359), Fax: 01302 320098 

Dr Senen Vilaro Coma, Facultat de Biologia, Department de Biologia Celular, 

AVDA Diagonal 1645 1o Planta, 08028 Barcelona, Spain. 

Tel: 00 34 93 402 1550, Fax: 00 34 93 411 2967 

Ms Heidi Vrijdagh, Huntleigh Healthcare, Stapelplein 70, 9000 Gent, Belgium 

Tel: +32 9 265 8770, Fax: +32 9 265 8771 heidi.vrijdagh@huntleigh-healthcare.be 

Ms Ann-Brigitte Vugelsang, Bogfinhevg 8, Hinnerup, 8382 Denmark. 

Tel: +45 86 91 2811 anne-brig@hotmail.tele.dk 

Ms Anna Watson, 72 The Paddocks, Hybreasal, South Circular Raod, Kilmainham, 

Dublin 8, Ireland. Tel: +353 1 473 1605 

Dr K-G. Werner, Compliance Network Physicians/Health Force Initiative, 

P.O. Box 02 12 45, Berlin, D–10123, Germany. 

Tel: +49 30 2472 1772, Fax: +49 30 2472 1773 

Jan Weststrate, University Hospital Rotterdam, Room H–897 Erasmus Medical 

Centre, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands. 

Tel: +31 10 463 4237, Fax: +31 10 463 4234 weststrate@aziv.azr.nl 

Miss Emma Wheat, 89 Llanishen Street, Heath, Cardiff, CF14 3QD, Wales, UK 

Tel: 02920 404729 ewheat@uwic.ac.uk 

Mr Arthur Wheeler, 1 Samsworth Close, Castor, Peterborough, Cambs. PE5 7BQ, 

England. Tel: 01733 380774 

Ms Ann Wilson, Tissue Viability Nurse, Queen Margaret Hospital, Whirefield 

Road, Dunfermline, Fife, KY12 0SU, Scotland. Tel: 01383 623623 

Ms Ada Wimmers, Boveny Ziekenhuis, Statenjachtstraat 1, 1034 CS, Amsterdam, 

The Netherlands. Tel: +31 20 634 6346, Fax: +31 20 634 6730 

Mrs Ann Withington, 10 Barnfield Crescent, Wellington, Telford, Shropshire 

TF1 2ES, England. Tel: 01952 641222 p.a.withington@tesco.net 

Dr Helene Wolff, Fyra Dalersgatan 32, 41319, Sweden Tel: 00 46 342 1000 

Mr David Woolfson, Kaymed, Bluebell Industrial Estate, Naas Rd, Dublin 12, 

Ireland. Tel: +353 1 419 2999, Fax: 353 1 460 2574 kaymed@kayfoam.com 

Mrs Frances Worboys, Block 2, Mile End Hospital, Bancroft Rd, London, E1 4DG, 

England. Tel: 020 7377 7873 Fax: 020 7377 7802 fran.worboys@thpct.nhs.uk 

Ms Trudie Young, School of Nursing, Glan Clwyd Hospital, Bodelwyddan, 

Denbighshire, LL18 5UJ, Wales, UK Tel: +44 (0)1745 534380, 

Fax: +44 (0)1745 534960 t.young@bangor.ac.uk 

Mr Arkadiusz Zbronski, ul Kasztanowa 27, Olsztyn, 10–156 Poland. 

real@real.olsztyn.pl 

Mr Ireneusz Zbronski, ul Kasztanowa 27, Olsztyn, 10–156 Poland. 

Tel: +48 89 533 1013, Fax: +48 89 533 3978 real@real.olsztyn.pl 

Mr Jintiene Zeilstra, Academisch Zienhuis Groningen, Postbus 30001 Groningen, 

Secretarial Dermatologie TI 250, 97008 B, The Netherlands. 

Tel: 00 31 50 361 2520 Fax: 00 31 50 361 2624 j.t.zeilstra@derm.az.nl 


epuap Membership 


Application Form, 2003–4 

MISSION STATEMENT 

The European Pressure Ulcer Advisory Panel’s objective is to provide the 

relief of persons suffering from, or at risk of pressure ulcers, in particular 

through research and the education of the public. The European Pressure 

Ulcer Advisory Panel is a registered charity, number 1066856. 

MEMBERSHIP APPLICATION PLEASE PRINT CLEARLY 

Name: _________________ _______________________ __________________________ ______________________ 

Title (Prof, Dr, etc) First name Last Name Degrees 

Full Postal Address: ___________________________________________________________________________________ 

_____________________________________________________________________________________________________ 

______________________________ Postcode: ______________________ Country: ___________________________ 

Tel: ___________________________________________________________ Fax: _______________________________ 

E-mail: ______________________________________________________________________________________________ 

Main fields of interest: _________________________________________________________________________________ 

_____________________________________________________________________________________________________ 

_____________________________________________________________________________________________________ 

Membership fee: £30 per year (September – September) 

Which includes Certificate of Membership plus the EPUAP Review 

Cheques should be made payable, in British Pounds drawn on a UK Bank, to: 

EPUAP Registered Charity 1066856 

And application forms should be returned to: 

EPUAP Office, Wound Healing Unit 

Department of Dermatology, Churchill Hospital 

Old Road, Headington, Oxford 

OX3 7LJ, UK 

Fax: +44 (0)1865 228233 

Arrangements can be made for payment by Access/Mastercard/Visa credit cards 

(There is a £2 service charge added for this facility) 

a) Credit card type: Access/Mastercard/Visa (Please delete as appropriate) b) Amount to be debited: £32 

c) Credit card number: ______________________________________ d) Expiry date of credit card: ______ /______ 

e) Exact name and initials on credit card: _______________________________________________________________ 

f) Address to which credit card statements are sent: _______________________________________________________ 

_____________________________________________________________________________________________________ 

_____________________________________________________________________________________________________ 

g) Signature to authorise debit of annual subscription: ____________________________________________________ 


76 

C O R P O R A T E M E M B E R S 

A N D S P O N S O R S O F T H E 

A N N U A L O P E N M E E T I N G 

O F T H E E P U A P 

3M 

Augustine Medical 

B. Braun Medical S.A. 

ConvaTec 

Cook 

Frontier Therapeutics 

Gaymar Industries Inc 

Hill-Rom Europe 

Huntleigh Healthcare 

Paul Hartmann AB 

Johnson & Johnson 

KAYMED 

Mölnlycke Healthcare AB 

Nutricia Healthcare 

Pegasus Ltd 

ROHO 

Smith & Nephew 

Tempur U.K. Ltd 

URGO 

Designed and produced by John Brennan at the Positif Press, Oxford 

Tel: +44 (0)1865 243220 Fax: +44 (0)1865 243272 

Printed by Oxuniprint at Oxford University Press 

© European Pressure Ulcer Advisory Panel, 2003 

ISSN 1464–7796

EPUAP Review 5/2 RIP - European Pressure Ulcer Advisory Panel

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