Pressure Ulcer Research: Current and Future Perspectives

Abstract

This multi-author volume brings together 30 contributors under an international editorship. The four editors include three biomedical engineers (one from Queen Mary's College, University of London and two from the Eindhoven University of Technology) and the medical director of l'Arche Rehabilitation Centre in France, who is the only clinical author. The final chapter on tissue repair strategies, which is of most surgical interest, focuses on ‘biochemical stimulation of the wound bed to improve wound healing. Important new therapeutics in this category are reviewed such as: (i) exogenous application of growth factors; (ii) tissue-engineered skin grafts; and (iii) gene therapy.’ The two authors from the Eindhoven University of Technology are (according to an internet search) not medically qualified, so understandably their viewpoints do not set out the full range of current reconstructive surgical options or ‘future perspectives’ in clinical surgery. The publishers have adopted the convention of excluding any reference to the contributors' professional qualifications. With this handicap, the clinical reader cannot effectively assess treatment strategies mentioned by the authors as merely being references from the literature or from the author's own authoritative experience. Nevertheless, this is a useful and unique contribution to a neglected area. Risk assessment, basic science and human and animal research are fully reviewed. Epidemiological studies from The Netherlands on the costs of pressure ulcer care and the medicolegal review from the US add significant practical insights. The chapter on the role of oxidative stress in the development and persistence of pressure ulcers is a particularly helpful summary of ischaemia-reperfusion injury from two Oxford biochemists who support their chapter with a comprehensive reference list. The editors have generally avoided repetition (a significant achievement in a multi-author text) though there is a colour illustration of a section through human skin that is a reiteration of a black and white graphic. This slim volume succeeds in its aim of providing ‘a clearer understanding of the mechanisms associated with the aetiology of pressure ulcers and to identify the risk levels of individuals’. Surgeons with a pressure sore and wound-healing interest will find a useful reference even if it does not find wider surgical acceptance. I would certainly want to have this on my medical bookshelf.