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Pressure ulcers (PUs) (also termed pressure injuries [PIs]) remain a major patient safety issue, particularly in critical care and other high-risk healthcare settings. Nurses are central to PUs/PIs prevention; however, deficiencies in knowledge, attitudes, and preventive practices among nursing staff may negatively affect patient outcomes. To systematically synthesise global evidence on nurses' knowledge, attitudes, and practices related to PUs/PIs prevention, and to identify factors influencing preventive performance. A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, CINAHL, EBSCO, MEDLINE, PsycINFO, and Springer were searched for studies published between 2011 and 2025. Eligible studies were primary research articles examining registered nurses' knowledge, attitudes, and/or practices regarding PUs/PIs prevention, using cross-sectional, observational, or non-experimental designs. Data extraction focused on study characteristics, settings, samples, assessment instruments, and key outcomes related to knowledge, attitudes, and preventive practices. Due to methodological heterogeneity, a narrative synthesis was performed. Twenty-nine studies from diverse geographical regions were included, with sample sizes ranging from 28 to 950 nurses. Overall, nurses' knowledge of PUs/PIs prevention was frequently inadequate, particularly in prevention-specific domains. In contrast, attitudes toward prevention were generally positive across studies. Preventive practices, however, were often suboptimal. Commonly reported barriers included staff shortages, high workload, limited resources, and insufficient institutional support. Higher educational attainment, specialised clinical experience, recent training, and professional seniority were consistently associated with better knowledge, more positive attitudes, and improved preventive practices. Although nurses generally demonstrate positive attitudes toward PUs/PIs prevention, persistent gaps in knowledge and practice remain. These findings underscore the need for structured education programmes, simulation-based training, and strengthened organisational support to enhance adherence to evidence-based prevention strategies. Future research should employ experimental and longitudinal designs, standardised measurement tools, and broader international representation to support sustainable improvements in PUs/PIs prevention and patient safety.
The aim in this human trial is to compare the efficacy and safety of polygalacturonic–caprylic acid (PG–CAP) ointment to MediHoney in chronic wounds at three international medical centres. In this prospective open-label study, patients with chronic full-thickness wounds were randomised to daily treatment with PG–CAP ointment or MediHoney. Assessments were obtained weekly for 6 weeks. The validated Pressure Ulcer Scale for Healing (PUSH) score was used to track healing. Efficacies were compared using the Wilcoxon rank-sum test for continuous variables and chi-square or Fisher's exact test for categorical variables. Twenty-six patients with chronic wounds were included. Baseline characteristics were comparable between the groups; however, the history of diabetes mellitus was higher in the PG–CAP group (p = 0.011). All 13 PG–CAP patients showed improvement (100%), compared to only 69% of the 13 MediHoney patients (p = 0.023). Half of the failures in the MediHoney arm were associated with death (15%). No failures, adverse events or deaths occurred in the PG–CAP arm. PG–CAP wound ointment is a novel combination of two plant-based compounds that pose minimal risk of promoting antimicrobial resistance, was highly effective for eradicating wound-pathogen biofilms in vitro and promoted chronic wound healing in vivo with minimal inflammatory reactions. Our findings support PG–CAP as safe, noninferior and possibly more effective than MediHoney in healing chronic contaminated wounds.
A comprehensive skincare regimen involves cleansing, moisturising, and using skin barrier protectants. Cyanoacrylate-based protectants safeguard vulnerable skin from damage caused by moisture, friction, and shear. This research involved two ex vivo and two clinical studies comparing the wear duration and wash-off resistance of a 100% cyanoacrylate and a solvent-cyanoacrylate mixture. Effectiveness was assessed using an ex vivo porcine skin model simulating urinary incontinence, evaluated with Lucifer yellow dye penetration and Corneometry, and a clinical model using Corneometry. Two single-blind clinical studies measured skin surface electrical capacitance in healthy volunteers. Study 1 (n = 42) evaluated the wear duration over 8 days, while Study 2 (n = 52) examined wash-off resistance after nine washes with various cleansers. Ex vivo results showed that both products were effective under repeated moisture and abrasion conditions, with the 100% cyanoacrylate outperforming the solvent-cyanoacrylate mixture. In clinical studies, both products maintained barrier protection throughout Study 1 (p < 0.007) and none of the cleansers significantly degraded either product in Study 2. In conclusion, the 100% cyanoacrylate provided superior protection compared to the solvent-cyanoacrylate mixture. Both products demonstrated comparable wear duration and wash-off resistance in clinical studies, but the 100% cyanoacrylate was more effective in ex vivo testing under harsh conditions.
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