EPUAP NPUAP PPPIA

Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline


Third Edition (anticipated publication 2019) Second Edition (2014)


Third Edition (anticipated publication 2019)

Information about the third edition

Work has commenced on the 3rd edition of the Guideline. In March 2018 working groups were formed to commence appraising the literature and developing recommendations. The peer-reviewed 2019 methodology document is available for review. The next edition is expected to be published in 2019.

For the third edition of the Guideline, small working groups include representatives from Associate Organisations of the Partner Organisations (EPUAP, NPUAP and PPPIA). Associate Organisations are:

World Council of Enterostomal Therapists Malysian Society of Wound Care Professionals Canadian Association for Enterostomal Therapy Indonesian Wound Ostomy Continence Nurses Association
Indonesian Wound Care Clinician Association Philipine Wound Care Society Saudi Chapter of Enterostomal Therapy China Nursing Association
Jiangsu Nursing Association Thai Enterosomal Therapy Society Japanese Society of Pressure Ulcers
Wounds Canada Korean Association of Wound Ostomy Continence Nurses

Second Edition (2014)

Information about the second edition (2014)

Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline is the result of a collaborative effort among the:

The guideline was developed using a rigorous scientific methodology to appraise available research and make 575 evidence-based recommendations. In this second edition, a consensus voting process (GRADE) was used to assign strengths of recommendation that indicate the extent to which one can be confident that adherence to a recommendation will do more good than harm, intended to assist the health professional to prioritize interventions.

The second edition of the guideline combines prevention and treatment recommendations in one expanded guideline. This edition includes newly added sections on emerging fields of interest including:

  • prevention and treatment of biofilms,
  • prophylactic dressings,
  • microclimate control,
  • medical-device related pressure ulcers,
  • prevention and management of heel pressure ulcers and,
  • low friction fabrics.

The guideline includes updated recommendations and/or research summaries for the following pressure ulcer topics:

  • etiology;
  • prevalence and incidence;
  • risk assessment;
  • skin and tissue assessment;
  • preventive skin care;
  • prophylactic dressings;
  • microclimate control;
  • fabrics and textiles;
  • nutrition;
  • repositioning and early mobilization;
  • support surfaces;
  • medical device related pressure ulcers;
  • pressure ulcer classification;
  • wound assessment;
  • monitoring of healing;
  • pain assessment and treatment;
  • cleansing;
  • debridement;
  • wound dressings (including growth factors and biological wound dressings);
  • assessment and treatment of infection and biofilms;
  • biophysical agents (e.g. electrical stimulation, negative pressure wound therapy, electromagnetic field treatment);
  • and surgery.
The guideline also includes the NPUAP/EPUAP International Pressure Ulcer Classification system, complete with full Category/Stage descriptions and illustrative photography.

Guideline support documents and permissions for reproduction and translated versions are available. News and statements from the guideline development team relating to guideline content can be found at News and Statements.

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