Abstract
This guideline is the result of a collaborative effort between the American
National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer
Advisory Panel (EPUAP). A comprehensive literature review was conducted on
pressure ulcer prevention and treatment. A rigorous scientific methodology
was used to analyze available research and to make evidence-based
recommendations for the prevention and treatment of pressure ulcers. Drafts
of the guideline were made available to 903 individuals and 146
societies/organizations registered as stakeholders in 63 countries on 6
continents. All stakeholder comments were carefully considered by guideline
developers. Explicit recommendations and summaries of supporting evidence
are provided for the following aspects of pressure ulcer prevention: etiology,
risk assessment, skin assessment, nutrition, repositioning, support surfaces,
and special pressure ulcer preventive needs of patients in the operating room.
Recommendations and research were also summarized for a wide variety of
topics related to pressure ulcer treatment: classification of pressure ulcers,
assessment and monitoring of healing, the role of nutrition in healing, pain
assessment and management, support surfaces, principles of wound bed
preparation (i.e., cleansing, debridement, dressing selection, assessment and
treatment of infection), biophysical agents (e.g., electrical stimulation,
negative pressure wound therapy), surgery, and management in individuals
receiving palliative care. The NPUAP and EPUAP also agreed on an
international classification system for pressure ulcers with the hope that it
will be adopted internationally and therefore help reduce discrepancies in
international reporting of pressure ulcer incidence and prevalence.