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About the Guidelines

The first edition of the guideline was developed as a four year collaboration between the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP). In the second edition of the guideline, the Pan Pacific Pressure Injury Alliance (PPPIA) has joined the NPUAP and EPUAP. The goal of this international collaboration was to develop evidence-based recommendations for the prevention and treatment of pressure ulcers that could be used by health professionals throughout the world.
An explicit scientific methodology was used to identify and critically appraise all available research. In the absence of definitive evidence, expert opinion (often supported by indirect evidence and other guidelines) was used to make recommendations. Drafts of the recommendations and supporting evidence were made available to 986 invited stakeholders (individuals and organizations) around the world. The final guideline was based on available research and the accumulated wisdom of the NPUAP, EPUAP, PPPIA and international stakeholders. In the 2nd edition of the guideline, a consensus voting process (GRADE) was used to assign a strength to each recommendation. The strength of recommendation identifies the importance of the recommendation statement based on potential to improve patient outcomes. It provides an indication to the health professional of the confidence one can have that the recommendation will do more good than harm, and can be used to assist in prioritizing pressure ulcer related interventions.


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 fall 2019.


For more information, visit the International Guideline website.

Click here for a free download of the 2014 Guidelines.