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Pressure injury continues to be problematic for health providers and consumers, despite the advancements in healthcare throughout the past century. International interest in benchmarking pressure injury prevalence and incidence is reflected in publications and discussed at peak forums. In Australia, associated costs to the healthcare budget for a period of 12 months were estimated to be US1. 65 billion (Graves Clinical Practice Guideline (2014) was launched. The development of this guideline involved an international collaboration, across three regions involving the National Pressure Ulcer Advisory Panel (NPUAP), the EPUAP and the Pan Pacific Pressure Injury Alliance (PPPIA). The PPPIA incorporates the Australian Wound Management Association, Hong Kong Enterostomal Therapist Society, New Zealand Wound Care Society and the Wound Healing Society Singapore. The guideline development comprised a rigorous methodology and input from 110 international experts in the field. The guideline was reviewed by 986 stakeholder groups and individuals and includes 575 recommendations for practice. The goal of this guideline is to expand the international uptake of the evidence-based recommendations for the prevention and treatment of pressure injuries. These guidelines have been designed to be used by all health professionals, across all health settings and for all health populations. One point of difference across the three regions is terminology. In Europe and North America the term ‘pressure ulcer’ is widely used, superseding pressure sore, bedsore and decubitus ulcer. However Australia, Singapore, Hong Kong and New Zealand have adopted the term ‘pressure injury’ rather than pressure ulcer as this draws attention to the preventative nature of these wounds. Six chapter topics in the guideline incorporate the latest evidence commencing with a background to the aetiology, prevalence and incidence, and the international classification system for pressure ulcers/injuries. Prevention topics outline risk factors, assessment and preventive skin care. Interventions for prevention and treatment such as: nutrition; repositioning; and early mobilization – particularly focusing on heels; support surfaces and medical device related pressure injuries are discussed. As expected, treatment for pressure injures is discussed at length, with recognition of special populations such as the bariatric, critically ill, older adults, palliative care, children and spinal cord injury patients. In addition, the individual undergoing surgery is discussed. Other new evidence and recommendations focus on emerging therapies, medical device related pressure injuries, use of prophylactic dressings and management of the skin's microclimate. The final chapter provides recommendations for implementation, education of health professionals, information for consumers and carers and further quality indicators for auditing implementation strategies. One noteworthy aspect of the guideline is that the majority of the evidence identified is graded and reported to be of moderate to high risk of bias. Such findings demonstrate the continuing need for further research in the domain. The guideline is available as a full clinical Practice guideline and a quick reference guide. The latter is also available as a free download (http: www. awma. com. au or http: internationalguideline. com; accessed 3 December 2014). These websites also provide information for purchasing the guideline.
Dunk et al. (Tue,) studied this question.