Pressure ulcers: The management of pressure ulcers in primary and secondary care
This is an extract from the guidance and may be misleading if read alone. The complete guidance is available at guidance.nice.org.uk/cg29
Introduction
The Royal College of Nursing (RCN) and National Institute for Health and Clinical Excellence (NICE or the Institute) collaborated to develop a clinical guideline on the management of pressure ulcers in primary and secondary care. Identification of the topic emerged from a consultation process with RCN members and referral of the topic by the Department of Health and Welsh Assembly Government. This document describes the methods used for developing the guidelines and presents the resulting recommendations. It is the source document for the NICE (abbreviated version for health professionals) and Information for the public (patient and carer) versions of the guidelines, which will be published by NICE. The Guideline was produced by a multidisciplinary Guideline Development Group (GDG) and the development process was wholly undertaken by the RCN.
The main areas examined by the Guideline are:
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holistic assessment for the risk of delayed healing or complications of having a pressure ulcer
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the ulcer assessment
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pressure-relieving support surfaces for the treatment of pressure ulcers
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mobility, positioning and re-positioning for the treatment of pressure ulcers
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dressings and topical agents for the treatment of pressure ulcers
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debridement for the treatment of pressure ulcers
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nutritional support
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surgery for the treatment of pressure ulcers
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therapeutic ultrasound for the treatment of pressure ulcers
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electrotherapy and electromagnetic therapy for the treatment of pressure ulcers, and
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topical negative pressure for the treatment of pressure ulcers.
Recommendations for good practice based on the best available evidence of clinical and cost-effectiveness are presented. Literature searching details, including cut-off dates, are reported in the methods section for each topic area. Update searches were performed for each area not less than six months prior to submission of the first consultation draft. Recommendations contained in this document are those considered to be central to the management of pressure ulcers. This is a guide to that management not a textbook of care.
Health care professionals should use their clinical judgement and consult with patients when applying the recommendations, which aim at reducing the negative personal, physical, social and financial impact of pressure ulcers.