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Resources

Pressure Ulcer Staging Illustrations:

The NPUAP has developed illustrations of the stages of pressure ulcers (Stage I-IV, suspected deep tissue injury, unstageable). These illustrations can be downloaded from the NPUAP website directly to your computer at no cost, if for educational purposes. There is also a normal skin illustration for reference. NPUAP updated the stages of pressure ulcers in 2007 and these stages are commonly cited in references and in lectures. NPUAP will further revise these slides so please check back.

There is no cost to use these illustrations; however donations to support the work of NPUAP are graciously accepted.  For profit uses of the drawings are subject to a charge, please contact Jennifer Bank for more information.

**Use of drawings is permitted for educational purposes only.

The use of NPUAP material does not imply endorsment of products or programs associated with the use of the material.

• Normal
• Stage One
• Stage Two
• Stage Three
• Stage Four
• Unstageable
• Suspected Deep Tissue Injury
  
  

NPUAP Free Resource Staging Illustrations:

• Updated Pressure Ulcer Staging 2007
• Selected Bibliography
• Pressure Ulcer Prevention Points
• PUSH Tool
• Links

International Pressure Ulcer Guidelines:

• Quick Reference Guide for Prevention
• Quick Reference Guide for Treatment
• Please Click here to access the Spanish and Hebrew translations of the Guidelines
  
  Corrections to the First Printing
  Pressure Ulcer Prevention & Treatment
  Clinical Practice Guideline and Quick Reference Guideline

  January 7, 2010

  Dear Colleagues:

  The National Pressure Ulcer Advisory Panel (NPUAP) would like to thank everyone who has contacted the NPUAP with comments and questions about inconsistent terminology in the first printing of Pressure Ulcer Prevention & Treatment Clinical Practice Guideline and Quick Reference Guideline.

  The NPUAP strives to be open and honest, and if we confirm that a page has an error, we will post a correction.

  The NPUAP noted in the first printing the few instances where stage was not placed with category in describing pressure ulcers (category/stage) The two terms are placed together to support the use of category by the European Pressure Ulcer Advisory Panel and stage by the NPUAP.  In addition, one recommendation was omitted from the website version of the prevention guideline.

  These corrections have been made to the website versionsprepared as PDF pages for you to print from the NPUAP website, and will be included as an insert in future mailed copies. Corrections are itemized below to facilitate making corrections to your current copy.

  The overall content and structure of the Pressure Ulcer Prevention & Treatment Clinical Practice Guideline and Quick Reference Guideline are accurate and sound and can safely be used in clinical practice, education, administration, etc. Nonetheless, the NPUAP apologizes for these omissions.

  Best regards,

  National Pressure Ulcer Advisory Panel Board of Directors

  
  Summary of Corrections for Various Guideline Versions

  Printed Copies Ordered from the NPUAP Website:

  1. Clinical Practice Guideline (130-page printed document):
  1. Pages 16 and 17:  There are 8 occasions in the non bolded explanatory text where category is listed alone. Correction: Add /stage to read category/stage.
  2. Page 34, under recommendation 2.3 (repositioning frequency):  Change (? Category/Stage) to (Category/Stage II or greater).

   

  1. Quick Reference Guide (62-page printed document):
  1. Page 11. In the non bolded text under Recommendation #2, category is listed alone on one occasion. Correction: Add /stage to read category/stage.
  2. Page 6: Text was added to explain the development of an International Classification System and encourage clinicians to use the term they are most comfortable with (stage, grade or category). 

   

  Website Versions of the Prevention and Treatment Guidelines
  Note: These corrections have been made to the current versions on the website.  If you downloaded PDF versions from either the NPUAP or EPUAP Website prior to January 7, 2010, you may wish to make these corrections to your downloaded copy.

  1. Website Treatment Quick Reference Guide (48-page PDF file)
  1. Add the following text to the title page: Note: The guidelines are copyrighted to NPUAP and EPUAP.  According to copyright law, individuals may make one copy for personal use; however, duplication of multiple copies is prohibited.
  2. Page 7: Explanation of the International Classification System was added.
  3. Page 7 & 8: Category is listed alone on 6 occasions.  Change to category/stage.
  4. Pages are renumbered.

   

  1. Website Prevention Quick Reference Guide (22-page PDF file)
  1. Pages 7, 8 & 11: Change category to category/stage.
  2. Page 22: Add Kinetic Concepts, Inc, Europe to the list of EPUAP Donors.
  3. Page 14: Add the following after nutrition recommendation #2.2:  

  2.3    Offer each individual with nutritional risk and pressure ulcer risk a minimum of 30-35 kcal per kg body weight per day, with 1.25-1.5 g/kg/day protein and 1 ml of fluid intake per kcal per day.  

  
  **Guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical conditions. The recommendations may not be appropriate for use in all circumstances.**
  
  **The decision to adopt any particular recommendation must be made by the health care professional in light of available resources and circumstances presented by the individual patient. Nothing contained in this guideline is to be considered medical advice for specific cases.**
  
  **Because of the rigorous methodology used to develop this guideline, the NPUAP and EPUAP believes that the research supporting these recommendations is reliable and accurate. However, we do not guarantee the reliability and accuracy of individual studies referenced in this document.**
  
  **This guideline and any recommendations herein are intended for educational and informational purposes only.**
  
  **This guideline contains information that was accurate at the time of publication. Research and technology change rapidly and the recommendations contained in this guideline may be inconsistent with future advances. The health care professional is responsible for maintaining a working knowledge of the research and technological advances that may affect his/her practice decisions.**
  
  **Generic names of products are provided. Nothing in this guide is intended as an endorsement of a specific product. Nothing in this guideline is intended as advice regarding coding standards or reimbursement regulations.**
  
  The guidelines are copyrighted to NPUAP and EPUAP. According to copyright law, individuals may make one copy for personal use; however duplication of multiple copies is prohibited.

FAQ

 

Pressure Ulcer Treatment Curriculum (PDF)

Prevention Curriculum (PDF)