2019 Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guidelines have been released.

The 2019 Clinical Practice Guidelines (CPG)1, recently launched jointly by NPIAP, EPUAP and PPPIA, recognises the critical significance of sub-epidermal moisture/edema and the biocapacitance biomarker as Pressure Ulcers/Injuries (PU/PI) develop.

“The primacy of clinical judgment of qualified health professionals pervaded the CPG text, rightly in our view. Of the many observations about the CPGs, there was strong recognition of the incipient etiological processes associated with PU/PI development. PU/PIs are wounds, and like other wounds, PU/PIs in the early stages of cell death and necrosis show measurable signs of localized inflammatory edema. Measurement of these by subjective tests alone is impossible, or near impossible”, said Martin Burns, BBI’s CEO.

“The days of subjective skin and tissue assessments of this #1 reported patient harm being the only tool available to nurses in their diagnosis of PU/PIs are ending. We are very pleased for patients, providers and payors that the CPGs state that healthcare practitioners, using their own qualified clinical judgement, ‚Äúconsider using a sub-epidermal moisture/edema measurement device as an adjunct to routine clinical skin assessment”1, added Burns.

The CPGs reiterated the health-disparity of patients with darkly pigmented skin. Such patients have higher incidence of more severe PU/PI and are four times more likely to die from PU/PI associated causes than patients with lightly pigmented skin2. CGP recommendation 2.7 states that healthcare practitioners, using their own qualified clinical judgement in assessing darkly pigmented skin, “consider assessment of skin temperature and sub-epidermal moisture as important adjunct assessment strategies”1.

“It is encouraging to see that the 2019 CPGs from global leading authorities and experts have recognised developments in clinical understanding of PU/PI development including the role of SEM in aiding clinical judgement. Nurses will be significantly aided in their day-to-day clinical judgements and patients will benefit as a result” Burns added.

The CPGs are a global leading reference on the prevention and treatment of PU/PI and is compiled by three independent bodies, National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP)and the Panel Pan Pacific Pressure Injury Alliance (PPPIA), working alongside other global experts including those from Indonesia, China and Japan.

For more information regarding the 2019 Clinical Practice Guidelines, visit:



  1. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. (2019) Emily Hasler (Ed.). EPUAP/NPIAP/PPPIA
  2. Redelings, M.D., Lee, N.E., & Sorvillo, F. (2005) Pressure ulcers: more lethal than we thought. Advances in Skin & Wound Care, 18(7), 367-372

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