Pressure ulcer


Key articles

Qaseem A, Humphrey LL, Forciea MA, et al; Clinical Guidelines Committee of the American College of Physicians. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2015 Mar 3;162(5):370-9.Full text  Abstract

Reference articles

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2. Pieper, M, ed. Pressure ulcers: prevalence, incidence, and implications for the future. Washington, DC: National Pressure Ulcer Advisory Panel; 2013.

3. Afzali Borojeny L, Albatineh AN, Hasanpour Dehkordi A, et al. The incidence of pressure ulcers and its associations in different wards of the hospital: A systematic review and meta-analysis. Int J Prev Med. 2020;11:171.Full text  Abstract

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5. Bauer K, Rock K, Nazzal M, et al. Pressure ulcers in the United States' inpatient population from 2008 to 2012: Results of a retrospective nationwide study. Ostomy Wound Manage. 2016 Nov;62(11):30-38.Full text  Abstract

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8. Vanderwee K, Clark M, Dealey C, et al. Pressure ulcer prevalence in Europe: a pilot study. J Eval Clin Pract. 2007 Apr;13(2):227-35.Full text  Abstract

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10. Raghavan P, Raza WA, Ahmed YS, et al. Prevalence of pressure sores in a community sample of spinal injury patients. Clin Rehabil. 2003;17:879-884. Abstract

11. Berlowitz DR, Brienza DM. Are all pressure ulcers the result of deep tissue injury? A review of the literature. Ostomy Wound Manage. 2007 Oct;53(10):34-8. Abstract

12. Kottner J, Black J, Call E, et al. Microclimate: A critical review in the context of pressure ulcer prevention. Clin Biomech (Bristol, Avon). 2018 Nov;59:62-70.Full text  Abstract

13. Bliss M, Simini B. When are the seeds of postoperative pressure sores sown? Often during surgery. BMJ. 1999 Oct 2;319(7214):863-4.Full text  Abstract

14. Sibbald RG, Krasner DL, Lutz J. SCALE: skin changes at life's end: final consensus statement: October 1, 2009. Adv Skin Wound Care. 2010 May;23(5):225-36. Abstract

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16. Coleman S, Nixon J, Keen J, et al. A new pressure ulcer conceptual framework. J Adv Nurs. 2014 Oct;70(10):2222-34.Full text  Abstract

17. European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP), Pan Pacific Pressure Injury Alliance PPIA). Prevention and treatment of pressure ulcers/Injuries: Clinical practice guideline. The International Guideline, 3rd edition. 2019 [internet publication].Full text

18. Houwing R, Rozendaal M, Wouters-Wesseling W, et al. Pressure ulcer risk in hip fracture patients. Acta Orthop Scand. 2004 Aug;75(4):390-3. Abstract

19. Boyle M, Green M. Pressure sores in intensive care: defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools. Aust Crit Care. 2001 Feb;14(1):24-30. Abstract

20. Hengstermann S, Fischer A, Steinhagen-Thiessen E, et al. Nutrition status and pressure ulcer: what we need for nutrition screening. JPEN J Parenter Enteral Nutr. 2007 Jul-Aug;31(4):288-94. Abstract

21. Berlowitz DR, Brandeis GH, Morris JN, et al. Deriving a risk-adjustment model for pressure ulcer development using the Minimum Data Set. J Am Geriatr Soc. 2001 Jul;49(7):866-71. Abstract

22. Krause T, Anders J, von Renteln-Kruse W. Urinary incontinence as a risk factor for pressure sores does not withstand a critical examination. Pflege. 2005 Oct;18(5):299-303. Abstract

23. Allman RM, Laprade CA, Noel LB, et al. Pressure sores among hospitalized patients. Ann Intern Med. 1986 Sep;105(3):337-42. Abstract

24. Liu P, He W, Chen HL. Diabetes mellitus as a risk factor for surgery-related pressure ulcers: a meta-analysis. J Wound Ostomy Continence Nurs. 2012 Sep-Oct;39(5):495-9.Full text  Abstract

25. Liang M, Chen Q, Zhang Y, et al. Impact of diabetes on the risk of bedsore in patients undergoing surgery: an updated quantitative analysis of cohort studies. Oncotarget. 2017 Feb 28;8(9):14516-24.Full text  Abstract

26. Padula WV, Pronovost PJ, Makic MBF, et al. Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis. BMJ Qual Saf. 2019 Feb;28(2):132-141.Full text  Abstract

27. Chou R, Dana T, Bougatsos C, et al. Pressure ulcer risk assessment and prevention: a systematic comparative effectiveness review. Ann Intern Med. 2013;159:28-38.Full text  Abstract

28. Gould L, Stuntz M, Giovannelli M, et al.Wound Healing Society 2015 update on guidelines for pressure ulcers. Wound Repair Regen. 2008 Mar-Apr;16(2):151-68.Full text  Abstract

29. Norton D, McLaren R, Exton-Smith AN. Pressure sores: an investigation of geriatric nursing problems in hospital. New York, NY: Churchill Livingstone; 1975.

30. Waterlow J. Pressure sores: a risk assessment card. Nurs Times. 1985;81:49-55. Abstract

31. Braden B, Bergstrom N. A conceptual schema for the study of the etiology of pressure sores. Rehabil Nurs. 1987;12:8-12. Abstract

32. Xie H, Peel NM, Hirdes JP, et al. Validation of the interRAI Pressure Ulcer Risk Scale in acute care hospitals. J Am Geriatr Soc. 2016;64:1324-1328. Abstract

33. Webster J, Coleman K, Mudge A, et al. Pressure ulcers: effectiveness of risk-assessment tools. A randomised controlled trial (the ULCER trial). BMJ Qual Saf. 2011;20:297-306. Abstract

34. Moore ZE, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019 Jan 31;1:CD006471.Full text  Abstract

35. Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Lopez-Medina IM, et al. Risk assessment scales for pressure ulcer prevention: a systematic review. J Adv Nurs. 2006;54:94-110. Abstract

36. Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA. 2006 Aug 23;296(8):974-84. Abstract

37. Defloor T, De Bacquer D, Grypdonck MH. The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. Int J Nurs Stud. 2005;42:37-46. Abstract

38. Gillespie BM, Walker RM, Latimer SL, et al. Repositioning for pressure injury prevention in adults. Cochrane Database Syst Rev. 2020 Jun 2;6:CD009958.Full text  Abstract

39. Moore Z, Cowman S, Conroy RM. A randomised controlled clinical trial of repositioning, using the 30° tilt, for the prevention of pressure ulcers. J Clin Nurs. 2011;20:2633-2644.Full text  Abstract

40. Yap TL, Kennerly SM, Simmons MR, et al. Multidimensional team-based intervention using musical cues to reduce odds of facility-acquired pressure ulcers in long-term care: a paired randomized intervention study. J Am Geriatr Soc. 2013;61:1552-1559. Abstract

41. European Pressure Ulcer Advisory Panel; National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers. Washington DC: National Pressure Ulcer Advisory Panel; 2014. 2014 [internet publication].Full text

42. McInnes E, Jammali-Blasi A, Bell-Syer SE, et al. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev. 2015;(9):CD001735.Full text  Abstract

43. Nixon J, Cranny G, Iglesias C, et al. Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial. BMJ. 2006;332:1413.Full text  Abstract

44. Nixon J, Smith IL, Brown S, et al. Pressure Relieving Support Surfaces for Pressure Ulcer Prevention (PRESSURE 2): Clinical and health economic results of a randomised controlled trial. EClinicalMedicine. 2019 Sep;14:42-52.Full text  Abstract

45. Brienza D, Kelsey S, Karg P, et al. A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. J Am Geriatr Soc. 2010;58:2308-2314. Abstract

46. Donnelly J, Winder J, Kernohan WG, et al. An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture. J Wound Care. 2011;20:309-312,314-318. Abstract

47. Walia GS, Wong AL, Lo AY, et al. Efficacy of monitoring devices in support of prevention of pressure injuries: systematic review and meta-analysis. Adv Skin Wound Care. 2016;29:567-574.Full text  Abstract

48. Langer G, Fink A. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2014;(6):CD003216.Full text  Abstract

49. Kalowes P, Messina V, Li M. Five-layered soft silicone foam dressing to prevent pressure ulcers in the intensive care unit. Am J Crit Care. 2016 Nov;25(6):e108-e19.Full text  Abstract

50. Santamaria N, Gerdtz M, Sage S, et al. A randomised controlled trial of the effectiveness of soft silicone multi-layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial. Int Wound J. 2015 Jun;12(3):302-8.Full text  Abstract

51. Moore ZE, Webster J. Dressings and topical agents for preventing pressure ulcers. Cochrane Database Syst Rev. 2018 Dec 6;12:CD009362.Full text  Abstract

52. Sullivan N, Schoelles KM. Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158:410-416.Full text  Abstract

53. Edwards L, Banks V. Pressure sore classification grading systems. J Community Nurs. 1999;13:28-35.

54. Kottner J, Cuddigan J, Carville K, et al. Pressure ulcer/injury classification today: An international perspective. J Tissue Viability. 2020 Aug;29(3):197-203.Full text  Abstract

55. Grayson ML, Gibbons GW, Balogh K, et al. Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients. JAMA. 1995 Mar 1;273(9):721-3. Abstract

56. Dow G. Bacterial swabs and the chronic wound: when, how, and what do they mean? Ostomy Wound Manage. 2003 May;49(5A Suppl):8-13. Abstract

57. Reddy M, Gill SS, Kalkar SR, et al. Treatment of pressure ulcers: a systematic review. JAMA. 2008 Dec 10;300(22):2647-62.Full text  Abstract

58. Smith ME, Totten A, Hickam DH, et al. Pressure ulcer treatment strategies: a systematic comparative effectiveness review. Ann Intern Med. 2013;159:39-50.Full text  Abstract

59. McInnes E, Jammali-Blasi A, Bell-Syer SE, et al. Support surfaces for treating pressure ulcers. Cochrane Database Syst Rev. 2018 Oct 11;10:CD009490.Full text  Abstract

60. Stratton RJ, Ek AC, Engfer M, et al. Enteral nutritional support in prevention and treatment of pressure ulcers: a systematic review and meta-analysis. Ageing Res Rev. 2005 Aug;4(3):422-50. Abstract

61. National Institute for Health and Care Excellence. Pressure ulcers: prevention and management of pressure ulcers. April 2014 [internet publication].Full text

62. Posner BM, Jette AM, Smith KW, et al. Nutrition and health risks in the elderly: the nutrition screening initiative. Am J Public Health. 1993 Jul;83(7):972-8.Full text  Abstract

63. Qaseem A, Humphrey LL, Forciea MA, et al; Clinical Guidelines Committee of the American College of Physicians. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2015 Mar 3;162(5):370-9.Full text  Abstract

64. Cereda E, Klersy C, Serioli M, et al; OligoElement Sore Trial Study Group. A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: a randomized trial. Ann Intern Med. 2015 Feb 3;162(3):167-74. Abstract

65. Bauman WA, Spungen AM, Collins JF, et al. The effect of oxandrolone on the healing of chronic pressure ulcers in persons with spinal cord injury: a randomized trial. Ann Intern Med. 2013;158:718-726. Abstract

66. Pieper B, Langemo D, Cuddigan J. Pressure ulcer pain: a systematic literature review and national pressure ulcer advisory panel white paper. Ostomy Wound Manage. 2009 Feb;55(2):16-31. Abstract

67. Arapaglou V, Katsenis K, Syrigos KN, et al. Analgesic efficacy of an ibuprofen-releasing foam dressing compared with local best practices for painful exuding wounds. J Wound Care. 2011 Jul;20(7):319-20, 322-5. Abstract

68. Zeppetella G, Paul J, Ribeiro MD. Analgesic efficacy of morphine applied topically to painful ulcers. J Pain Symptom Manage. 2003 Jun;25(6):555-8. Abstract

69. Vowden K, Vowden P. Wound bed preparation. March 2002 [internet publication].Full text

70. Falanga V. Classifications for wound bed preparation and stimulation of chronic wounds. Wound Repair Regen. 2000;8:347-352. Abstract

71. Moore ZE, Cowman S. Wound cleansing for pressure ulcers. Cochrane Database Syst Rev. 2013 Mar 28;(3):CD004983.Full text  Abstract

72. Westby MJ, Dumville JC, Soares MO, et al. Dressings and topical agents for treating pressure ulcers. Cochrane Database Syst Rev. 2017 Jun 22;6:CD011947.Full text  Abstract

73. Thomas S. A structured approach to the selection of dressings. July 1997. (last accessed 31 March 2017).Full text

74. Bradley M, Cullum N, Nelson EA, et al. Systematic reviews of wound care management: (2). Dressings and topical agents used in the healing of chronic wounds. Health Technol Assess. 1999;3:1-35. Abstract

75. Bouza C, Saz Z, Munoz A, et al. Efficacy of advanced dressings in the treatment of pressure ulcers: a systematic review. J Wound Care. 2005;14:193-199. Abstract

76. Jull AB, Cullum N, Dumville JC, et al. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2015;(3):CD005083.Full text  Abstract

77. Sibbald RG, Orsted HL, Coutts PM, et al. Best practice recommendations for preparing the wound bed: update 2006. Adv Skin Wound Care. 2007 Jul;20(7):390-405. Abstract

78. Leaper D. Sharp technique for wound debridement. December 2002 [internet publication].Full text

79. Sherman RA, Wyle F, Vulpe M. Maggot therapy for treating pressure ulcers in spinal cord injury patients. J Spinal Cord Med. 1995 Apr;18(2):71-4. Abstract

80. Gray M. Is larval (maggot) debridement effective for removal of necrotic tissue from chronic wounds? J Wound Ostomy Continence Nurs. 2008 Jul-Aug;35(4):378-84. Abstract

81. Gurunluoglu R. Experiences with waterjet hydrosurgery system in wound debridement. World J Emerg Surg. 2007 May 2;2:10.Full text  Abstract

82. Bradley M, Cullum N, Sheldon T. The debridement of chronic wounds: a systematic review. Health Technol Assess. 1999;3:iii-iv,1-78. Abstract

83. Kwok AC, Simpson AM, Willcockson J, et al. Complications and their associations following the surgical repair of pressure ulcers. Am J Surg. 2018 Dec;216(6):1177-1181.Full text  Abstract

84. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. Sep 2017 [internet publication].Full text

85. National Institute for Health and Care Excellence. Cellulitis and erysipelas: antimicrobial prescribing. Sep 2019 [internet publication].Full text

86. Norman G, Dumville JC, Moore ZE, et al. Antibiotics and antiseptics for pressure ulcers. Cochrane Database Syst Rev. 2016;(4):CD011586.Full text  Abstract

87. Ebright JR. Microbiology of chronic leg and pressure ulcers: clinical significance and implications for treatment. Nurs Clin North Am. 2005 Jun;40(2):207-16. Abstract

88. Arora M, Harvey LA, Glinsky JV, et al. Electrical stimulation for treating pressure ulcers. Cochrane Database Syst Rev. 2020 Jan 22;1:CD012196.Full text  Abstract

89. Polak A, Taradaj J, Nawrat-Szoltysik A, et al. Reduction of pressure ulcer size with high-voltage pulsed current and high-frequency ultrasound: a randomised trial. J Wound Care. 2016 Dec 2;25(12):742-754.Full text  Abstract

90. Polak A, Franek A, Blaszczak E, et al. A prospective, randomized, controlled, clinical study to evaluate the efficacy of high-frequency ultrasound in the treatment of Stage II and Stage III pressure ulcers in geriatric patients. Ostomy Wound Manage. 2014 Aug;60(8):16-28.Full text  Abstract

91. Ubbink DT, Westerbos SJ, Nelson EA, et al. A systematic review of topical negative pressure therapy for acute and chronic wounds. Br J Surg. 2008;95:685-692. Abstract

92. Dumville JC, Webster J, Evans D, et al. Negative pressure wound therapy for treating pressure ulcers. Cochrane Database Syst Rev. 2015;(5):CD011334.Full text  Abstract

93. Kranke P, Bennett M, Martyn-St James M, et al. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev. 2015;(6):CD004123.Full text  Abstract

94. Roeckl-Wiedmann I, Bennett M, Kranke P. Systematic review of hyperbaric oxygen in the management of chronic wounds. Br J Surg. 2005;92:24-32. Abstract

95. Moore ZE, Cowman S. Repositioning for treating pressure ulcers. Cochrane Database Syst Rev. 2015 Jan 5;1:CD006898.Full text  Abstract

96. Ramos-Torrecillas J, García-Martínez O, De Luna-Bertos E, et al. Effectiveness of platelet-rich plasma and hyaluronic acid for the treatment and care of pressure ulcers. Biol Res Nurs. 2015 Mar;17(2):152-8.Full text  Abstract

97. Gilligan AM, Waycaster CR, Milne CT. Cost effectiveness of Becaplermin gel on wound closure for the treatment of pressure injuries. Wounds. 2018 Jun;30(6):197-204.Full text  Abstract

98. Hu X, Sun H, Han C, et al. Topically applied rhGM-CSF for the wound healing: a systematic review. Burns. 2011 Aug;37(5):729-41 Abstract

99. Hao XY, Li HL, Su H, et al. Topical phenytoin for treating pressure ulcers. Cochrane Database Syst Rev. 2017 Feb 22;2:CD008251.Full text  Abstract

100. Russo CA, Steiner C, Spector W. Hospitalizations related to pressure ulcers among adults 18 years and older, 2006: Statistical Brief #64. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Health Care Policy and Research (US); 2006-2008 Dec.Full text  Abstract

101. Anthony D, Parboteeah S, Saleh M, et al. Norton, Waterlow and Braden scores: a review of the literature and a comparison between the scores and clinical judgement. J Clin Nurs. 2008 Mar;17(5):646-53. Abstract

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