Quick Reference Guideline Number 15

AHCPR Publication No. 95-0653:

December 1994

The Clinical Practice Guideline on which this Quick Reference Guide for Clinicians is based was developed by a multidisciplinary, private-sector panel comprising health care professionals and a consumer representative sponsored by the Agency for Health Care Policy and Research (AHCPR). Panel members were:

Nancy Bergstrom, PhD, RN, FAAN (Chair)

Richard M. Allman, MD

Oscar M. Alvarez, PhDM.

Alisan Bennett, EdD, RN

Carolyn E. Carlson, PhD, RN

Rita A. Frantz, PhD, RN, FAAN

Susan L. Garber, MA, OTR, FAOTA

Mitchell V. Kaminski, Jr., MD, SC, FACS, FICS, FACN

Mildred G. Kemp, PhD, RN, CETN, FAAN

Thomas A. Krouskop, PhD

Victor L. Lewis, Jr., MD, FACS

JoAnn Maklebust, MSN, RN, CS

David J. Margolis, MD, FACP

Elena M. Marvel, MSN, MA, RN

Steven I. Reger, PhD, CP

George T. Rodeheaver, PhD

Richard Salcido, MD, FAAPMR

George C. Xakellis, MD

Gary M. Yarkony, MD, FAAPMR

Consultants to the panel were Richard M. Allman, MD; Ronni Chernoff, PhD, RD; Sue Crow, MSN, RN; David C. Hadorn, MD; JoAnne Horsley, PhD, RN, FAAN; Henry Miller, PhD; Mary Susan O'Brien, PhD; George T. Rodeheaver, PhD; and Steven H. Woolf, MD, MPH.

An explicit, science-based methodology was employed along with expert clinical judgement to develop specific statements on patient assessment, treatment, and management of pressure ulcers. Extensive literature searches were conducted and critical reviews and syntheses were used to evaluate empirical evidence and significant outcomes. Peer review and pilot review were undertaken to evaluate the validity, reliability, and utility of the guideline in clinical practice.

This Quick Reference Guide for Clinicians presents summary points from the Clinical Practice Guideline. The latter provides a description of the guideline development process, thorough analysis and discussion of the available research, critical evaluation of the assumptions and knowledge of the field, more complete information for health care decisionmaking, consideration for patients with special needs, and references. Decisions to adopt particular recommendations from either publication must be made by practitioners in light of available resources and circumstances presented by the individual patient.

AHCPR invites comments and suggestions from users for consideration in development and updating of future guidelines. Please send written comments to: Director, Office of the Forum for Quality and Effectiveness in Health Care, AHCPR, Willco Building, Suite 310, 6000 Executive Boulevard, Rockville, MD 20852.

This Quick Reference Guide for Clinicians contains highlights from the Clinical Practice Guideline version of Treatment of Pressure Ulcers, which was developed by a private-sector panel of health care providers and a consumer. Selected aspects of pressure ulcer assessment and treatment are presented. Topics covered include assessment of the patient and pressure ulcer(s), tissue load management, ulcer care, management of bacterial colonization and infection, operative repair of the pressure ulcer, and education and quality improvement. Algorithms are included to show the sequence of events related to the overall care of the individual with a pressure ulcer, nutritional assessment and support, management of tissue loads, ulcer care, and management of bacterial colonization and infection. Tables and forms are included as aids for selecting irrigation devices, cleansing solutions, support surfaces, and assessing the pressure ulcer and the patient's nutritional status.

This document is in the public domain and may be used and reprinted without special permission. AHCPR appreciates citation as to source, and the suggested format is provided below:Bergstrom N, Bennett MA, Carlson CE, et al. Pressure Ulcer Treatment.Clinical Practice Guideline. Quick Reference Guide for Clinicians, No. 15. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. AHCPR Pub. No. 95-0653. Dec. 1994.