Interpretation of <i>WHS Guidelines for the Treatment of Pressure Ulcers-2023 update</i>_West China Medical Journal

Authors：

LEI Changbin ¹ , HE Lingxiao ¹ , LIAO Dengbin ¹ , CAO Hua ² , NING Qian ¹ ,  JIANG Yan ³

1. Trauma Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Evidence-Based Nursing Center, Nursing Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

JIANG Yan, Email: hxhljy@163.com

Keywords：

Pressure ulcer; pressure injury; clinical practice guideline; interpretation of guideline

DOI：

10.7507/1002-0179.202407082

Video：

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This article interprets the core updated content of WHS Guidelines for the Treatment of Pressure Ulcers-2023 update compared to Wound Healing Society 2015 update on Guidelines for Pressure Ulcers in multiple key areas, including posture and support surface, infection, wound bed preparation, surgical treatment, and adjuvant therapy. Additionally, the article deeply interprets the new content of the 2023 updated guidelines (palliative wound care for patients with severe pressure ulcers), in order to provide efficient and convenient reference tools for domestic medical personnel to quickly grasp the latest developments in pressure ulcer treatment, standardize treatment processes, and improve treatment effectiveness.

Citation： LEI Changbin, HE Lingxiao, LIAO Dengbin, CAO Hua, NING Qian, JIANG Yan. Interpretation of WHS Guidelines for the Treatment of Pressure Ulcers-2023 update. West China Medical Journal, 2024, 39(10): 1520-1525. doi: 10.7507/1002-0179.202407082 Copy

1.	Kottner J, Cuddigan J, Carville K, et al. Pressure ulcer/injury classification today: an international perspective. J Tissue Viability, 2020, 29(3): 197-203.
2.	Li Z, Lin F, Thalib L, et al. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud, 2020, 105: 103546.
3.	Sugathapala RDUP, Latimer S, Balasuriya A, et al. Prevalence and incidence of pressure injuries among older people living in nursing homes: a systematic review and meta-analysis. Int J Nurs Stud, 2023, 148: 104605.
4.	张润节, 郭彤, 刘心菊, 等. 两部压力性损伤相关指南推荐意见的解读. 护理研究, 2020, 34(24): 4319-4323.
5.	顾梦倩, 赵燕燕, 陈圣枝, 等. 2019 年版国际《压力性损伤的预防与治疗: 临床实践指南》解读. 河北医科大学学报, 2021, 42(5): 497-500.
6.	Gould LJ, Alderden J, Aslam R, et al. WHS guidelines for the treatment of pressure ulcers-2023 update. Wound Repair Regen, 2024, 32(1): 6-33.
7.	Gould L, Stuntz M, Giovannelli M, et al. Wound Healing Society 2015 update on guidelines for pressure ulcers. Wound Repair Regen, 2016, 24(1): 145-162.
8.	Yap TL, Horn SD, Sharkey PD, et al. Effect of varying repositioning frequency on pressure injury prevention in nursing home residents: TEAM-UP trial results. Adv Skin Wound Care, 2022, 35(6): 315-325.
9.	Alshahrani B, Sim J, Middleton R. Nursing interventions for pressure injury prevention among critically ill patients: a systematic review. J Clin Nurs, 2021, 30(15/16): 2151-2168.
10.	Griffey J, Barnes J, Bardonner MK. Use of air-fluidized or fluid immersion redistribution support surfaces for the treatment of stage 4 pressure injuries: a case series. Wound Manag Prev, 2021, 67(1): 35-43.
11.	Saha S, Smith MEB, Totten A, et al. Pressure ulcer treatment strategies: comparative effectiveness. Rockville: Agency for Healthcare Research and Quality, 2013.
12.	Arnold M, Yanez C, Yanez B. Wound healing in the long-term acute care setting using an air fluidized therapy/continuous low-pressure therapeutic bed: a multiple case series. J Wound Ostomy Continence Nurs, 2020, 47(3): 284-290.
13.	Rivolo M, Dionisi S, Olivari D, et al. Heel pressure injuries: consensus-based recommendations for assessment and management. Adv Wound Care (New Rochelle), 2020, 9(6): 332-347.
14.	Swanson T, Ousey K, Haesler E, et al. IWII wound infection in clinical practice consensus document: 2022 update. J Wound Care, 2022, 31(Suppl 12): S10-S21.
15.	Malone M, Bjarnsholt T, McBain AJ, et al. The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data. J Wound Care, 2017, 26(1): 20-25.
16.	Alam W. Wound bed preparation and treatment modalities. Clin Geriatr Med, 2024, 40(3): 375-384.
17.	Roes C, Calladine L, Morris C. Rapid debridement with monofilament fibre debridement technology: clinical outcomes and practitioner satisfaction. J Wound Care, 2019, 28(8): 534-541.
18.	Dissemond J, Eberlein T, Bültemann A, et al. A purpose-designed monofilament-fibre pad for debridement of hard-to-reach wounds: experience in clinical practice. J Wound Care, 2018, 27(7): 421-425.
19.	Yang K, Graf A, Sanger J. Pressure ulcer reconstruction in patients with heterotopic ossification after spinal cord injury: a case series and review of literature. J Plast Reconstr Aesthet Surg, 2017, 70(4): 518-528.
20.	季超, 肖仕初. 负压伤口疗法在创面治疗中的临床应用及其相关研究进展. 中华烧伤与创面修复杂志, 2022, 38(6): 585-589.
21.	梁媛媛, 许佳捷, 郭鑫, 等. 伤口组织与电刺激调控的相关性研究. 解剖学杂志, 2021, 44(6): 469-472.
22.	Honaker JS, Forston MR, Davis EA, et al. The effect of adjunctive noncontact low frequency ultrasound on deep tissue pressure injury. Wound Repair Regen, 2016, 24(6): 1081-1088.
23.	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, 25(12): 742-754.
24.	Taradaj J, Shay B, Dymarek R, et al. Effect of laser therapy on expression of angio- and fibrogenic factors, and cytokine concentrations during the healing process of human pressure ulcers. Int J Med Sci, 2018, 15(11): 1105-1112.
25.	Higgins J, Casey S, Taylor E, et al. Comparing the braden and jackson/cubbin pressure injury risk scales in trauma-surgery ICU patients. Crit Care Nurse, 2020, 40(6): 52-61.
26.	姚秀英, 徐栩, 陈霞, 等. 汉化版 Cubbin & Jackson 量表与 Braden 量表在 ICU 压疮风险评估中的应用比较. 护理学杂志, 2017, 32(6): 44-46.
27.	Anderson F, Downing GM, Hill J, et al. Palliative performance scale (PPS): a new tool. J Palliat Care, 1996, 12(1): 5-11.
28.	Amorim Araujo I, Jeanneret Brand S, Espolio Desbaillet Y. Assessment of the Palliative Performance Scale in a specialized palliative care unit. Rev Med Suisse, 2023, 19(813): 295-298.
29.	Delmore B, Cox J, Smith D, et al. Acute skin failure in the critical care patient. Adv Skin Wound Care, 2020, 33(4): 192-201.
30.	Davies N, Barrado-Martín Y, Vickerstaff V, et al. Enteral tube feeding for people with severe dementia. Cochrane Database Syst Rev, 2021, 8(8): CD013503.
31.	Lyvers E, Elliott DP. Topical metronidazole for odor control in pressure ulcers. Consult Pharm, 2015, 30(9): 523-526.

1. Kottner J, Cuddigan J, Carville K, et al. Pressure ulcer/injury classification today: an international perspective. J Tissue Viability, 2020, 29(3): 197-203.
2. Li Z, Lin F, Thalib L, et al. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud, 2020, 105: 103546.
3. Sugathapala RDUP, Latimer S, Balasuriya A, et al. Prevalence and incidence of pressure injuries among older people living in nursing homes: a systematic review and meta-analysis. Int J Nurs Stud, 2023, 148: 104605.
4. 张润节, 郭彤, 刘心菊, 等. 两部压力性损伤相关指南推荐意见的解读. 护理研究, 2020, 34(24): 4319-4323.
5. 顾梦倩, 赵燕燕, 陈圣枝, 等. 2019 年版国际《压力性损伤的预防与治疗: 临床实践指南》解读. 河北医科大学学报, 2021, 42(5): 497-500.
6. Gould LJ, Alderden J, Aslam R, et al. WHS guidelines for the treatment of pressure ulcers-2023 update. Wound Repair Regen, 2024, 32(1): 6-33.
7. Gould L, Stuntz M, Giovannelli M, et al. Wound Healing Society 2015 update on guidelines for pressure ulcers. Wound Repair Regen, 2016, 24(1): 145-162.
8. Yap TL, Horn SD, Sharkey PD, et al. Effect of varying repositioning frequency on pressure injury prevention in nursing home residents: TEAM-UP trial results. Adv Skin Wound Care, 2022, 35(6): 315-325.
9. Alshahrani B, Sim J, Middleton R. Nursing interventions for pressure injury prevention among critically ill patients: a systematic review. J Clin Nurs, 2021, 30(15/16): 2151-2168.
10. Griffey J, Barnes J, Bardonner MK. Use of air-fluidized or fluid immersion redistribution support surfaces for the treatment of stage 4 pressure injuries: a case series. Wound Manag Prev, 2021, 67(1): 35-43.
11. Saha S, Smith MEB, Totten A, et al. Pressure ulcer treatment strategies: comparative effectiveness. Rockville: Agency for Healthcare Research and Quality, 2013.
12. Arnold M, Yanez C, Yanez B. Wound healing in the long-term acute care setting using an air fluidized therapy/continuous low-pressure therapeutic bed: a multiple case series. J Wound Ostomy Continence Nurs, 2020, 47(3): 284-290.
13. Rivolo M, Dionisi S, Olivari D, et al. Heel pressure injuries: consensus-based recommendations for assessment and management. Adv Wound Care (New Rochelle), 2020, 9(6): 332-347.
14. Swanson T, Ousey K, Haesler E, et al. IWII wound infection in clinical practice consensus document: 2022 update. J Wound Care, 2022, 31(Suppl 12): S10-S21.
15. Malone M, Bjarnsholt T, McBain AJ, et al. The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data. J Wound Care, 2017, 26(1): 20-25.
16. Alam W. Wound bed preparation and treatment modalities. Clin Geriatr Med, 2024, 40(3): 375-384.
17. Roes C, Calladine L, Morris C. Rapid debridement with monofilament fibre debridement technology: clinical outcomes and practitioner satisfaction. J Wound Care, 2019, 28(8): 534-541.
18. Dissemond J, Eberlein T, Bültemann A, et al. A purpose-designed monofilament-fibre pad for debridement of hard-to-reach wounds: experience in clinical practice. J Wound Care, 2018, 27(7): 421-425.
19. Yang K, Graf A, Sanger J. Pressure ulcer reconstruction in patients with heterotopic ossification after spinal cord injury: a case series and review of literature. J Plast Reconstr Aesthet Surg, 2017, 70(4): 518-528.
20. 季超, 肖仕初. 负压伤口疗法在创面治疗中的临床应用及其相关研究进展. 中华烧伤与创面修复杂志, 2022, 38(6): 585-589.
21. 梁媛媛, 许佳捷, 郭鑫, 等. 伤口组织与电刺激调控的相关性研究. 解剖学杂志, 2021, 44(6): 469-472.
22. Honaker JS, Forston MR, Davis EA, et al. The effect of adjunctive noncontact low frequency ultrasound on deep tissue pressure injury. Wound Repair Regen, 2016, 24(6): 1081-1088.
23. 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, 25(12): 742-754.
24. Taradaj J, Shay B, Dymarek R, et al. Effect of laser therapy on expression of angio- and fibrogenic factors, and cytokine concentrations during the healing process of human pressure ulcers. Int J Med Sci, 2018, 15(11): 1105-1112.
25. Higgins J, Casey S, Taylor E, et al. Comparing the braden and jackson/cubbin pressure injury risk scales in trauma-surgery ICU patients. Crit Care Nurse, 2020, 40(6): 52-61.
26. 姚秀英, 徐栩, 陈霞, 等. 汉化版 Cubbin & Jackson 量表与 Braden 量表在 ICU 压疮风险评估中的应用比较. 护理学杂志, 2017, 32(6): 44-46.
27. Anderson F, Downing GM, Hill J, et al. Palliative performance scale (PPS): a new tool. J Palliat Care, 1996, 12(1): 5-11.
28. Amorim Araujo I, Jeanneret Brand S, Espolio Desbaillet Y. Assessment of the Palliative Performance Scale in a specialized palliative care unit. Rev Med Suisse, 2023, 19(813): 295-298.
29. Delmore B, Cox J, Smith D, et al. Acute skin failure in the critical care patient. Adv Skin Wound Care, 2020, 33(4): 192-201.
30. Davies N, Barrado-Martín Y, Vickerstaff V, et al. Enteral tube feeding for people with severe dementia. Cochrane Database Syst Rev, 2021, 8(8): CD013503.
31. Lyvers E, Elliott DP. Topical metronidazole for odor control in pressure ulcers. Consult Pharm, 2015, 30(9): 523-526.

West China Medical Journal

Interpretation of WHS Guidelines for the Treatment of Pressure Ulcers-2023 update

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