Updating of the npuap staging system

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Visit the online shop to order your copy of the Guideline.June 2016 The National Pressure Ulcer Advisory Panel (NPUAP) recently released the NPUAP Pressure Injury Staging System based on a review of the literature, stakeholder comments and the results of a consensus conference involving 400 participants. The International Guideline Development Group (including representatives from the EPUAP, PPPIA and NPUAP) have reviewed the work of the NPUAP and determined that the International Pressure Ulcer Classification System published in the 2014 International Guideline is still valid.For this edition of the Guideline, the member organizations are seeking to expand international contribution and collaboration to organizations not currently represented by the PPPIA, EPUAP or NPUAP.Other international not-for-profit pressure injury/ulcer organizations that share the mission, values and purposes of the EPUAP, NPUAP and PPPIA are invited to apply to join the Guideline development process through designation as "Associate Organizations".October 2017 Work has commenced on the 3rd edition of the Guideline.All individuals and organization representatives interested in reviewing the Guideline and providing feedback on the final version of the 3rd edition are invited to register to receive notification when the draft becomes available for stakeholder feedback.The recommendation to avoid using small cell alternating pressure mattresses and overlays has been retracted by the guideline development team.In one older study (Bliss, Mc Laren et al., 1966) pressure ulcers occurred more frequently in individuals who received a small cell mattress (diameter 1.5 to 2 inches or 3.8 to 5.1 cm) compared with a large cell mattress (diameter 6 inches or 15.25 cm).

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The individual's body shape, size, weight distribution, and any asymmetrical bony prominences may influence the performance of an alternating pressure support surface.

Expressions of Interest for Small Working Group members will be made on EPUAP, NPUAP and PPPIA organization websites and (when applicable) in newsletters in late 2017.

Expressions of Interest for involvement in the Guideline development are not accepted from industry representatives.

Following the study by Bliss (1966) the small cell design of alternating pressure mattress was abandoned in favour of the large cell design (Bliss, 1978).

However, the pressure ulcer incidence rate noted for the large cell design ripple mattress used in Bliss' study was still high (33% in high-risk individuals who were pressure ulcer free at commencement) (Bliss, Mc Laren et al., 1966) and ongoing concerns regarding the functionality of this large cell ripple mattress design, for example its easily displaced or kinked tubing and high maintenance requirements, were documented by Bliss in 1978 (Bliss, 1978).

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