Evidence
Surveillance decision
We will not update the guideline on pressure ulcers.
Reasons for the decision
New evidence was found for most areas of the guideline focussing on adults (few studies were found specifically in children and young people), and were either consistent with current recommendations or insufficient to propose an update.
We therefore currently propose to not update the guideline.
Some evidence suggesting there might be a need to update the guideline was found in 2 areas, but we do not currently plan to update for the reasons discussed below:
Medical device-related pressure ulcers
A gap in current guidance in this area was identified by the placeholder statement in NICE's quality standard on pressure ulcers. A placeholder statement is an area of care that has been prioritised by the Quality Standards Advisory Committee, but for which no source guidance is currently available. Such statements also indicate the need for evidence-based guidance to be developed in this area.
The new evidence from the surveillance review found that:
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there is a high rate of medical device-related pressure ulcers
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risk factors can be identified for medical device-related pressure ulcers
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the Braden QD Scale reliably predicts both immobility-related and device-related pressure ulcers in the paediatric acute care environment
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medical device-related pressure ulcers can be prevented.
However, only single studies for each of these different aspects of this new area were identified by the current surveillance review. Therefore as part of the consultation, we asked stakeholders if they were aware of any further evidence on medical device-related pressure ulcers. No additional evidence was submitted to NICE, therefore we will not update the guideline at this time, but will review this area again at the next surveillance review.
Electrotherapy
The guideline states do not offer electrotherapy to adults to treat a pressure ulcer.
New evidence suggests there may be a benefit of electrotherapy in reducing ulcer area and improving wound healing time. As there is a Cochrane review protocol on Electrical stimulation for treating pressure ulcers, we will await completion of this review and then consider any impact on the guideline when the results are available.
For further details and a summary of all evidence identified in surveillance, see appendix A.
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