New Pressure Injury Evidence and the Upcoming 4th Edition of the EPUAP/NPPIAP/PPPIA International Pressure Injury Practice Guideline

This issue marks the 7th annual themed issue on pressure injuries (PIs). With article authors from China, Israel, Japan, South Korea, Spain, Australia, and the US, it truly underscores that PIs are an important global concern. This year also marks another special PI milestone: The 4th edition of the EPUAP/NPIAP/PPPIA International Pressure Injury Clinical Practice Guideline is being launched. The International Guideline will be freely accessible by interactive website presenting the Guideline Governance Group (GGG)’s recommendations, good practice statements, and implementation considerations. It was developed with input from the GGG, panel groups, and consumers. The website is expected to be accessible at the end of February 2025 at www.internationalguideline.com. Those who attended the NPIAP meeting in Dallas in February heard Prof Janet Cuddigan, PhD, RN, the lead for the GGG, speak about the preprint publication prevention guideline recommendations. The GGG representatives include one of your journal Editors-in-Chief (EAA); Dan Berlowitz, MD; and Jill Cox, PhD, RN; and a consumer representative, Sue Creehan, RN. The PI treatment recommendations will be available sometime after September 2025. Please see information about the EPUAP conference in Helsinki, Finland September 24-25, 2025 at https://epuap2025.org/. The GGG group was guided by Emily Haesler, an experienced guideline methodologist, and members of the GGG topic-specific workgroups included national and international wound organization representatives. A consumer panel group reviewed the latest evidence for PI management recommendations and implementation considerations. This 4th edition guideline uses GRADE methodology for the first time.1 GRADE methodology2 is known for its rigorous assessment to downgrade or upgrade the evidence with explicit means to develop clinical recommendations while balancing management with clinical implementation. To learn more about GRADE and how it was used in the development of the 4th edition of the guideline, please refer to the development protocol published previously in Advances.1,2 Thank you to all the stakeholders who provided comments on the draft documents. Congratulations to all whose efforts made the guideline a reality! This issue contains more than 10 new PI articles (in print or online) covering a variety of PI topics, from pediatrics to palliative care, spinal cord injury, and the impact of skin tone on tolerance to shear. We hope you enjoy this issue that reports PI evidence from seven countries and that you begin preparing to update your institution practice guidelines now that the 4th edition of the guidelines will be available in 2025.Elizabeth A. Ayello, PhD, MS, RN, CWON, MAPWCA, FAANR. Gary Sibbald, MD, Med, FRCPC (Med Derm), FAAD, MAPWCA, JM