What’s New (and What’s Next) in the 2025 International Pressure Injury Guideline

What’s New (and What’s Next) in the 2025 International Pressure Injury Guideline

Kirra Fedyszyn

November 3, 2025
Keywords
Pressure Injuries
Categories
Pressure Ulcers

As pressure injury prevention and treatment continue to span acute, post-acute, and home settings, the International Guideline remains the field’s north star. In 2025, partner organizations National Pressure Injury Advisory Panel (NPIAP), European Pressure Ulcer Advisory Panel (EPUAP), and Pan Pacific Pressure Injury Alliance (PPPIA) are rolling out the fourth edition of this guideline with an expanded online format and staged release of chapters, plus refreshed quick-reference materials for busy clinicians.1 

Governance is provided by the Guideline Governance Group (GGG), established jointly by NPIAP/EPUAP/PPPIA and led by Professor Janet Cuddigan, PhD, RN, FAAN. The 2025 development team includes more than 240 clinical experts and consumer representatives across panel groups who shape evidence-to-decision (EtD) frameworks, review recommendations, and advise on implementation and consumer materials.1 

Methodologically, the 2025 edition follows GRADE, a widely regarded gold standard, using prespecified clinical questions (PICOT), comprehensive literature searches, standardized risk-of-bias tools (eg, RoB 2, ROBINS-I), meta-analysis where appropriate, and transparent EtD frameworks to determine both the certainty of evidence and strength of recommendations.2 

Two resources from the prior edition, published in 2019, remain freely available and highly useful for day-to-day practice. The full 2019 Clinical Practice Guideline (CPG) is a deep dive into evidence summaries, implementation considerations, and discussion.3 Meanwhile, the 2019 Quick Reference Guide (QRG) is explicitly designed for busy health professionals as a concise summary of evidence-based recommendations and good-practice statements, though it should not be used in isolation from the full CPG.4

For 2025, the guideline team is publishing topic-based chapters online as they’re finalized. Chapters live as of November 1, 2025, include Definition & Etiology, Preventive Skin Care, Nutrition, Repositioning, Support Surfaces, Seating, Heel Pressure Injuries, and Device-Related Pressure Injuries, with additional sections coming soon to include Pressure Injury Risk and Skin and Tissue Assessment.1

There is also an abridged 2025 Quick Reference Guide, which features “recommendations and good practice statements are extracted from the full Clinical Practice Guideline (CPG) for convenience of use in clinical practice.”5  This document is expected to be updated as further sections of the full CPG are made available.

The online guideline hub is live in beta (desktop-optimized), and consolidates chapters, methods, and navigation in one place. A mobile version is also planned.1 

How Clinicians Can Use These Now

  1. At the bedside and in huddles: Reach first for the QRG to check “what to do,” then open the corresponding online 2025 chapter (or the 2019 CPG for topics where 2025 content isn’t yet posted) for “how and why,” including implementation considerations and the graded certainty/strength for each recommendation.3-5 
  2. For protocols and education: Align local policies with the newest posted prevention chapters.1
  3. For quality projects: Use the methods pages and linked EtD frameworks to justify priority interventions and to educate teams on how certainty of evidence informs the strength of recommendations, which may be useful when negotiating equipment budgets, staffing for repositioning, or nutrition support pathways.2 

Looking Ahead

Several sections, including Pressure Injury Risk, Skin & Tissue Assessment, and the Glossary, are flagged on the site as “content coming soon.”1 Meanwhile, the methods team notes that PICOT searches will be published as they are conducted, so additional content and updates will appear iteratively on the site.2 A mobile version of the online guideline is also planned.1 

While more guideline information continues to emerge, clinicians may consider using the 2019 CPG/QRG together with the published 2025 chapters to refresh their practices over the coming months. Interested parties may choose to bookmark the beta online guideline hub, and check back regularly as remaining chapters and tools go live. 

 

References

  1. NPIAP/EPUAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. 2025. Accessed October 2025. Available at: https://internationalguideline.com/the-international-guideline
  2. NPIAP/EPUAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Methodology Protocol for the Clinical Practice Guideline (fourth edition). 2023. Accessed October 2025. Available at: https://static1.squarespace.com/static/6479484083027f25a6246fcb/t/679fe…
  3. NPIAP/EPUAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. The International Guide 2019. Emily Haesler, Ed. Accessed October 2025. Available at: https://static1.squarespace.com/static/6479484083027f25a6246fcb/t/6553d…
  4. NPIAP/EPUAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide 2019. Emily Haesler, Ed. Accessed October 2025. Available at: https://static1.squarespace.com/static/6479484083027f25a6246fcb/t/647dc…
  5. NPIAP/EPUAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. The International Guideline: Fourth Edition. Emily Haesler, Ed. 2025. Accessed October 2025. Available at: https://static1.squarespace.com/static/6479484083027f25a6246fcb/t/67bd4…

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