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Pressure Injury Recurrence Toolkit

An evidence-based toolkit for guidance of healthcare workers, patients and informal caregivers providing strategies for prevention of recurrence among patients with spinal cords injuries.

The project is developed in collaboration with Wounds Australia.

Introduction

This EWMA toolkit is a comprehensive, evidence-based resource designed to support the prevention of pressure ulcers (PU) and pressure injuries (PI) and reduce recurrence in people living with spinal cord injury (SCI).

Developed by international experts, the toolkit provides practical guidance, tools and educational materials applicable across the entire patient pathway.
The materials cover three key care settings including acute hospital, rehabilitation and home and offers tailored materials for clinicians and other health care professionals, homecare providers, caregivers, patients and family members.

The resources available include structured guidance, checklists, training materials, and patient-friendly information supporting early detection, optimal care, and long-term prevention.

This project is developed by EWMA in collaboration with Wound Australia. 

  • Editor: Dimitri Beeckman (Belgium and Sweden)
  • Editor: Hayley Ryan (Australia)
  • Editor: Paulo Ramos (Portugal)
  • Author: Samantha Holloway (UK)
  • Author: Knærke Søgaard (Denmark)
  • Author: Andrea Pokorná (Czech Republic)
  • Author: Cátia Borges (Portugal)

All resources are freely available for download. Please feel free to print or share the resources unlimited for non-commercial purposes. For reuse purposes please ensure proper credit is made to the original source and copyright holder.

Copyright @EWMA 2026

Questions or comments can be sent to ewma@ewma.org 

HOSPITAL – ACUTE IN-PATIENT CARE
  • Implement PU/PI prevention measures immediate after the SCI before admission to hospital, and maintain them throughout hospitalization, including during examinations, care, and treatment.
  • Prioritise PU/PI prevention as PU/PI in the acute phase can delay rehabilitation and increase the risk of PU/PI recurrence.
  • Early transfer to specialised SCI rehabilitation facility reduces the risk of recurrent PU/PI.
REHABILITATION
  • Implement PU/PI prevention measures.
  • A multidisciplinary approach involving SCI-specialised team is recommended.
  • Educate people with SCI and their relatives in PU/PI prevention strategies.
  • Thorough planning of the transition is essential, and lifelong follow-up services, either in-person or via telemedicine, are recommended.
HOME – LONG-TERM CARE
  • Comprehensive discharge planning from hospital or rehabilitation centre is crucial for PU/PI prevention.
  • Implement PU/PI prevention measures.
  • Ensure necessary accommodation, home modifications, and timely access to required assistive devices.
  • Establish follow-up services with access to multidisciplinary SCI-specialised team.
  • Contact SCI-specialised healthcare professionals if local management is insufficient, complications arise, or specialised support is needed.

Resources and materials by type

Project supporters

The project is supported by:

Author group

  • Editor: Dimitri Beeckman (Belgium and Sweden)
  • Editor: Hayley Ryan (Australia)
  • Editor: Paulo Ramos (Portugal)
  • Author: Samantha Holloway (UK)
  • Author: Knærke Søgaard (Denmark)
  • Author: Andrea Pokorná (Czech Republic)
  • Author: Cátia Borges (Portugal)

HOSPITAL – ACUTE IN-PATIENT CARE
  • Implement PU/PI prevention measures immediate after the SCI before admission to hospital, and maintain them throughout hospitalization, including during examinations, care, and treatment.
  • Prioritise PU/PI prevention as PU/PI in the acute phase can delay rehabilitation and increase the risk of PU/PI recurrence.
  • Early transfer to specialized SCI rehabilitation facility reduces the risk of recurrent PUPI.

 

 

 

REHABILITATION
  • Implement PU/PI prevention measures.
  • A multidisciplinary approach involving SCI-specialized team is recommended.
  • Educate people with SCI and their relatives in PU/PI prevention strategies.
  • Thorough planning of the transition is essential, and lifelong follow-up services, either in-person or via telemedicine, are recommended.

 

 

 

 

HOME – LONG-TERM CARE
  • Comprehensive discharge planning from hospital or rehabilitation centre is crucial for PU/PI prevention.
  • Implement PU/PI prevention measures.
  • Ensure necessary accommodation, home modifications, and timely access to required assistive devices.
  • Establish follow-up services with access to multidisciplinary SCI-specialized team.
  • Contact SCI-specialised healthcare professionals if local management is insufficient, complications arise, or specialised support is needed.

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Project introduction

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Introductions and epidemiology
About pressure injuries in people with SCI

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