Pressure ulcers are frequent complications in PMR wards. Some patients arrive with PU, prevalence is 12% in national survey conducted by French society for PU (PERSE - prevention, education, research, care of PU). Some patients are Spinal cord injured (SCI) and require surgery. French society for PU provide guidelines: in 2012 general guidelines according with international guidelines and in 2016 guidelines for surgical PU in SCI.

As PU is a general disease and some recommendation are contradictory, PERSE organized 2 conferences. The first updated previous guidelines from 2001 and the second provided first guidelines for surgical PU in SCI. During the conferences, all the references are reviewed to remove EBM recommendations. In a second time, for questions without EBM guidelines, professional agreement is searched out.

Guidelines for prevention and care is written. First is: assess risk level as soon as possible. Second is organize prevention in relation to the issue and always with effort on nutrition and mobilization. Third is care is not only local dressings. Then, the first guideline for surgical PU SCI was written. The result is: to improve good results for patients, multidisciplinary work and patient compliance assessment is necessary. Second is progressive recovery of sitting is essential.

Elaborate and disseminate guidelines is necessary and bring more consistent between all care givers.