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WOUND CARE TODAY
2015,Vol 2, No 1
FOCUS ON PRESSURE ULCERS
i
T
he Declaration of Rio (2011)
stated that pressure ulcers
were a major health problem
affecting millions of people
worldwide. As well as the wound
itself, pressure ulcers contribute
to deteriorating health and
quality of life for patients
and can eventually lead to
disability and even death.
In the UK, the Health
and Social Care Information
Centre (HSCIC), using the
NHS Safety Thermometer,
reported 27,159 ‘new’
pressure ulcers in England
between December 2013 and
December 2014 — a new
pressure ulcer is defined as
one which developed 72 hours
or more after the patient was
admitted (HSCIC, 2015).
Through its quality,
innovation, productivity and
prevention (QIPP) programme, the
Department of Health selected four
common ‘harms’ that are largely
preventable through appropriate
How to categorise and assess
pressure ulcers
patient care (pressure ulcers; falls;
urinary tract infections (UTIs)
in patients with a catheter; new
venous thromboembolisms
[HSCIC, 2015]).
Pressure Ulcer Advisory Panel and
National Pressure Ulcer Advisory
Panel (EPUAP/NPUAP, 2009):
‘A pressure ulcer is defined as
localised injury to the skin and
underlying tissue usually
over a bony prominence, as a
result of pressure, or pressure
in combination with shear.
A number of contributing or
confounding factors are also
associated with pressure ulcers,
the significance of these factors
are yet to be elucidated.’
Once it is established that
the skin damage is due to
pressure damage and not for
example a moisture lesion
(
Figure 1
), leg ulcer, skin tear
or other traumatic damage,
it should be categorised and
recorded as per local policy and
using a validated classification
tool (
Table 1
illustrates some of the
main differences between pressure
damage and that caused by moisture).
Menna Lloyd Jones,independent tissue
viability nurse
Menna Lloyd Jones
Figure 1.
Moisture lesions are easily mistaken for
pressure damage.
Top tip:
Always follow local policy and
guidelines and ensure dressing
selection is only made after a
thorough assessment of the wound.
Information gathered on these
areas is recorded nationally and
it is vital that it is as accurate as
possible. In order to do this, nurses
need an understanding of what
pressure ulcers are and how to
categorise them.
PRESSURE ULCER CLASSIFICATION
The definition of a pressure ulcer
has been outlined by the European
IN BRIEF
Despite prevention measures, some patients still develop and are
admitted with pressure ulcers.
The prioritites are to verify the presence of pressure damage and
instigate a management plan that will prevent further deterioration.
The basic principles of pressure ulcer management include the
need for assessment and reassessment, as well as the use of
pressure-relieving equipment and repositioning.
KEY WORDS:
Pressure ulcers
Holistic assessment
Exudate
Pressure ulcer staging
Repositioning
