National Pressure Ulcer Advisory Panel's updated pressure ulcer staging system

Area of Science:

• Wound care and tissue injury research.
• Clinical dermatology and nursing standards.

Background:

• Existing pressure ulcer definitions required updates for improved accuracy and clinical application.
• Current research and expert consensus highlighted the need for revised pressure ulcer staging.

Purpose of the Study:

• To revise and update the definition and staging of pressure ulcers.
• To enhance the clarity, accuracy, and clinical utility of pressure ulcer classifications.
• To incorporate new understandings of pressure ulcer development, including deep tissue injury.

Main Methods:

• Solicitation of expert opinion from hundreds of clinicians, educators, and researchers nationwide.
• Review of current research on pressure ulcer development and classification.
• Drafting new definitions focused on accuracy, clarity, clinical utility, and discrimination.

Main Results:

• Updated definitions for pressure ulcers and their stages have been established.
• The anatomical tissue loss descriptions for existing stages remain unchanged.
• Deep tissue injury is now recognized as a distinct category within the pressure ulcer staging system.

Conclusions:

• The updated pressure ulcer staging system offers improved diagnostic accuracy and clinical utility.
• The revised definitions facilitate better discrimination between pressure ulcer stages and other wound types.
• Inclusion of deep tissue injury addresses a critical area in pressure ulcer assessment and management.