[Valid and reliable methods for describing pressure sores and leg ulcer--a systematic literature review]

In the wound documentation of pressure sore and leg ulcer the most important tasks and objectives are the presentation of the outcomes of the diagnostic inspection, planning of therapy and evaluation of wound healing. The aim of the systematic literature review covering the period of time between 2001 and 2006 was to look for valid, reliable and feasible methods to the size, appearance, edge, grade, and healing of wounds. Due to their heterogeneity the studies that were found can hardly be compared; some of them show methodological weaknesses. Measurements of an elliptical area based on the perpendicular method using a ruler are the most reliable within the linear methods; however, they only allow an estimation of the size. Together with mechanical or digital planimetry tracings can measure the wound's size reliably. Photographs do not assess large or circular wounds reliably, nor do they adequately document the wound's colour. There are no valid and reliable standardized procedures for the documentation of the wound's colour, exudate, odour; margins and maceration. To describe the pressure sore's degree of severity there are twenty different systems of classification. The data, however, confirm the difficulty to classify pressure ulcers reliably. Wound healing can also be assessed by a number of standardized tools: PSST, PUSH, SWHT, SS, PUHP, CODED and DESIGN (pressure sore) and LUMT (leg ulcer). These tools have not been translated into German and have not been adequately researched. No data exists to allow generalization concerning the practicability of these methods. For all methods of measurement, it can be concluded that training and experience in the use of the method is required and that the validity and reliability are higher when measurements are conducted by an experienced person.