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NPUAP CLASSIFICATION OF PRESSURE ULCER GUIDELINES:
Use a validated pressure ulcer classification system to document the level of tissue loss.
Do not use a pressure ulcer classification system to describe tissue loss in wounds other than pressure ulcers.
Educate the professional about special assessment techniques in darkly pigmented individuals.
Educate the professional to differentiate pressure ulcers from other types of wounds (e.g. venous ulcers, arterial ulcers, neuropathic ulcers, incontinence associated dermatitis, skin tears, and intertrigo).
Educate the professional about the appropriate use of the classification system and the appearance of different tissue types at common pressure ulcer sites.
Confirm the reliability of classifications among the professionals responsible for classifying pressure ulcers.
Do Not classify pressure ulcers on mucous membranes.
This recommendation is based on expert opinion. Mucosal Pressure Ulcers (MPrU) are pressure ulcers found on mucous membranes with a history of a medical device use at the location of the ulcer. Mucous membrane is the moist lining of the body cavities that communicate with the exterior. These tissue line the tongue, gastrointestinal (GI) tract, nasal passages, urinary tract and vaginal tract. Pressure applied to this tissue can render it ischemic and lead to ulceration. Mucosal tissues are especially vulnerable to pressure from medical devices, such as oxygen tubing, endotracheal tubes, bite blocks, orogastric and nasogastric tubes, urinary catheters and fecal containment devices.
The classification system for pressure ulcers of the skin cannot be used to stage mucosal pressure ulcers. Nonblanchable erythema cannot be seen in mucous membranes, shallow open ulcers indicating superficial tissue loss of the nonkertantinized epithelium are so shallow that the naked eye cannot distinguish them from deeper, full thickness ulcers. Soft coagulum seen in mucosal pressure ulcers, which looks like slough in Stage III pressure ulcers, is actually soft blood clot. Exposed muscle would seldom be seen and bone is not present in these soft tissues.
ŠNPUAP-EPUAP FEBRUARY 27, 2009 PG 59-63.
CATEGORY III
DON'T MISS THE NEW NPUAP CLASSIFICATION DEFINITIONS
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Last Update 10/14/2009 Mideast Region of the Wound Ostomy Continence Nurses Society
