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Updating of the npuap staging system

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The guidelines will provide an objective means for evaluating and comparing support surface characteristics.Through Support Surfaces Standards (S3I) the NPUAP intends to improve the understanding of the importance of the support surface body ...Pressure injuries are staged to indicate the extent of tissue damage.The National Pressure Ulcer Advisory Panel (NPUAP) is coordinating the development of a uniform terminology, test methods and reporting standards for support surfaces.The revised document incorporates several changes, reflecting growing understanding of the causes and development of pressure injuries in recent years.Pressure injuries are defined as "localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device." Key revisions include a change to the term "pressure injury" rather than the previously used term "pressure ulcer." After extensive discussion, that change was made to reflect the fact that the term "ulcer" does not accurately describe the appearance of some injuries—Dr.Edberg and colleagues write, "An ulcer cannot be present without an injury, but an injury can be present without an ulcer." Otherwise, the basic staging system remains the same—pressure injuries are designated Stage 1 to Stage 4, reflecting the extent of skin and underlying tissue damage.The staging system also includes descriptions of "unstageable" pressure injuries in which the full extent of damage can't be assessed; deep tissue pressure injuries (no longer termed "suspected") caused by "intense and/or prolonged pressure or shear forces"; and medical device-related and mucosal membrane pressure injuries.

The revised staging system also includes high-quality color illustrations, available for at the NPUAP website.

There is no cost to use these illustrations; however donations to support the work of NPUAP are graciously accepted.

For profit uses of the drawings are subject to a charge, please contact Jen Bank for more information.

to include modified definitions of certain terms and to provide a clarifying staging system to better address the different types of skin wounds commonly seen by medical professionals.

The Panel elected to make these changes to avoid future confusion regarding the distinction between intact and ulcerated skin.