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Pressure Injuries: Prevention, Staging and Treatment

wound-care

Pressure Injuries: Prevention, Staging and Treatment

Pressure injuries are largely preventable. We summarise risk assessment, prevention strategies and stage-by-stage treatment based on the 2019 NPIAP/EPUAP/PPPIA guideline.

Published8 min read

Pressure injury (Pressure Ulcer) results from prolonged pressure, friction or shear. ICU prevalence is 12–28% and ~59% are preventable.

NPIAP staging

  1. Stage 1 — non-blanchable erythema
  2. Stage 2 — partial-thickness skin loss
  3. Stage 3 — full-thickness skin loss
  4. Stage 4 — exposed muscle/bone/tendon
  5. Unstageable — slough or eschar obscures depth
  6. Deep Tissue Pressure Injury — persistent maroon discolouration

Five pillars of prevention

  1. Braden risk assessment
  2. Repositioning every 2 hours supine, hourly when seated
  3. Pressure-redistribution support surfaces
  4. Skin hygiene and moisturisation
  5. Adequate protein and hydration

References

  1. EPUAP/NPIAP/PPPIA. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. 2019. https://internationalguideline.com/
  2. Edsberg LE, et al. Revised NPUAP Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016;43(6):585–597. https://doi.org/10.1097/WON.0000000000000281

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