Pressure Ulcers

EPUAP grading system
Glos Trust Policy
RCN Guidelines
NICE Guidelines for management of pressure ulcers in primary and secondary care.
Powerpoint presentation
Wound care websites
2004 Nursing Times Article
Glos Policy on Fungating Wounds
Glos Patient Leaflet on Pressure Ulcers
Judy Waterlow Site
Whittington Hospital Guidelines
30% Tilt
Critical review of Waterlow
Systematic review of Positioning as a means to improve pressure area care.

EPUAP² (European Pressure Ulcer Advisory Panel) grading system

Grade Four

Full thickness skin loss involving muscle, bone or supporting structures

Grade Three

Full thickness skin loss involving damage to sub-cutaneous tissue that may extend to but not through the underlying fascia

Grade Two

Partial thickness skin loss involving epidermis, dermis or both

Grade One

Non blanching erythema

Figure 1: This illustrates the stages of pressure ulcer
development according to the EPUAP grading system.

Figure 2: A grade 4 pressure ulcer.

The principles of best practice with regard to wound management should be adopted in order to resolve symptoms and tissue types at the wound bed and ensure the dressing regime selected maximises patient comfort and supports a moist wound healing interface. Pressure Ulcers are recognised to be chronic wounds which can take time to heal.

Pressure Ulcers are prone to infection and odour and Clinisorb activated charcoal dressing is a useful dressing to use in the management of these symptoms. LBF may also prove valuable in protecting the delicate peri-wound area from exudate and excoriation.

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