The Myth of Stage 1 Pressure Injuries

The current body of knowledge surrounding pressure injuries is replete with myths that have been accepted as fact. A myth is defined as a popular belief, sometimes imaginary, that has no basis in reality but serves to perpetuate an opinion or world view.  Stage 1 pressure injuries are one of the common myths ingrained into our wound care lexicon.  According to NPIAP criteria, Stage 1 manifests no impairment of skin integrity, with vague and nonspecific criteria that renders its inclusion in the staging system unwarranted and misleading.   The designation of “Stage 1 Pressure Injury” should be eliminated from the staging system as it is a mythological entity.  NPIAP criteria for Stage 1 Pressure Injury relies upon “non-blanchable erythema of intact skin.”  The “non-blanchable” component of the NPIAP criteria can be subject to inaccuracies related to lighting, patient positioning, observer skill, presence of moisture associated skin damage (MASD), fungal or bacterial infection, underlying vascular disease, anatomic location, and skin tone.  To establish the criteria of “non-blanchable,” the observer must press on the tissue and observe whether redness disappears when the finger is removed.  However, there is no validated guideline for amount of finger pressure or time duration, leaving substantial room for inter-rater disparities and/or misjudgment.  Designation of a wound as a PI is associated with quality deficit, which may not be warranted when other...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: Featured Medical Articles Geriatric Medicine Long-Term Care Pressure Injuries & Wound Care bedsore bedsores decubiti decubitus ulcer Healthcare Quality Jeff Levine MD Jeffrey M Levine MD pressure sore pressure sores pressure ulce Source Type: blogs