Pressure Staging? - Page 2Register Today!
- Aug 18, '04 by nursing04Hello. I have a question for you wound care nurses out there. Today in clinical I had a patient who had an ulcer on the heel of her foot. The RN said you don't stage ulcers on the heel which I had never heard of. It was an open wound the skin was not in tact meaning that there was a small crater (about 1cm deep) the skin edges did not meet. No undermining, not going into muscle or bone, some drainage, yellow in color, no odor. To me this would be a stage III ulcer. But, she said you don't stage them on the heel. What do you all think??
- Aug 18, '04 by gwenithI would love to know her reasoning. As far as I know the four stage classification system was written as a guide. I know we aim to intervene as soon (hopefully sooner) as we see a stage 1. I will agree though that sometime heels are difficult as I have seen some black necrotic areas I thought for sure would end up as stage 4 heal beautifully. These areas though were from a combination of high inotrope therapy, poor circulation and pressure.
- Aug 18, '04 by CHATSDALEwe always stage heel decubitis that does not have eschar.....how do you chart this???
- Aug 24, '04 by sheilabwe stage all ulcers no matter where they are. they are photographed measured then treated appropriately. where is her rationale for what she said
- Aug 24, '04 by nursing04Quote from sheilabUnfortunately, i don't know her rationale. I had told her that I worked w/ a wound care nurse on a difft occasion and she did stage them so you know how it is progressing. I'm a nursing student and she was asking her colleagues around us whether you stage an ulcer on the heel. Some said yes, some said maybe and she just thought you didn't. So, she went w/ that. This is a cardiac tele floor. (not that that matters). Yes, I still hold firmly to staging it. Thanks for your input!! I also went back to the wound care nurse I worked with and she said yes, she does. Just wanted to know so when I'm in practice (which is soon), I do the right thing. Thankswe stage all ulcers no matter where they are. they are photographed measured then treated appropriately. where is her rationale for what she said
i hope that's what you looking for
i took it from fundamental concepts and skills for nursing
reddened or darkened skin that will not turn white when firmly pressed
partial skin loss that may appear as an abrasion, blister or shallow crater
full skin loss extending to underlying tissue
full skin loss extending beyond the underlying tissue to muscle and bone
by this way we can reduce the pressure
see theses websites about it
- Nov 27, '04 by totallytheresaThere was a report on our local news about maggot therapy. They came in a little vial marked Medical Maggots, the doctor applied them to the wound, covered them with a special dressing that keeps them all in but allows them to breathe, and away they went! They really cleaned up a huge foot ulcer, it was amazing- they showed the progress with before and after pics, with the MD saying he undoubtably would have had to amputate if not for the maggots. The patient was obviously happy with the results, and didn't appear to be too creeped out by it.