Pressure Staging? - page 2

I am looking for a web site that has really good pictures of staging. I am going to be doing training with LN... Read More

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    Hello. 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??

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    I 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.
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    we always stage heel decubitis that does not have do you chart this???
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    we stage all ulcers no matter where they are. they are photographed measured then treated appropriately. where is her rationale for what she said
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    Quote from sheilab
    we stage all ulcers no matter where they are. they are photographed measured then treated appropriately. where is her rationale for what she said
    Unfortunately, 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. Thanks
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    i hope that's what you looking for
    i took it from fundamental concepts and skills for nursing

    stage 1

    reddened or darkened skin that will not turn white when firmly pressed

    stage 2

    partial skin loss that may appear as an abrasion, blister or shallow crater

    stage 3

    full skin loss extending to underlying tissue

    stage 4

    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
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    There 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.

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