Module 4 Program Segment 2 of 3 - Home Care Information Network

Home Care Information Network www.homecareinformation.netUltimate OASIS-C Training Item by Item [Rev 2/11]2/13/2011M1324 Stage of Most ProblematicUnhealed (Observable) PressureUlcer• Most problematic may be• Largest• Most advanced stage• Most difficult to access for treatment• Most difficult to relieve pressure, etc.,depending on the specific situation.M1324 Stage of Most ProblematicUnhealed (Observable) Pressure Ulcer• Follow NPUAP to make determination--No reversestaging!!• “NA”• NO pressure ulcers• Pressure ulcers cannot be observed due to necrotictissue (including eschar or slough) that obscuresvisualization of the wound base• A pressure ulcer that is covered with eschar cannot be stageduntil the wound bed is visible (even if previously staged).• Non-removable dsg or cast• Until the SDTI evolves and opens, the Stage will beconsidered NA, as the wound bed cannot be visualizedThe Specifics on SuturedPressure UlcersQuestion 3: How do I categorize a pressure ulcerthat has been sutured closed?Answer 3: Since it is relatively uncommon toencounter direct suture closure of a pressureulcer, it is important to make sure that thepressure ulcer was not closed by a surgicalprocedure (such as a skin advancement flap,rotation flap, or muscle flap). A pressure ulcerthat is sutured closed (without a flap procedure)would still be reported as a pressure ulcer.While this approach (direct suture closure) mayrarely be attempted due to a low success rate,home care providers are reporting occurrence.© Lisa Selman-Holman 27