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

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Home Care Information Network www.homecareinformation.netUltimate OASIS-C Training Item by Item [Rev 2/11]2/13/2011Healing Defined: Stage I andStage II Pressure Ulcers• Stage I and Stage II (partial thickness)pressure ulcers can heal through theprocess of regeneration of the epidermisacross a wound surface, known as“epithelialization.”NPUAP 2004• Once healed, a Stage I or II is no longerpresent.Healing Defined: Stage IIIand Stage IV Pressure Ulcers• Stage III and IV (full thickness) pressureulcers heal through a process of contraction,granulation, and epithelialization.• They can never be considered "fully healed"but they can be considered ‘closed’ whenthey are fully granulated and the woundsurface is covered with new epithelial tissue.• Once ‘closed,’ a Stage III or IV is stillpresent.Pressure UlcerGeneral Guidance• Do not reverse stage• A muscle flap, *skin advancement flap, orrotational flap performed to surgicallyreplace a pressure ulcer is a surgical woundand is no longer a pressure ulcer.• A pressure ulcer that has been surgicallydebrided remains a pressure ulcer. It doesnot become a surgical wound.*New guidance© Lisa Selman-Holman 8
Home Care Information Network www.homecareinformation.netUltimate OASIS-C Training Item by Item [Rev 2/11]2/13/2011Pressure UlcerGeneral Guidance• Unhealed: The absence of the skin’soriginal integrity. (includes closed Stage IIIand Stage IV)• Non-epithelialized: The absence ofregenerated epidermis across a woundsurface.Unresolved Issue on PressureUlcers with Skin Grafts• Pressure ulcer with a skin graft is apressure ulcer.• Skin graft does not meet the definition ofunstageable.• Also cannot visualize the wound bed to beable to stage.• So what to do with a pressure ulcercovered with a skin graft??M1300 Pressure Ulcer AssessmentM1302 Risk of Developing PressureUlcersProcess Measure© Lisa Selman-Holman 9
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Module 4 Program Segment 2 of 3 - Home Care Information Network

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