Page 158 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Pressure Ulcers 133

Table 5.3 Pressure ulcer and skin classification scale ( http://www.
npuap.org )
Category/stage Brief description
.
Category/ Non-blanchable erythema Intact skin with non-
stage I blanchable redness of a localized area usually
over a bony prominence. May indicate “at risk”
persons.
.
Category/ Partial thickness Partial thickness loss of dermis
stage II presenting as a shallow open ulcer with a red
pink wound bed, without slough. This category
should not be used to describe skin tears, tape
burns, incontinence associated dermatitis,
maceration or excoriation
.
Category/ Full thickness skin loss Full thickness tissue
stage III loss. Subcutaneous fat may be visible but bone,
tendon or muscle are not exposed.
.
Category/ Full thickness tissue loss Full thickness tissue
stage IV loss with exposed bone, tendon or muscle.

impact of such ulcers separate from the impact of other condi-
tions. Nonetheless, research has tried to explore this area.
One phenomenological study considering the lived expe-
riences of eight individuals with either existing or healed
pressure ulcers, discovered particularly important negative
consequences in association with pressure ulcers (Langemo
et al. 2000 ). Not only did these findings reveal physical, social
and financial constraints, but patient’s revealed how living
with pressure ulcers led to a negative body image, feelings of
lack of control (helplessness) and of independence. Similar to
previous findings on wounds, Fox ( 2002 ) discovered a num-
ber of negative consequences stemming from pressure ulcers.
These included pain, wound exudation, loss of independence,
worries connected with healing, relationship issues, social
isolation and reduced body image satisfaction.
One of the key issues for those with the pressure ulcers
is pain (Gorecki et al. 2009 ; Rastinehad 2006 ; Reddy et al.
2003a , b ; Szor and Bourguignon 1999 ; Gorecki et al. 2010 ),
although according to a literature review (Girouard et al.
2008 ) it is poorly understood and highlighted the complex-
ity and difficulty in its assessment (see also Chap. 2 ). PU