Assessment of pressure ulcers
Various characteristics of a pressure ulcer are important, both in understanding the depth and degree of tissue damage and defining principles of care including dressing selection.
The following elements should be assessed:
- Size (length, width, depth)
(photography may be prove useful)
- Is undermining present?
- Sinus tract/ tunneling
- Necrotic tissue/slough presence
- Granulation tissue presence
- Pain – Has pain assessment be conducted and pain relief strategies implemented
- Peri wound skin condition