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25th July 2023
Assessment
Risk assessment tools such as Norton, Braden and the Waterlow scales can be used to identify patients at risk of developing pressure sores. When ulcers are assessed, it is important to check for local signs of infection. The classification system from the European Pressure Ulcer Advisory Panel Grading System is outlined below.
| Grade 1 | Non-blanchable erythema of intact skin. Darker skin may appear blue or purple. |
| Grade 2 | Partial thickness skin loss involving epidermis, dermis, or both. An ulcer is superficial and presents clinically as an abrasion or blister. Surrounding skin may be red or purple. |
| Grade 3 | Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to but not through the underlying fascia. |
| Grade 4 | Extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures with or without full thickness skin loss. Extremely difficult to heal and predisposes to a fatal infection. |
| Unstageable (Depth Unknown) | Full thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar; therefore,e depth cannot be determined. |
Table 2: European Pressure Ulcer Advisory Panel Grading System
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