Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System.
Laura E Edsberg, Joyce M Black, Margaret Goldberg and 3 others
PMID 27749790WHAT IT FOUND
The revised staging system calls pressure damage an injury, not an ulcer, and uses Arabic numerals.
Device-related pressure injury is an etiology, not a stage. Stages do not reliably progress in order, so reassess after cleansing.
Key findings
01The revised system calls pressure damage an injury, not an ulcer, and uses Arabic numerals; some pressure injuries may have no open ulcer.
02Medical device-related pressure injury is an etiology, not a stage, but the injury still needs to be staged.
03Stage numbers do not prove predictable progression from an early stage to the deepest stage.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The work is based on literature review, stakeholder comments, and expert consensus, not on patient outcomes. The literature search found a dearth of studies focused on pressure injury staging definitions. References were limited to English-language publications. Validation used photographs and focused histories rather than real patients followed over time. Some proposed changes did not reach consensus, so the final definitions still reflect negotiated wording rather than definitive evidence. The authors say more clinical evidence is needed about pressure effects on soft tissue and tissue tolerance.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the numbered stages as proof that an injury started as an early stage or will inevitably reach the deepest stage. The paper says progression is not predictable and more clinical evidence is needed.