It’s time for some straight talk about the pressure ulcer staging system. I don’t have much hope that anyone will make the changes that need to be made, but let’s at least be clear about a few things. Stage 3 and 4 pressure ulcers form from the inside out, the way an apple rots. Stage 2 ulcers are due to moisture and friction so they form from the “outside-in”. This means that the system is not a “staging” system because the term “staging” implies progression (e.g. cancer staging). Stage 2 ulcers do not become stage 3 or 4, and stage 3 or 4 ulcers are not preceded by stage 2 ulcers. However, try to explain that to a jury (like I have). Try explaining to reasonable, non-medical people that the numbers don’t imply progression and you don’t get to a 4 by starting with a 1 or 2 so the stage 4 ulcer could not have been “stopped” at a stage 2. Don’t get me started on “unstageable.”
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
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