AAWC President on NPUAP’s Wound Care Terminology Changes

AAWC Logo
AAWC is the leading, nonprofit organization in the United States dedicated to interdisciplinary wound healing and tissue preservation. With a mission to advance the care of people with and at risk for wounds, AAWC offers membership to everyone involved in wound care – clinicians, researchers, educators and other healthcare professionals; patients and lay-caregivers; clinics, hospitals and other healthcare facilities; corporations and manufacturers; students and retirees; and advocates. (PRNewsFoto/AAWC)

I have provided a link to the AAWC newsletter and the excellent article by AAWC President Greg Bohn discussing the NPUAP’s change in terminology (pressure “injuries” rather than pressure ulcers). Within the article you will find the AAWC Board’s position statement regarding the term “pressure injury”.

I’ve written before regarding the serious medico-legal implications of this change, but there’s another huge implication that has been overlooked. The universe of “wound care” is divided into “ulcers” (open lesions usually related to an underlying medical condition) and “wounds” (open lesions caused by an accident or surgery).

The NPUAP has created a third category of lesion never before described as a diagnosis which are the “injuries.” It is the equivalent of deciding to call arterial ulcers “ischemias” or diabetic foot ulcers “neuropathics.” The possible cause of the lesion has been conflated with the lesion itself.

While the NPUAP was understandably trying to correct a fundamental problem with the old staging system, namely, that there were areas of skin color change they called “ulcers,” they have now created the opposite problem. By calling everything an “injury” it is now not possible to tell if the lesion is actually an open sore requiring a dressing. If I say I “injured” myself, you don’t know if I have a bruise, a fracture, or a laceration (wound). That’s because bruise, fracture and wound/ulcer are diagnoses; the term injury is not. Good luck using this for patient care.

I am proud that the AAWC has stood its ground on this issue.

https://s3.amazonaws.com/aawc/2016_AAWC_Fall_Winter_News_FINAL.pdf


Caroline Fife, MD    Twitter Facebook  |  LinkedIn