International NPUAP-EPUAP Pressure Ulcer Definition:
A pressure ulcer is localized injury to the skin and/or underlying tissue usually
over a bony prominence, as a result of pressure, or pressure in combination with
shear. A number of contributing or confounding factors are also associated with
pressure ulcers; the significance of these factors is yet to be elucidated.
A "European Pressure Ulcer Advisory Panel" (EPUAP) has been created to lead and support all European countries in the efforts to prevent and treat pressure ulcers. At its inaugural meeting in London in December 1996, which included experts from many European countries, the group of over twenty agreed their mission statement and the initial Executive Board and Trustees.
The mission statement reads:
"to provide the relief of persons suffering from or at risk of pressure ulcers, in particular through research and the education of the public"
Since we began to develop cushions for wheelchairs in 1992, we at Vital Base AS have strived to learn as much as we could about sitting and comfort. This has lead us to EPUAP, where we are a member since 2002. Back in 1995 we had SINTEF find out by means of MRI "what happens to moisture in PU-foams?". The resulting knowledge has since been implemented in our products, and in 1996 we introduced the "ventilating layer" directly beneath the outer cover. This has helpen create better micro-climate and thus reduce the risk of pressure ulcers. In 2002 we introduced ClimaTherm which in addition to ventilating better than anything else on the market, it kept a steady temperature of 32 °C by means of PCMs. Pressure distribution is evident in all cushions for wheelchairs coming from Vital Base AS.
Here you can get a short introduction into "pressure ulcers" (from www.epuap.org)
Development of an International Pressure Ulcer Classification System:
Category/Stage I: Non-blanchable erythema
Intact skin with non-blanchable redness of a localized area usually over a bony
prominence. . Darkly pigmented skin may not have visible blanching; its color
may differ from the surrounding area. The area may be painful, firm, soft, warmer
or cooler as compared to adjacent tissue. Category I may be difficult to detect in
individuals with dark skin tones. May indicate “at risk” persons.
Category/Stage II: Partial thickness
Partial thickness loss of dermis presenting as a shallow open ulcer with a red
pink wound bed, without slough. May also present as an intact or open/ruptured
serum-filled or sero-sanginous filled blister.Presents as a shiny or dry shallow
ulcer without slough or bruising*. This category should not be used to describe
skin tears, tape burns, incontinence associated dermatitis, maceration or
excoriation. *Bruising indicates deep tissue injury.
CategoryStage III: Full thickness skin loss
Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or
muscle are not exposed. Slough may be present but does not obscure the depth
of tissue loss. May include undermining and tunneling. The depth of a
Category/Stage III pressure ulcer varies by anatomical location. The bridge of the
nose, ear, occiput and malleolus do not have (adipose) subcutaneous tissue and
Category/Stage III ulcers can be shallow. In contrast, areas of significant
adiposity can develop extremely deep Category/Stage III pressure ulcers.
Bone/tendon is not visible or directly palpable
Category/Stage IV: Full thickness tissue loss
Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar
may be present. Often includes undermining and tunneling. The depth of a
Category/Stage IV pressure ulcer varies by anatomical location. The bridge of
the nose, ear, occiput and malleolus do not have (adipose) subcutaneous tissue
and these ulcers can be shallow. Category/Stage IV ulcers can extend into
muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making
osteomyelitis or osteitis likely to occur. Exposed bone/muscle is visible or directly
palpable.
For more information, see www.epuap.org or here at PUCLAS http://www.puclas.ugent.be/puclas/e/