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We have a patient here today who is diabetic and has pressure ulcers to L ischium, L calf and R plantar foot. My question is am I correct in remembering anything hip or below should be graded vs. staged due to the diabetes even if these are pressure areas. It seems like we would stage the L ischium and grade the L calf, R plantar foot. Thank you for your help!
Erin
Feb 6, 2018 by Erin E, RN,
2 replies
Tiffany Hamm
BSN, ACHRN, CWS
Hi Erin,
Thank you so much for the question. Pressure injuries are staged to indicate the extent of tissue damage. The L ischium and L calf ulcers seem to be due to pressure injury. Diabetes would be would be a co-morbiity which would impair healing but the primary treatment would be pressure relief. For the plantar diabetic foot ulcer, this ulcer would be graded as the diabetes, which causes neuropathy, is most likely a primary determinant for the ulcer. Most clinicians use one of the available systems when assessing and documenting a diabetic ulcer; The Wagner diabetic foot ulcer grade classification system and the University of Texas diabetic foot ulcer classification system.
Let me know if I have answered your question or if more information is needed.
Thanks,
Tiffany

Feb 6, 2018
Yes Erin, what Tif said!! I stage pressure injuries everywhere but the diabetic foot where I use the wagner scale. I find the wagner scale mostly helpful in documentation for HBO therapy as a wagner gr 3 is an HBO qualifier and is something straightforward we can use.
Feb 7, 2018
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