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Evaluation and treatment algorithm for pressure ulcers based on the dip pressure ulcer classification

02 September 2021
5 min read
Volume 5 · Issue 4


Pressure ulcers (PUs) continue to represent a significant cause of morbidity and expense, as well as a therapeutic challenge across medical settings. While there are several staging systems for PUs, and considerable efforts have been made to develop strategies for their prevention, there is a scarcity of research and clinical guidelines to help select therapeutic interventions for wounds of varying depth and severity. An algorithm based on the depth, infection and perfusion (DIP) classification is hereby presented to aid the clinician in the initial evaluation, classification and management of PU.

Pressure ulcers (PU) are a common healthcare problem affecting patients across hospital and community settings. Despite increasing interest in developing risk assessment tools and prevention strategies, their evaluation and management continues to be largely based on personal experience and poses a significant challenge for healthcare providers. An algorithm was created to guide clinicians in the initial evaluation and classification of PU. It also provides general management guidelines for every grade and stage of the depth, infection and perfusion (DIP) classification.

The first step in the algorithm (Fig 1) is to identify people at risk of developing a PU, such as those with reduced mobility, urinary or fecal incontinence, and those who are malnourished.1 Once identified, a risk assessment tool such as the Braden Scale for Predicting Pressure Ulcer Risk2 or the Norton Pressure Sore Risk-Assessment Scale Scoring System3 can be used to assess their risk level. Appropriate primary or secondary prevention interventions to reduce their risk of developing a first or new PU should be undertaken for every patient based on their risk level; this may include frequent mobilisation, support surfaces, nutritional consultation and continence assessment and care.4

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