Systems and methods for classification and treatment of decubitus ulcers

Abstract

Systems and methods for accurately and efficiently diagnosing, assessing, staging/grading/categorizing, and treating pressure ulcers, as well as preventing reverse staging of pressure ulcers, are disclosed. The system, in one embodiment, ensures that the rationale for the stage assigned to the patient will be in the patients' medical record. The system, in various embodiments, further suggests the pressure ulcer classification and allows the user to choose which classification terms should be used. In various embodiments, the system also allows for the different classification/staging system guidelines to be used, including the National Pressure Ulcer Advisory Panel (NPUAP) guidelines, the European Pressure Ulcer Advisory Panel Guidelines (EPUAP), the Pan Pacific Pressure Injury Alliance, CMS, WHO, and the MDS Guidelines.

What is claimed is: 
     
         1 . A system for classifying decubitus ulcers, comprising:
 a data store; and   a processor operatively connected to the data store, wherein the processor is operative to:
 determine the previous classification of a particular wound; 
 determine, in a predefined order of decreasing severity based on the determined previous classification, which one or more symptoms the particular wound presents; and 
 generate, based on the determined one or more symptoms and the determined previous classification, a current classification corresponding to the particular wound. 
   
     
     
         2 . The system of  claim 1 , wherein the determined previous classification comprises a Stage 4 decubitus ulcer; the one or more symptoms comprise whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and the current classification comprises the Stage 4 decubitus ulcer. 
     
     
         3 . The system of  claim 1 , wherein the determined previous classification comprises a Resurfaced Full-Thickness decubitus ulcer and the predefined order comprises whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and then whether the particular wound is or was closed, is or was resurfaced with scar tissue or epithelium, and the particular wound was previously classified as Unstageable or Unknown. 
     
     
         4 . The system of  claim 1 , wherein the determined previous classification comprises an Unstageable decubitus ulcer and the predefined order comprises whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and then whether the particular wound is or was closed, is or was resurfaced with scar tissue or epithelium, and the particular wound was previously classified as Unstageable or Unknown; and then whether slough, eschar, or a non-removable dressing is obscuring a portion of the particular wound such that an extent of tissue loss cannot be determined. 
     
     
         5 . The system of  claim 1 , wherein the determined previous classification comprises a Stage 3 decubitus ulcer and the predefined order comprises whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and then whether the particular wound is or was closed, is or was resurfaced with scar tissue or epithelium, and the particular wound was previously classified as Unstageable or Unknown; and then whether slough, eschar, or a non-removable dressing is obscuring a portion of the particular wound such that an extent of tissue loss cannot be determined; and then whether any of the following are visible in, palpable in, or true of the particular wound: adipose tissue, granulation tissue, slough, eschar, sinus tract, tunneling, or undermining. 
     
     
         6 . The system of  claim 1 , wherein the determined previous classification comprises a Deep Tissue Injury and the predefined order comprises whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and then whether the particular wound is or was closed, is or was resurfaced with scar tissue or epithelium, and the particular wound was previously classified as Unstageable or Unknown; and then whether slough, eschar, or a non-removable dressing is obscuring a portion of the particular wound such that an extent of tissue loss cannot be determined; and then whether any of the following are visible in, palpable in, or true of the particular wound: adipose tissue, granulation tissue, slough, eschar, sinus tract, tunneling, or undermining; and then whether any of the following are visible in, palpable in, or true of the particular wound: blood filled blisters/ruptured blisters surrounded by or adjacent to discolored purple, maroon, or deep red intact skin/intact blister surrounded by or adjacent to non-blanching discolored purple, maroon, or deep red intact skin/intact and non-intact non-blanching discolored purple, maroon, or deep red skin/or skin surrounding or adjacent to the particular wound is non-blanching and discolored purple, maroon, or deep red. 
     
     
         7 . The system of  claim 1 , wherein the determined previous classification comprises a Stage 2 decubitus ulcer and the predefined order comprises whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and then whether the particular wound is or was closed, is or was resurfaced with scar tissue or epithelium, and the particular wound was previously classified as Unstageable or Unknown; and then whether slough, eschar, or a non-removable dressing is obscuring a portion of the particular wound such that an extent of tissue loss cannot be determined; and then whether any of the following are visible in, palpable in, or true of the particular wound: adipose tissue, granulation tissue, slough, eschar, sinus tract, tunneling, or undermining; and then whether any of the following are visible in, palpable in, or true of the particular wound: blood filled blisters/ruptured blisters surrounded by or adjacent to discolored purple, maroon, or deep red intact skin/intact blister surrounded by or adjacent to non-blanching discolored purple, maroon, or deep red intact skin/intact and non-intact non-blanching discolored purple, maroon, or deep red skin/or skin surrounding or adjacent to the particular wound is non-blanching and discolored purple, maroon, or deep red; and then whether any of the following is currently visible in the particular wound: intact blisters, ruptured blisters, or shallow opened wounds with exposed dermis. 
     
     
         8 . The system of  claim 1 , wherein the determined previous classification comprises a Stage 1 decubitus ulcer and the predefined order comprises whether any of the following are visible in, palpable in, or true of the particular wound: bone, muscle, tendon, ligament, cartilage, fascia, joint capsule, other supporting structures, or the particular wound was previously classified as a Stage 4 decubitus ulcer; and then whether the particular wound is or was closed, is or was resurfaced with scar tissue or epithelium, and the particular wound was previously classified as Unstageable or Unknown; and then whether slough, eschar, or a non-removable dressing is obscuring a portion of the particular wound such that an extent of tissue loss cannot be determined; and then whether any of the following are visible in, palpable in, or true of the particular wound: adipose tissue, granulation tissue, slough, eschar, sinus tract, tunneling, or undermining; and then whether any of the following are visible in, palpable in, or true of the particular wound: blood filled blisters/ruptured blisters surrounded by or adjacent to discolored purple, maroon, or deep red intact skin/intact blister surrounded by or adjacent to non-blanching discolored purple, maroon, or deep red intact skin/intact and non-intact non-blanching discolored purple, maroon, or deep red skin/or skin surrounding or adjacent to the particular wound is non-blanching and discolored purple, maroon, or deep red; and then whether any of the following is currently visible in the particular wound: intact blisters, ruptured blisters, or shallow opened wounds with exposed dermis; and then whether intact skin with non-blanching erythema is currently visible in the particular wound. 
     
     
         9 . A method of preventing reverse staging of decubitus ulcers, comprising the steps of:
 determining the previous classification of a particular wound;   determining only whether the particular wound presents one or more symptoms of one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification; and   generating, based on the determined one or more symptoms and the previous classification, a current classification corresponding to the particular wound.   
     
     
         10 . The method of  claim 9 , wherein the previous classification of the particular wound comprises a Stage 4 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprises the Stage 4 decubitus ulcer. 
     
     
         11 . The method of  claim 9 , wherein the previous classification of the particular wound comprises a Resurfaced Full-Thickness decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Resurfaced Full-Thickness decubitus ulcer and a Stage 4 decubitus ulcer. 
     
     
         12 . The method of  claim 9 , wherein the previous classification of the particular wound comprises an Unstageable decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         13 . The method of  claim 9 , wherein the previous classification of the particular wound comprises a Stage 3 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         14 . The method of  claim 9 , wherein the previous classification of the particular wound comprises a Deep Tissue Injury and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Deep Tissue Injury, a Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         15 . The method of  claim 9 , wherein the previous classification of the particular wound comprises a Stage 2 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Stage 2 decubitus ulcer, a Deep Tissue Injury, a Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         16 . The method of  claim 9 , wherein the previous classification of the particular wound comprises a Stage 1 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Stage 1 decubitus ulcer, a Stage 2 decubitus ulcer, a Deep Tissue Injury, a Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         17 . A system for preventing reverse staging of decubitus ulcers, comprising:
 a data store; and   a processor operatively connected to the data store, wherein the processor is operative to:
 determine the previous classification of a particular wound; 
 determine only whether the particular wound presents one or more symptoms of one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification; and 
 generate, based on the determined one or more symptoms and the previous classification, a current classification corresponding to the particular wound. 
   
     
     
         18 . The system of  claim 17 , wherein the previous classification of the particular wound comprises a Stage 4 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprises the Stage 4 decubitus ulcer. 
     
     
         19 . The system of  claim 17 , wherein the previous classification of the particular wound comprises a Resurfaced Full-Thickness decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Resurfaced Full-Thickness decubitus ulcer and a Stage 4 decubitus ulcer. 
     
     
         20 . The system of  claim 17 , wherein the previous classification of the particular wound comprises an Unstageable decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         21 . The system of  claim 17 , wherein the previous classification of the particular wound comprises a Stage 3 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         22 . The system of  claim 17 , wherein the previous classification of the particular wound comprises a Deep Tissue Injury and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Deep Tissue Injury, a Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         23 . The system of  claim 17 , wherein the previous classification of the particular wound comprises a Stage 2 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Stage 2 decubitus ulcer, a Deep Tissue Injury, a Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer. 
     
     
         24 . The system of  claim 17 , wherein the previous classification of the particular wound comprises a Stage 1 decubitus ulcer and the one or more classifications of decubitus ulcers that are at least as severe as the determined previous classification comprise the Stage 1 decubitus ulcer, a Stage 2 decubitus ulcer, a Deep Tissue Injury, a Stage 3 decubitus ulcer, an Unstageable decubitus ulcer, a Resurfaced Full-Thickness decubitus ulcer, and a Stage 4 decubitus ulcer.