Just when I thought things seem to be sorted out, it feels like we are adding another layer of complication. We finally reached agreement on the categories with the publication of the Revised Pressure Ulcer (PU) Definition and Measurement Framework in June 2018 (NHS Improvement, 2018) — and even have some standard posters on the way. However, now we have to decide what to call a PU that had healed but has opened up again. Is it the same PU — so the same category it had been— or is it a new PU — so whatever category it now presents itself as? The Americans, of course, have already had this discussion and have offered a variety of definitions, such as: closed PU, healed PU, mature resolved PU, reopened PU, recurrent PU and new PU (Tew et al, 2014).
But isn’t it complicated enough already? We are struggling to get staff to allocate the existing six categories without adding even more. However, it is important that we all do the same, so we need to look at how we can reach a consensus on this. If we are to improve the care patients with wounds receive, we need to have a clear vision of how to make and measure those improvements — and sometimes it needs to be made clear that this means to stop doing certain things.
