Ms. DT was a diabetic patient living in a skilled nursing facility (SNF). She developed a pressure ulcer on the heel and was sent to the hospital for surgical debridement. Upon return to the SNF she was referred to physical therapy for help in wound healing. She is alert/confused and non-ambulatory for an unknown period of time. Her diabetes is controlled with medication and diet.
Figure 1A shows the measurement method used to determine the initial wound size on July 22. The clock method of measurement of the length from 12:00 to 6:00 and 9:00 to 3:00 was used as shown.
Periwound tissue assessment:
Maceration of periwound tissue along proximal wound margins.
Wound edges are soft and irregular in shape.
Wound bed tissue assessment:
Surface of wound is predominantly covered with slough.
Patches of granulation tissue are observed.
There is minimal exudate.
The PUSH tool was used to quantify wound healing status of during the course of care.
PUSH score consists of 3 elements:
Size: 42 cm2 area = 10
Tissue type: slough = 3
Exudate: moderate = 2
Total PUSH Score = 15
Evaluation: Wound healing diagnosis and pressure ulcer stage: