Apressure ulcer is an area of localized damage to the<br/>skin and underlying tissue caused by pressure or shear<br/>and/or a combination of these.<br/>The identification of pressure damage is an essential<br/>and integral part of clinical practice and pressure ulcer<br/>research. Pressure ulcer classification is a method of determining<br/>the severity of a pressure ulcer and is also used<br/>to distinguish pressure ulcers from other skin lesions. A<br/>classification system describes a series of numbered<br/>grades or stages, each determining a different degree of<br/>tissue damage.<br/>The European Pressure Ulcer Advisory Panel (EPUAP)<br/>defined 4 different pressure ulcer grades (Table 1).1<br/>Nonblanchable erythema is a sign that pressure and<br/>shear are causing tissue damage and that preventive measures<br/>should be taken without delay to prevent the development<br/>of pressure ulcer lesions (Grade 2, 3, or 4).<br/>The diagnosis of the existence of a pressure ulcer is<br/>more difficult than one commonly assumes. There is often<br/>confusion between a pressure ulcer and a lesion that is<br/>caused by the presence of moisture, for example, because<br/>of incontinence of urine and/or feces. Differentiation between<br/>the two is clinically important, because prevention<br/>and treatment strategies differ largely and the consequences<br/>of the outcome for the patient are imminently<br/>important.<br/>This statement on pressure ulcer classification is limitedto the differentiation between pressure ulcers and<br/>moisture lesions. Obviously, there are numerous other lesions<br/>that might be misclassified as a pressure ulcer (eg, leg<br/>ulcer and diabetic foot). Experience has shown that becauseof their location, moisture lesions are the ones most<br/>often misclassified as pressure ulcers.2-3<br/>Wound-related characteristics (causes, location, shape,<br/>depth, edges, and color), along with patient-related characteristics,<br/>are helpful to differentiate between a pressure<br/>ulcer and a moisture lesio
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