Is the Distinction Between Superficial Pressure Ulcers and Moisture Lesions Justifiable? A Clinical‐Pathologic Study

Abstract

There is no justification for singling out moisture lesions from pressure ulcer lesions. The distinction may even be dangerous when proper preventive measures for the development of pressure ulcers are not taken because of the existence of a possible moisture lesion.

Incontinence-Associated Dermatitis

“…16 , 17 Areas of erosion are associated with dermal and epidermal proliferation and vascular occlusion resulting in necrobiosis and partial tissue destruction. These fi ndings differ from histopathologic analysis of pressure ulcers that revealed ischemia as the predominant factor 17 and ultrasonic imaging that revealed subdermal pockets of edema in deeper tissues nearer underlying bone. 18 These fi ndings support clinical observations that IAD is the result of top-down damage to the skin when exposed to stool or urine whereas pressure ulcers primarily result from bottom-up damage when pressure or shear leads to destruction of deeper tissues such as muscle.…”

How do microclimate factors affect the risk for superficial pressure ulcers: A mathematical modeling study

“…(1) to be physically meaningful. Likewise, preservation of perspiration mass requires that _ S > _ E þ _ D at any 1 It should be noted that in this study, the ambient temperature is the local environmental temperature within the ROI (using the "microclimate" concept), as opposed to the average room temperature. The body of the patient continuously heats the relatively small volume of air contained in the ROI (Fig.…”

“…Though there is a continuous debate in regard to what is the correct wording in the definition of superficial pressure ulcers (SPUs) [1], it is a common feature for all the proposed definitions that they describe damage to skin tissue. In this study, the term SPUs is being used to describe skin damage associated with sustained mechanical loading.…”

Issues Related to Accurate Classification of Buttocks Wounds

“…In fact, some patients present with both types of wounds in the same area. 8 In addition, a long history of disordered terminology related to both moisture-related lesions and pressure ulcers contributes to existing confusion. The confusion regarding terminology is understandable since our classification and staging systems were developed at a time when the understanding of the pathology of pressure ulcer development was incomplete and differential assessment of moisture-related skin damage versus pressure ulcers was not an issue.…”