Question 1

How do I stage a pressure injury with stable eschar on the heel?

Accepted Answer

Stage as 'unstageable' if depth is obscured. Heel eschar should not be debrided if dry, stable, and non-infected.

Question 2

Can a pressure injury be reverse-staged as it heals?

Accepted Answer

No — NPIAP recommends against reverse staging. A healed stage 4 ulcer is documented as 'healed stage 4 pressure injury.'

Question 3

How do I distinguish MASD from stage 2 pressure injury?

Accepted Answer

MASD occurs in skin folds or perineal area, not over bony prominences. It is caused by moisture rather than pressure. Manage with barrier products.

Question 4

How should I stage sacral pressure injuries in patients with sacral oedema?

Accepted Answer

Palpation rather than visual inspection determines depth. Oedema should be documented separately.