Pressure Ulcer Scale For Healing (PUSH)

Original Editor - Ahmed M Diab

Top Contributors - Ahmed M Diab and Kim Jackson  

Introduction[edit | edit source]

Once a pressure ulcer is identified, it should be staged and the wound size carefully documented. Additional assessments of the ulcer include its location, surrounding skin condition, presence of tissue undermining and tunneling, and amount of exudate, odour and tenderness.[1]

Pressure Ulcer Scale for Healing (PUSH)[edit | edit source]

The pressure ulcer scale for healing (PUSH) is a widely used tool developed by the National Pressure Ulcer Advisory Panel (NPUAP) that grades pressure ulcers based on wound size, wound bed tissue type, and exudate amount.[1]

The PUSH provides a reliable measure of pressure ulcer healing over time and accurately distinguishes between healing and nonhealing ulcers. When used at weekly intervals, it is a clinically useful, evidence-based tool for tracking changes in pressure ulcer status.[2]

Characteristics and directions for scoring[edit | edit source]

Examine the pressure ulcer well and do not guess.

  • Length x Width: Using a centimetre ruler, measure the greatest length (head to toe) and greatest width (side to side). Multiply these two measurements (length x width) to get a surface area estimate in square centimetres. (cm2).
  • Exudate Amount: Assess the amount of drainage present after removing the dressing. Exudate should be estimated as none, light, moderate, or heavy.
  • Tissue type: refers to the various types of tissue found in the wound (ulcer) bed. Score a "4" if necrotic tissue is present. If there is any slough present and necrotic tissue is absent, give it a 3. Score a "2" if the wound is clean and contains granulation tissue. A superficial wound that is reepithelializing receives a "1" score. Give it a "0" when the wound is healed. [3]

Resources[edit | edit source]

The National Pressure Injury Advisory Panel (NPIAP) Pressure Ulcer Scale for Healing (PUSH)

PUSH Tool 3.0

References[edit | edit source]

  1. 1.0 1.1 Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Advances in Wound Care. 2018; 7 (2): 57-67.
  2. Gardner SE, Frantz RA, Bergquist S, Shin CD. A prospective study of the pressure ulcer scale for healing (PUSH). The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005 Jan 1;60(1):93-7.
  3. Push Tool 3.0