SCALE Wounds: Unavoidable Pressure Injury

Diane L. Krasner, PhD, RN; Thomas P. Stewart, PhD


Wounds. 2015;27(4):92-94. 

In This Article

The Unavoidability of SCALE Wounds

Due to their complex underlying pathology and the lack of understanding of the mechanisms surrounding SCALE wounds at this time, these wounds are generally considered to be unavoidable[4] provided the standard of care was met for pressure relief, topical treatment, and nutritional support as appropriate for the individual patient. Like other ischemic events related to alterations in perfusion, such as heart attack, the goal of SCALE wound research is to develop the means for early detection and prevention and for the development of effective treatment protocols that can reverse this phenomenon. In the interim, SCALE wounds are usually considered unavoidable and unable to heal. The SCALE Consensus Document Statement 1 states: "Physiologic changes that occur as a result of the dying process (days to weeks) may affect the skin and soft tissues and may manifest as observable (objective) changes in skin color, turgor or integrity, or as subjective symptoms such as localized pain. These changes can be unavoidable and may occur with the application of appropriate interventions that meet or exceed the standard of care."[1]