CLASSIFICATION OF the INJURY the evolutivo process of the injury if develops due the periods of training of tecidual suffering, in which it consists of drawn out time, effectiveness of the quality of the nursing assistance, beyond external factors. In them we classify in IV levels, which go of I the IV, classification this published by European Pressure Ulcer Advisory Panel (EPUAP) and GNEAUPP, apud BLOND, 2007. Period of training I the skin is presented unbroken, can occur color alteration (vermelhido, hematoma), eritrema that the pressure does not disappear (> 30 min), beyond alteration of Temperature (hot or cold), can occur sensation of pain and irritation, beyond a possible indurao. hout. Period of training II Is about partial a cutaneous injury, which reaches derme and/or epidermis, normally they are superficial ulcers and presents in form of socket (crater) flat or fstulas, abrasion and flictema. Period of training III Is observed for presenting a total cutaneous injury. Injury and necrosis of the fabric cellular subcutaneous, without involving the underlying muscular fscia, therefore are about deep and cavitria ulcer.
Period of training IV recognized must to the aggravation of period of training III, where a damage in all thickness of the skin will occur, getting an extensive destruction and necrosis extending itself it the muscle, bone and other structures (corporal tendes, joints and sockets). Frequent existence of fistulosos passages associate to the osteomielite, sepses and high mortality. NURSING REGISTER the ulcers for pressure in cicatrizao phase are not classified. The evolution of the ulcers will have to be registered in the nursing notations.