Ask the treatment expert: What is the PUSH Tool

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What's the best way to prevent skin tears?
What's the best way to prevent skin tears?
Q: What is the PUSH Tool?

PUSH is an acronym for Pressure Ulcer Scale for Healing. The National Pressure Ulcer Advisory Panel developed this tool to monitor pressure healing over time. The PUSH Tool monitors three parameters: surface area of the wound, wound exudate and type of wound tissue.

Wounds are measured using a centimeter ruler. The scores are rated from 0 to 10 according to the size of the wound.

Tissue type is noted as necrotic, slough, granulation, epithelial or closed/resurfaced. The scoring is from 0 to 4. The explanations, taken directly from the tool itself, are:

4 - Necrotic tissue (Eschar): Black, brown or tan tissue that adheres firmly to the wound bed or ulcer edges and may be either firmer or softer than surrounding skin

3 - Slough: Yellow or white tissue that adheres to the ulcer bed in strings or thick clumps, or is mucinous

2 - Granulation tissue: Pink or beefy red tissue with a shiny, moist, granular appearance

1 - Epithelial tissue: For superficial ulcers, new pink or shiny tissue (skin) that grows in from the edges or as islands on the ulcer surface

0 - Closed/Resurfaced: Wound completely covered with epithelium (new skin)

The total score ranges from 0 to 17 (0 = healed). A comparison of total scores measured over time provides an indication of the improvement or deterioration in pressure ulcer healing. NPUAP's (PUSH) tool 3.0 can be found at

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