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On behalf of the National Pressure Ulcer Advisory Panel (NPUAP) Board of Directors, the members of the Staging Task Force would like to thank Dr Richard "Sal" Salcido for his summary of the changes to the NPUAP staging system (July 2016 editorial in Advances in Skin & Wound Care). The NPUAP Board and the Task Force did not undertake this endeavor lightly. The impetus for these revisions was our attempt to close the gap between what we see clinically and what the research tells us. In addition, in the past, the NPUAP has received complaints that the staging system was not an accurate description of clinical phenomenon.


We appreciate that no staging or classification system in medicine will ever be perfect and that pressure injury staging both before and after revision remains imperfect. We acknowledge the passion of many voices that feel the revision does not match their vision of how best to stage pressure injuries. We also are passionate about our work and stand by the revisions made. We believe these revisions represent our best attempt at an up-to-date staging system as we understand the clinical findings and research to date. We acknowledge that over time this revised system will also require updating.


Although no slight was intended, we were enlightened by the ethnographic material on the word "Caucasian." Dr Salcido's efforts to bridge the cultural gap were appreciated. Our illustrations contain the phrase "skin tone" to avoid the mistake in the future.


Our focus throughout this endeavor has been patient-centric. We are confident that this revised system lives up to that expectation. The NPUAP has a mission to serve as an authoritative voice for improved patient outcomes in pressure injury prevention and treatment. We take this mission very seriously. The revised pressure injury staging system is our best attempt at moving patient care and research science in a parallel direction. We thank all of those who worked with us and support the changes.


-Mary Sieggreen, MSN, CNS, NP, CVN


President, National Pressure Ulcer Advisory Panel