Skip to main content

Table 1 DESIGN-R assessment tool for pressure sore. (Reprinted with permission from John Wiley and Sons. In: Matsui et al., Development of the DESIGN-R with an observational study: an absolute evaluation tool for monitoring pressure ulcer wound healing. Wound Repair Regen 2011, 19(3):309–315)

From: Small intestinal bacterial overgrowth as a cause of protracted wound healing and vitamin D deficiency in a spinal cord injured patient with a sacral pressure sore: a case report

Depth

d

0

No particular skin lesion and no redness

D

3

Lesion extends into the subcutaneous tissue

1

Persistent redness

4

Lesion extends to the muscle, tendon, and bone

2

Lesion extends into dermis

5

Lesion extends into the articular or body cavity

U

It is impossible to measure the depth

Exudate

e

0

None

E

6

Heavy: requires dressing change more than twice a day

1

Slight: does not require daily dressing change

3

Moderate: requires daily dressing change

Size

s

0

None

S

15

100 cm2 or larger

3

Smaller than 4 cm2

6

4 cm2 or larger, but smaller than 16 cm2

8

16 cm2 or larger, but smaller than 36 cm2

9

36 cm2 or larger, but smaller than 64 cm2

12

64 cm2 or larger, but smaller than 100 cm2

Inflammation/Infection

i

0

None

I

3

Clear signs of local infection (e.g., inflammation, pus, and foul smell)

1

Signs of inflammation (fever, redness, swelling, and pain around the wound)

9

Systemic impact, such as fever

Granulation tissue

g

0

Granulation cannot be assessed because the wound is healed or too shallow

G

4

Healthy granulation tissue occupies 10% or more, but less than 50%

1

Healthy granulation tissue occupies 90% or more

5

Healthy granulation tissue occupies less than 10%

3

Healthy granulation tissue occupies 50% or more, but less than 90%

6

No healthy granulation tissue exists

Necrotic tissue

n

0

None

N

3

Soft necrotic tissue exists

6

Hard and thick necrotic tissue is attached to the wound

Pocket

p

0

None

P

6

Smaller than 4 cm2

9

4 cm2 or larger, but smaller than 16 cm2

12

16 cm2 or larger, but smaller than 36 cm2

24

36 cm2 or larger