The Pressure Ulcer Scale for Healing (PUSH) tool is a validated tool used to measure pressure wound status over time. It measures wound size, exudate amount, and tissue type - the parameters most indicative of healing. Wound size is calculated by multiplying wound length by width. Exudate amount is estimated as none, light, moderate, or heavy after dressing removal. Tissue type scores the wound bed based on the presence of necrotic tissue, slough, granulation tissue, or reepithelialization. The PUSH tool provides an objective measure of a wound's status and progress.

1. PUSH TOOL
(Pressure Ulcer Scale For Healing)
MAHESH S., (M.Sc. Nursing)
NURSE EDUCATOR
MGMCRI

2. PUSH:
• The Pressure Ulcer Scale for Healing (PUSH) tool is a fast and accurate
tool used to measure the status of pressure wounds over time. The
tool was designed by the National Pressure Ulcer Advisory Panel
(NPUAP) and has been validated many times over. The NPUAP
recommends that the tool be used on a regular basis, at least weekly
or whenever the patient or wound status changes.

3. PARAMETERS OF PUSH SCALE
The PUSH tool measures three parameters that are considered most
indicative of healing:
Wound size (greatest length x greatest width = wound surface
area)
Exudate amount (estimate as light, moderate or heavy after
removal of the dressing)
Tissue type (closed/resurfaced, epithelial tissue, granulation
tissue, slough, necrotic tissue/eschar)

5. Length x Width:
• Measure the greatest length (head to toe) and the greatest
width (side to side) using a centimetre ruler. Multiply
these two measurements (length x width) to obtain an
estimate of surface area in square centimetres (cm2).
• Caveat: Do not guess! Always use a centimetre ruler and
always use the same method each time the ulcer is
measured.

6. FOR EXAMPLE:
Length x Width
Length = 6 CM
Width = 5 CM
Length x Width = 30 cm

7. 10

8. Exudate Amount:
• Estimate the amount of exudate (drainage)
present after removal of the dressing and before
applying any topical agent to the ulcer. Estimate
the exudate (drainage) as none, light, moderate, or
heavy.

9. Exudate Amount

10. 10
2

11. Tissue Type:
This refers to the types of tissue that are present in the wound (ulcer)
bed.
• Score as a “4” if there is any necrotic tissue present.
• Score as a “3” if there is any amount of slough present and necrotic
tissue is absent.
• Score as a “2” if the wound is clean and contains granulation tissue.
• A superficial wound that is reepithelializing is scored as a “1”.
• When the wound is closed, score as a “0”

12. Tissue Type:

13. 10
2
3

14. 10
2
3
15

15. 10
2
3
15

16. Healing
Worsening