American Board of Internal Medicine (ABIM) Certification Practice Exam

What method is used to assess the depth of unstageable pressure ulcers?

1. Visual inspection alone

2. Ultrasound imaging

3. Debridement of eschar

4. Magnetic resonance imaging

The correct answer is: Debridement of eschar

The depth of unstageable pressure ulcers can often be assessed through the process of debridement of the eschar. Unstageable pressure ulcers are characterized by the presence of necrotic tissue or eschar, which obscures the underlying tissue and prevents a direct assessment of the ulcer's depth. By performing debridement, clinicians can remove the eschar, allowing for a clearer view of the wound bed and enabling an accurate determination of the ulcer's depth and potential stage according to established guidelines. In this context, the other methods listed may not adequately assess the depth of the ulcer. Visual inspection alone is insufficient for unstageable ulcers due to the covering eschar that hides the wound’s true depth. Ultrasound imaging and magnetic resonance imaging, while useful in some medical contexts, are not commonly employed for assessing pressure ulcers, particularly in routine clinical practice, and would not provide the tactile or direct observation needed for proper evaluation. Therefore, debridement serves a dual purpose: it not only assists in wound assessment but also contributes to the overall management and healing of the ulcer.