Pressure Ulcer Stages

How Does Staging Work?

Staging pressure ulcers helps healthcare professionals determine the severity of the wound and develop an appropriate care plan.

The staging system provides a standardized approach to classify pressure ulcers based on the extent of tissue damage. There are four main stages of pressure ulcers, ranging from stage 1 to stage 4. Let’s delve into each stage in detail.

Stage 1 Pressure Ulcer

Stage 1 pressure ulcers are characterized by intact skin with non-blanchable redness. This means that the redness does not fade or turn white when pressure is applied to the area. Stage 1 ulcers may also present as skin temperature, texture, or firmness changes compared to surrounding areas.

The underlying tissue may be damaged at this stage, but the skin remains intact. Identifying stage 1 ulcers early is crucial to prevent progression to more severe stages.

Stage 2 Pressure Ulcer

In stage 2 pressure ulcers, the skin breaks open, forming a shallow open wound. The wound may appear as a blister, abrasion, or shallow crater. The damage extends beyond the topmost layer of the skin and may involve the dermis.

Stage 2 ulcers are often painful and require careful wound care to prevent infection. It is essential to keep the wound clean and protected to promote healing.

Stage 3 Pressure Ulcer

extend into the subcutaneous tissue. The wound appears as a deep crater with visible fat. At this stage, the ulcer may have a foul odor and may be accompanied by drainage.

Stage 3 ulcers are more challenging to heal and often require advanced wound care techniques, such as debridement and the use of specialized dressings. It is crucial to monitor these wounds closely for signs of infection.

Stage 4 Pressure Ulcer

Stage 4 pressure ulcers are the most severe and involve extensive tissue damage. The wound extends beyond the skin and subcutaneous tissue, affecting muscles, tendons, and even bones.

Stage 4 ulcers may appear as a deep, crater-like wound with exposed muscle or bone. These wounds are highly susceptible to infection and may require surgical intervention, such as skin grafts or flap reconstruction.

Managing stage 4 ulcers is complex and often involves a multidisciplinary approach.

Unstaged Sores

At times, it’s challenging to pinpoint the exact stage or category of a bedsore. You might find a pressure sore that’s deep, but its full depth remains unclear.

The term “unstageable” is used when the exact stage of the bedsore is ambiguous. Often, the sore’s base is obscured by dense connective tissue and possibly discolored pus. Consequently, doctors can’t clearly see and determine the sore’s actual stage.

This is called a deep tissue injury (DTI) and is notably tricky to manage. The silver lining is that since the skin is intact, there’s a lower risk of infection.

These so-called “unstageable” pressure sores might resemble blood-filled blisters. Even if the skin remains unbroken, it’s treated with the same seriousness as a traditional bedsore. Keeping the area clean, dry, and free from any pressure is crucial to allow natural healing.