Pressure ulcer staging was reclassified in 2007 by an advisory panel to better identify these type of deep tissue injuries. The predetermined 4 stages remain, but additional un-stageable pressure ulcer injuries were added. Redefining the definitions of the different stages was designed to remove some confusion for physicians and lead to more thorough classifications for patients.
What is a Pressure Ulcer?
Before you can become more informed on pressure ulcer staging, you must first understand exactly what a pressure ulcer is. In basic terms, a pressure ulcer is an injury to deep tissue that is on top of bone. This creates pressure and this type of injury is referred to as a pressure ulcer. There are other variables that are associated with pressure ulcers, but they range depending on the stage of the pressure ulcer.
Here is a brief overview of pressure ulcer staging:
Stage 1:
This type of deep skin injury culminates in an area of skin above bone that has non-blanchable redness. Some of the skin make be dark in color and painful or hot to the touch. This painfulness and warmth should be noticeably different from other areas of the skin surrounding it. People with dark skin may be hard to diagnose with a stage 1 pressure ulcer.
Stage 2:
This stage of pressure ulcers is most recognized due to the thickness loss in the affected skin and tissue area. Sometimes an open ulcer will be visible with a pinkish wound bed. If a shallow wound bed is not visible a blister may be in its place. If tears of the skin are present, this is not the category that the pressure ulcer should be defined under.
Stage 3:
Pressure ulcers that are classified as stage 3 have substantial full thickness tissue loss. However, you should not be able to see the bone or surrounding muscles. Some stage 3 pressure ulcers can be shallow, so the depth of tissue loss ranges.
Stage 4:
This stage is similar to stage 3 with just one slight difference. Pressure ulcers that are classified as stage 4 have full thickness tissue loss, but also expose bone and tendons. Most stage 4 pressure ulcers go into the muscles, tendons and surrounding structures.
The additional pressure ulcer staging classifications are designed for pressure ulcers that are difficult to see. This includes pressure ulcers that are obstructed by slough or Escher in the bed of the wound. This obstruction makes it difficult to evaluate depth.
