What are the 5 stages of pressure ulcers?

What are the 5 stages of pressure ulcers?


  • Stage 1. The skin isn’t broken, but it’s discolored.
  • Stage 2. A break in the skin reveals a shallow sore or cut that may leak pus.
  • Stage 3. The ulcer is much deeper within the skin, affecting your fat layer.
  • Stage 4. This ulcer is very deep and affects many tissue layers, possibly including the bone.
  • Unstageable.

What are the 6 stages of pressure ulcers?

Classifications of Pressure Ulcers.

  • Stage I.
  • Intact skin with non-blanchable redness of a localized area usually over a bony prominence.
  • Stage II.
  • Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough.
  • Stage III.
  • Full thickness tissue loss.
  • Stage IV.
  • What are the guidelines for pressure ulcer management?

    Managing pressure is also necessary and the following is recommended.

    • Provide appropriate support surface.
    • Reposition every two hours in bed.
    • Off-load heels – use pillows or positioning boot.
    • Reposition every hour when in chair.
    • Use pillow between legs for side lying.
    • Do not position directly on trochanter.

    How do you determine the stage of a pressure ulcer?

    Stages of Pressure Injuries

    1. Stage 1 sores are not open wounds.
    2. At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful.
    3. During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater.

    What are the 4 categories of pressure ulcers?

    Category I – non-blanchable erythema. Category II – partial thickness skin loss. Category III – full thickness skin loss. Category IV – full thickness tissue loss.

    How do you treat a Stage 3 pressure ulcer?

    Treatment of Stage 3 Bedsores

    1. Relieving pressure: Taking pressure off the affected area helps ensure it will not worsen.
    2. Debridement: Doctors remove the eschar and slough from the sore.
    3. Cleaning: Once the bedsore is free of eschar and slough, water or saltwater will be used to clean it.

    What are the 4 stages of a pressure ulcer?

    These are:

    • Stage 1. The area looks red and feels warm to the touch.
    • Stage 2. The area looks more damaged and may have an open sore, scrape, or blister.
    • Stage 3. The area has a crater-like appearance due to damage below the skin’s surface.
    • Stage 4. The area is severely damaged and a large wound is present.

    What is Stage 3 pressure ulcer?

    Stage 3 bedsores (also known as stage 3 pressure sores, pressure injuries, or decubitus ulcers) are deep and painful wounds in the skin. They are the third of four bedsore stages. These sores develop when a stage 2 bedsore penetrates past the top layers of skin but has yet not reached muscle or bone.

    What does Stage 3 of a pressure ulcer look like?

    Stage 3. These sores have gone through the second layer of skin into the fat tissue. Symptoms: The sore looks like a crater and may have a bad odor. It may show signs of infection: red edges, pus, odor, heat, and/or drainage.

    { Stage 1 or 2 pressure ulcers { Skin tears { Moisture associated skin damage (MASD) of the incontinence-associated dermatitis (IAD) type { Contact dermatitis { Friction blisters. Superficial { Stage 3 or 4 pressure ulcers { Unstageable including slough and/or eschar, deep tissue injury pressure ulcers. Deep. 5/12/2014

    What is a stage 1 pressure ulcer?

    – The area may be painful, firm, soft, warmer, or cooler, as compared to adjacent tissue. – Stage I may be difficult to detect in individuals with dark skin tones. – May indicate at-risk persons (a heralding sign of risk).

    What are the stages of a pressure ulcer?

    Pressure Ulcer Staging Stage 1: Intact skin with non-Stage 2 fi Stage 3: Full thickness tissue loss. Stage 4 Unstageable: Full thickness tissue Suspected Deep Tissue Injury (sDTI): Purple or maroon localized area of discolored intact skin or blood-fi lled blister due to damage of underlying soft tissue from pressure and/or shear.

    Do you know the four stages of pressure ulcers?

    Stage 1 ulcers have not yet broken through the skin. Stage 2 ulcers have a break in the top two layers of skin. Stage 3 ulcers affect the top two layers of skin, as well as fatty tissue.