Following is the staging system that is most widely used to differentiate the condition of pressure sores. It is consistent with the National Pressure Ulcer Advisory Panel and with the International Association for Enterostomal Therapy; thus, we highly recommend it to evaluate a bedridden patient’s condition in regards to developed pressure sores:
Nonblanchable erythema of intact skin; the heralding lesion of skin ulceration.
Note: Reactive hyperemia can normally be expected to be present for one half to three fourths as long as the pressure occluded blood flow to the area (Lewis and Grant, 1925). This should not be confused with a Stage I pressure ulcer.
Partial thickness skin loss involving epidermis and/or dermis. The sore is superficial and presents clinically as an abrasion, blister, or shallow crater.
Full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. The sore presents clinically as a deep crater with or without undermining of adjacent tissue.
Full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures (for example, tendon or joint capsule).
Note: Undermining and sinus tracts may also be associated with Stage IV pressure ulcers.
It is crucial to know at what stage the bedsores are to be able to assess the patient’s condition, dangers he or she may face, and the best treatment for his or her specific case.
In most cases, life-threatening bedsores, the ones at Stages III and IV, can be prevented and stopped at the first two Stages with prompt and rigorous treatment and with the constant use of devices like the low air loss mattress. Nevertheless, there are two limitations within this staging system:
One, it may be difficult to identify Stage I pressure sores in patients with dark pigmentation skin.
Two, When there is an eschar (a layer of dead, burned tissue), it is not possible to identify the severe staging of the sore until the eschar peels away or the damaged tissue has been surgically removed.
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