No matter the severity, assessing a wound is always the first step toward recovery. But once a health care giver has conducted a thorough examination, the healing process can begin. Depending on the assessed severity of the wound, however, the road to recovery can vary.
To understand the various levels of pressure ulcer wound severity, the Mayo Clinic offered up the following break down:
Stage I
The beginning stage of a pressure sore has the following characteristics:
- – The skin is intact.
- – The skin appears red on people with lighter skin color, and the skin doesn’t briefly lighten (blanch) when touched.
- – On people with darker skin, there may be no change in the color of the skin, and the skin doesn’t blanch when touched. Or the skin may appear ashen, bluish or purple.
- – The site may be painful, firm, soft, warmer or cooler compared with the surrounding skin.
Stage II
The stage II ulcer is an open wound:
- – The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost.
- – The pressure ulcer may appear as a shallow, pinkish-red, basin-like wound.
- – It may also appear as an intact or ruptured fluid-filled blister.
Stage III
At this stage, the ulcer is a deep wound:
- – The loss of skin usually exposes some amount of fat.
- – The ulcer has a crater-like appearance.
- – The bottom of the wound may have some yellowish dead tissue (slough).
- – The damage may extend beyond the primary wound below layers of healthy skin.
Stage IV
A stage IV ulcer exhibits large-scale loss of tissue:
- – The wound may expose muscle, bone and tendons.
- – The bottom of the wound likely contains slough or dark, crusty dead tissue (eschar).
- – The damage often extends beyond the primary wound below layers of healthy skin.
Care plans during the various stages can include extensive charting and tracking by nurses or long-term caregivers, made easier through the implementation of automated wound management technology. To learn more about the WoundRounds systems, feel free to contact us.
