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Staging of pressure-induced skin and soft tissue injuries[1]

Staging of pressure-induced skin and soft tissue injuries[1]
Stage Description
1 Skin intact but with non-blanchable redness for >1 hour after relief of pressure.
2 Blister or other break in the dermis with partial thickness loss of dermis, with or without infection.
3 Full-thickness tissue loss. Subcutaneous fat may be visible; destruction extends into muscle with or without infection. Undermining and tunneling may be present.
4 Full-thickness skin loss with involvement of bone, tendon, or joint, with or without infection. Often includes undermining and tunneling.
Unstageable Full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed.
Deep tissue pressure injury Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying tissue from pressure and/or shear.
Reference:
  1. ​National Pressure Injury Advisory Panel. NPIAP Pressure Injury Stages. Available at: https://npiap.com/page/PressureInjuryStages (Accessed on January 29, 2020).
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