Pressure Injuries

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7 Terms

1
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stage I

intact skin

non-blanchable periwound erythema

2
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stage 2

blister OR partial thickness loss of dermis

3
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stage 3

full thickness tissue loss

subcutaneous tissue may be present

necrotic tissue may be present

4
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stage IV

full thickness tissue loss

exposed bone, tendon or muscle

once a stage IV, always a stage IV

5
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unstageable

full thickness tissue loss

wound depth obscured by necrotic tissue

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sDTI

purple or maroon area of discolored intact skin or blood-filled blister

7
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intact, stable eschar over the heel should be

left intact and protected