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August 23, 2017  
REFERENCE: Ask an Expert

Below are some of the most-recently-answered questions from our Medical Experts. We recommend you read over these questions to see if your question has already been answered.



Question:
Please explain the four stages of a decubitus ulcer, pressure sore. Thank You, Martha

Question submitted by: [email protected]

Dr. Swanson
Terry Swanson Terry Swanson is a Wound Management Consultant at South West Healthcare, Warrnambool, Victoria, Australia. Terry completed her nursing in Springfield, Illinois and was a Neurosurgical nurse before immigrating to Australia in 1988. She developed an interest in perioperative nursing and wound management in the early 90’s. Terry completed her post-graduate education in 1996 and was appointed as a wound management consultant in 1997 at South West Healthcare. She manages a nurse-led regional and outpatient wound management service. Terry was a successful candidate for the Nurse Practitioner Victorian Project in 1999/2000 and will be seeking endorsement as a Nurse Practitioner (Wound Management) in 2001. Terry is active professionally by participating on various state and national committees. She is the Vice President of the Australian Wound Management Association, as well as the immediate past president of the Victorian Wound Management Association.

Terry is currently undertaking study at the University of South Australia, completing a Masters level advanced pharmacology course. Her professional interests include education, mentoring, lecturing, and advocating for nursing and patient's rights.



Answer:
Dear Martha, There a few ways to assess pressure (decubitus) ulcers and the 4 stages is one way. It is generally recognised that the four stages are described as such: Stage 1 Nonblanchable redness of intact skin. In individuals with darker skin there may discoloration of skin. There may also be warmth, local swelling and firmness below the skin, (nonblanchable is when you push on the skin and it does not turn white with light pressure) Stage 2 A superficial loss of skin. It can look like a blister, abrasion or small wound. Stage 3 Damage to the layers of skin and may look like a crater. This wound may be deeper and the layers of skin around the ulcer may have separated. Stage 4 Full loss of skin and may involve bone, muscle and tendon. There may be damage to the surrounding skin and there may be sinus tracts. This wound has extensive damage. These are based on the Agency for Healthcare Policy and Research (AHCRP) Clinical Practice Guidelines Number 15, Treatment of Pressure Ulcers, pages 12 –13. Terry Swanson RN WMC

   
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