Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - 8

8

PRESSURE ULCER PREVENTION AND TREATMENT FOLLOWING SPINAL CORD INJURY

as a shiny or dry shallow ulcer without slough
or bruising. The presence of bruising indicates
deep tissue injury (see below) and the wound
should not be staged as a category/stage II ulcer.
This category should not be used to describe
skin tears, tape burns, incontinence associated
dermatitis, maceration, or excoriation.

The depth of a category/stage IV pressure
ulcer varies by anatomical location. The bridge
of the nose, ear, occiput, and malleolus do not
have adipose or subcutaneous tissue and these
ulcers are typically shallow. Category/stage IV
ulcers can extend into muscle and/or supporting
structures (e.g., fascia, tendon, or joint capsule),
making osteomyelitis or osteitis likely to occur.
Exposed tendon, bone, or muscle is visible or
directly palpable.

C AT E G O RY / S TAGE III

A category/stage III ulcer is notable for full
thickness skin loss. Subcutaneous fat may be
visible, but bone, tendon, or muscle are not
exposed. Slough may be present but it does not
obscure the depth of tissue loss. It may include
undermining and tunneling. The depth of a
category/stage III pressure ulcer varies by
anatomical location. The bridge of the nose, ear,
occiput, and malleolus do not have significant
subcutaneous tissue, and here a category/stage III
ulcer can be shallow. In contrast, areas of
significant adiposity can develop extremely deep
category/stage III pressure ulcers. Bone and
tendon are not visible or directly palpable.

UNSTAGEABL E/ UNCL ASSI F I ED

An unstageable/unclassified ulcer shows full
thickness tissue loss in which the actual depth of
the ulcer is obscured by slough (yellow, tan, gray,
green, or brown) and/or eschar (tan, brown, or
black) in the wound bed. Until enough slough
and/or eschar are removed to expose the base of
the wound, the true depth cannot be determined.
When the true depth is determined, typically a
category/stage III or IV ulcer will be revealed.
Stable (dry, adherent, intact, with no erythema or
fluctuance) eschar on the heels serves as the
body's natural (biological) cover and should not
be removed.

C AT E G O RY / S TAGE IV

A category/stage IV ulcer shows full thickness
skin loss with exposed bone, cartilage, tendon,
or muscle. Slough or eschar may be present on
some parts of the wound bed. It often includes
undermining and tunneling.

SUSPECTED DEEP TI SSUE I NJURY

Suspected deep tissue injury (sDTI) may
present as a purple or maroon localized area of
discolored skin (which may otherwise appear



Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury

Table of Contents for the Digital Edition of Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury

Contents
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - Cover1
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - Cover2
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - i
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - Contents
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - iii
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - iv
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - v
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - vi
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - vii
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - viii
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - ix
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - x
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - xi
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - xii
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - xiii
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - xiv
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - 1
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