Pressure Sore Diagnosis & Grading

Grading Pressure Sores

Pressure sores are classified into a number of stages, based on how severe they are. The National Pressure Ulcer Advisory Panel, based in the USA defines each of the four stages as follows:

• Grade 1 Pressure Sore – this is when a pressure sore begins as a persistent area of red skin, which might be itchy and painful. It may also feel warm, firm or spongy when touched. The mark may appear to have blue or purple cast amongst those of African ancestry and people with darker skin, or even appear quite flaky. Once the pressure is relieved, the sore will generally disappear quite quickly.
• Grade 2 Pressure Sore – At this stage the skin loss will have already taken place. This might be in the epidermis (outer layer of skin) or dermis (deeper in the skin). It may sometimes be both. At this point the pressure sore will be an open sore, like an abrasion or blister and tissue surrounding it may look red or purple.
• Grade 3 Pressure Sore – The sore will now be a deep wound and the damage down below in the skin. There is skin loss throughout the total thickness of the skin and the underlying bone and muscles are not damaged.
• Grade 4 Pressure Sores – This is the most severe type of pressure sore. The skin will be severely damaged by this point and there will be tissue necrosis (where the surrounding tissue begins to die). The underlying muscles and/or bone might also be damaged, as well as the tendons and joints. There is a serious risk of the sufferer developing a life-threatening infection by this point.