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Purple or maroon localized area of discoloured intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear.

The area may be painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.

May be difficult to detect in individuals with dark skin tones.

Evolution may include a thin blister over a dark wound bed. The wound may further evolve and become covered by thin eschar.

EPUAP, 2014

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Full thickness skin loss involving damage to subcutaneous tissue. Bone, tendon or muscle are not exposed.

Slough may be present but not to obscure the depth of tissue loss.  It may include undermining and tunnelling

EPUAP (2014)

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Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough.

May also present as an intact or open/ruptured serum filled blister.

Presents as a shiny or dry shallow ulcer without slough or bruising.* This Category/Stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration or excoriation.

*Bruising indicates suspected deep tissue injury.

EPUAP (2014)

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Full thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed.

Until enough slough and/or eschar is removed to expose the base of the wound, the true depth and therefore Category, cannot be determined.

EPUAP (2014)

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Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its colour may differ from the surrounding area. The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. Category I may be difficult to detect in individuals with dark skin tones. May indicate “at risk” persons.

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Full thickness tissue loss with exposed bone, tendon and muscle.

Slough may be present is some parts of the wound bed. Often includes undermining and tunnelling.

As it can extend to muscle and underlying structures, osteomyelitis is possible.

EPUAP (2014)