From the Research
Pressure ulcers are staged according to the depth of tissue damage, with four main stages plus two additional categories. The staging of pressure ulcers is crucial for determining the appropriate treatment plan and interventions. The four main stages of pressure ulcers are:
- Stage 1: intact skin with non-blanchable redness, typically over a bony prominence
- Stage 2: partial-thickness skin loss with exposed dermis, appearing as a shallow open ulcer with a red-pink wound bed without slough
- Stage 3: full-thickness skin loss where adipose tissue is visible but bone, tendon, and muscle are not exposed
- Stage 4: full-thickness skin and tissue loss exposing bone, tendon, or muscle Additionally, there are two other categories:
- Unstageable: where the wound bed is covered by slough or eschar preventing accurate staging
- Deep Tissue Pressure Injury (DTPI): appears as a purple or maroon localized area of discolored intact skin or blood-filled blister due to underlying tissue damage, as described in various studies 1, 2, 3, 4, 5. Accurate staging is essential for appropriate treatment planning, with interventions becoming more intensive as the stage increases, and regular reassessment is necessary as wounds heal or deteriorate 5. Some studies suggest that hydrocolloid dressings may be effective in the management of pressure ulcers, particularly in critically ill adult subjects 5, with a recent meta-analysis showing that hydrocolloid dressings had significantly higher complete healing rates for pressure ulcers, stage II ulcers, and stage III ulcers compared to control 5. However, it is essential to note that the evidence is not always consistent, and more research is needed to determine the most effective treatments for pressure ulcers, as highlighted in a Cochrane review 1. In clinical practice, the choice of treatment should be based on the individual patient's needs and the severity of the pressure ulcer, taking into account the latest available evidence and guidelines. Regular reassessment and monitoring of the wound are crucial to ensure that the treatment plan is effective and to prevent further complications, as emphasized in various studies 1, 2, 3, 4, 5. The most recent and highest-quality study, a 2023 meta-analysis, suggests that hydrocolloid dressings may be an effective treatment option for pressure ulcers in critically ill adult subjects 5.