How many stages are there in the classification of pressure ulcers?

In general, pressure ulcers are divided into four stages: the stage of blood congestion and erythema, the inflammatory infiltration stage, the superficial ulcer stage, and the necrotic ulcer stage. If discomfort occurs, it is recommended to seek medical attention promptly. The specific analysis is as follows:

1. Blood Congestion and Erythema Stage

This is the initial stage of pressure ulcers. The skin remains intact but shows redness, swelling, warmth, pain, or numbness in the pressured area. After pressure is relieved, the skin color fails to return to normal within 30 minutes. The main feature of this stage is partial impairment of local blood circulation, although the integrity of the skin has not yet been compromised. If effective nursing measures—such as regular repositioning, relieving local pressure, and improving local blood circulation—are implemented promptly at this stage, the progression of the pressure ulcer can be prevented.

2. Inflammatory Infiltration Stage

The local skin turns purplish-red, with induration forming beneath the surface, and blisters appear on the epidermis. These blisters are prone to rupture, exposing a moist, red wound bed, causing pain to the patient. Without proper care at this stage, ruptured blisters may easily lead to infection. It is important to protect the wound, avoid further pressure, and prevent blister rupture and subsequent infection. Under medical guidance, medications or dressings that promote wound healing may be used.

3. Superficial Ulcer Stage

Epidermal blisters gradually enlarge and rupture, with yellow exudate appearing from the dermal wound surface. Following infection, pus covers the surface, leading to necrosis of superficial tissues and the formation of ulcers. At this stage, enhanced wound care is required, including timely removal of necrotic tissue, infection control, and promotion of granulation tissue growth and wound healing.

4. Necrotic Ulcer Stage

Necrotic tissue extends into the subdermal layers and muscle, with infection spreading laterally and deeper, potentially reaching the bone surface. The ulcer surface contains large amounts of necrotic tissue, with increased purulent discharge and a foul odor. This stage represents severe disease with high treatment difficulty, possibly requiring surgical debridement, flap transplantation, and intensive systemic nutritional support and anti-infective therapy.

To prevent and manage pressure ulcers, maintain clean and dry skin, change body position regularly, use appropriate pressure-relieving mattresses and dressings, and ensure adequate nutritional support.