What is a pressure injury?
A pressure injury, sometimes called a pressure ulcer or bedsore, is damage to the skin and the tissue underneath it. It forms when steady pressure on one spot reduces blood flow, usually over a bony area such as the heel, hip, tailbone, shoulder blade, or the back of the head. Friction, shear, moisture, and limited movement all raise the risk.
Clinicians describe pressure injuries in stages. The stage reflects how deep the damage reaches, not how serious the situation feels. Staging guides the treatment plan, so an accurate assessment by a trained clinician matters. The stages below follow the widely used framework from the National Pressure Injury Advisory Panel.
The four stages, explained
Stage 1: intact skin with redness that does not fade
The skin is still unbroken, but there is a defined area of discoloration that does not turn white when you press on it and then release. On lighter skin this often looks red. On darker skin tones the change can be subtle and may appear purple, blue, or simply different from the skin around it, so it helps to compare with nearby areas and to feel for warmth, firmness, or tenderness.
Stage 1 is an early warning. Relieving pressure on the area promptly can often keep it from getting worse.
Stage 2: partial-thickness skin loss
The top layer of skin is broken. A Stage 2 injury may look like a shallow open sore, a scrape, or an intact or burst blister filled with clear fluid. The wound bed is usually pink or red and moist. There is no deeper tissue, fat, muscle, or bone showing.
Stage 3: full-thickness skin loss
The wound now extends through the full thickness of the skin, and fat may be visible in the wound bed. The injury can look like a deeper crater. Muscle, tendon, and bone are not exposed at this stage. Some wounds at this point develop tunneling, where the wound extends sideways under the skin edges.
Stage 4: full-thickness tissue loss with exposed structures
This is the deepest stage. The wound reaches down to muscle, tendon, ligament, cartilage, or bone, and these structures may be visible or able to be felt. Stage 4 injuries carry a higher risk of serious infection and need close clinical management.
Two descriptions that are not numbered stages
Not every pressure injury fits neatly into a number. Two other terms are important to recognize.
- Deep tissue pressure injury: an area of intact or broken skin that looks deep purple or maroon, or a blood-filled blister. It signals damage to tissue below the surface and can change quickly, so it deserves prompt attention.
- Unstageable: the bottom of the wound is covered by dead tissue, often yellow, tan, brown, or black, so the true depth cannot be seen. Once a clinician removes or the body clears that covering, the wound can be staged.
Why staging matters for the care plan
The stage shapes nearly everything: how the wound is cleaned, which dressing is chosen, whether dead tissue needs to be removed, how pressure is redistributed, and how often the wound is reassessed. A clinician also looks beyond the wound itself at nutrition, moisture, mobility, and overall health, since all of these affect healing. Staging is a snapshot in time, and wounds are reassessed as they change.
Everyday prevention basics for caregivers
These general habits support skin health between clinical visits. They do not replace a personalized plan from your clinician.
- Help reposition the person regularly and relieve pressure on at-risk areas.
- Keep skin clean and dry, and manage moisture from incontinence or perspiration.
- Check the skin daily, including heels, hips, and the tailbone, and note any new redness or changes.
- Support good nutrition and hydration as advised by the care team.
- Use cushions or support surfaces your clinician recommends.
Coverage
Medicare may cover medically necessary wound care, including pressure injury treatment, when eligibility criteria are met. We verify benefits before the first visit so there are no surprises.
When to get specialist help
Contact a clinician promptly if you notice an open or deepening wound, skin that stays red, purple, or discolored, spreading warmth or swelling, drainage with an odor, fever, or a wound that is not improving. When in doubt, ask. Early specialist care gives a pressure injury the best chance to heal. Victory Wound Care treats pressure injuries at home, in assisted living, and in skilled nursing facilities across the Greater Austin metro. You can request a visit or call 737-667-5566.