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The Reston, VA-based National Pressure Ulcer Advisory Panel staging system from the 1989 Consensus Development Conference is cited more frequently than others. For more information, please refer to its Web site at www.npuap.org.
Stage 1: Nonblanchable erythema of intact skin the heralding lesion of skin ulceration. In individuals with darker skin, discoloration of the skin, warmth, edema, induration, or hardness may be indicators.
Stage 2: Partial thickness skin loss involving epidermis, dermis, or both. The ulcer is superficial and presents clinically as an abrasion, blister, or shallow center.
Stage 3: Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.
Stage 4: Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures (e.g., tendon, joint capsule). Undermining and sinus tracts also may be associated with Stage 4 pressure ulcers.
Wagner’s Classification For Foot Ulcers
Grade 0: Pre-ulcerative lesion, healed ulcers, presence of bony deformity
Grade I: Superficial ulcer without subcutaneous tissue involvement
Grade 2: Penetration through the subcutaneous tissue (may expose bone, tendon, ligament, or joint capsule)
Grade 3: Osteitis, abscess, or osteomyelitis
Grade 4: Gangrene of the forefoot
Grade 5: Gangrene of the entire foot