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What are the stages and warning signs of a pressure sore?

Pressure injuries range from Stage 1, where skin remains intact but has persistent discoloration, to Stage 4, where deeper tissue, muscle, tendon, or bone may be exposed. Unstageable and deep-tissue injuries can hide their true depth. Any worsening discoloration, blister, open area, drainage, odor, or dark tissue deserves prompt evaluation.

Stage 1 and Stage 2 pressure injuries

At Stage 1, the skin is intact but has persistent redness or discoloration that does not fade when pressure is relieved. It may feel warmer, firmer, softer, or more painful than nearby skin. Stage 2 involves partial skin loss and may look like a shallow open sore or an intact or ruptured blister.

Stage 3 and Stage 4 pressure injuries

Stage 3 involves full-thickness skin loss, and fatty tissue may be visible. Stage 4 extends deeper, with exposed or directly palpable fascia, muscle, tendon, cartilage, or bone. Tunneling and undermining may be present in both stages. These wounds require professional treatment.

Unstageable and deep-tissue pressure injuries

An unstageable pressure injury is covered by dead tissue or a scab-like layer, so its full depth cannot yet be seen. A deep-tissue pressure injury may appear dark red, maroon, or purple beneath intact skin and can deteriorate quickly.

What caregivers should watch for

Check common pressure points daily, including the tailbone, heels, hips, ankles, elbows, shoulder blades, and back of the head. Repositioning, moisture control, nutrition, appropriate support surfaces, and pressure relief are important, but an existing injury should be assessed rather than treated with positioning alone.

  • Discoloration that does not fade after pressure is removed
  • A blister, shallow open area, crack, or skin tear
  • Increasing drainage, odor, warmth, swelling, or pain
  • Black, yellow, maroon, or purple tissue
  • Fever, confusion, or rapidly spreading redness

Call 877-545-1300 or request a provider to begin care. Healix360 serves Southern California and Nevada and accepts Medicare Part B and most major insurance plans.