A bruise would not be considered a Stage I wound.

Wounds come in all shapes and sizes, so having standardized criteria to categorize each can help clinicians provide more holistic and seamless care for patients, especially if multiple individuals are providing various segments of wound care for a single patient.

While there are four different wound healing stages that wounds can be categorized under, the wounds can also be considered unstageable.

Stage IV

This is the most serious in terms of treatment and wound healing needs for a wound. Stage IV wounds may feature extensive loss or damage to tissue, muscles and bones, and often feature muscle and bone that is exposed. The severity of a wound can often cause complications and disrupt the support of the joint or body area that it affects. Stage IV wounds often involve full thickness tissue loss, and may have necrotic tissue present. Tunneling wounds – which are wounds that have developed channels through the tissue and/or muscle – are also common complications in Stage IV wounds.

Because this type of wound often goes beyond the nerve endings, pain levels in the patient may not match the severity of the wound. Stage IV wounds can come with a range of complications, including osteomyelitis, a bacterial infection in the bone.

Healing a Stage IV wound often includes surgery, as well as wound debridement of some tissue, particularly necrotic or eschar that may be partially or completely covering the wound. Wet dressings may be used on some wounds to provide the appropriate level of moisture on the wound bed, and the uneven texture of the wound may warrant packing dry gauze, such as alginate rope, Silvercel NA-Rope as an example, into the wound.

Stage III

Stage III wounds are characterized by full-thickness tissue loss – loss extends to the subcutaneous level. While bone, fat or muscle may be visible, large areas of these tissues are not readily viewable. Necrotic tissue may also be present in the wound, as well as some tunneling. Because many layers of tissue are exposed, these wounds often have complications, similar to Stage IV wounds.

Stage II

Considered partial thickness wounds, Stage II wounds may involve tissue loss at the epidermis and dermis levels. Most wounds in this stage remain rather superficial in terms of tissue loss. Common types of Stage II wounds include abrasion injuries and most blisters.

Stage II wounds can be cared for through the use of a hydrocolloid such as Convatec’s Duoderm Signal or other hydrocolloid dressings that are particularly suited for pressure ulcers.

Stage I

Stage I wounds are wounds where affected tissue is observable, but often only on the top layers of tissue. Common symptoms include skin color that is slightly more red, blue or purple than the surrounding tissue, skin that is slightly warmer, or a skin area that is raised or different in texture.

Many Stage I wounds will heal readily on their own, but can be assisted with topical ointments with antibacterial properties.

Eschar- and slough-covered wounds

Some wounds are considered unclassifiable due to tissue covering the wound. Eschar, which is visually a tan, brown or black covering on a wound, can hide the true thickness and severity of the wound, as can excess slough – tissue that is soft, moist and has lost its nutrients and or blood supply.

In these wounds, debridement (tissue removal) may be required to assess the extent of the wound. However, eschar and slough coverings may fall off on their own.

Advanced Tissue is the nation’s leader in delivering specialized wound care supplies to patients, delivering to both homes and long-term care facilities.