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Table 1 Pressure Ulcer Grading System (according to the European Pressure Ulcer Advisory Panel Grading System [[15]])

From: A pilot randomised controlled trial of negative pressure wound therapy to treat grade III/IV pressure ulcers [ISRCTN69032034]

Grade 1

Non-blanching erythema of intact skin. Discoloration of the skin,

warmth, oedema, induration or hardness may also be used as indicators,

particularly on individuals with darker skin

Grade 2

Partial thickness skin loss involving the epidermis, dermis or both.

The ulcer is superficial and presents clinically as an abrasion or blister

Grade 3

Full thickness skin loss involving damage to or necrosis of

subcutaneous tissue that may extend down to but not

through the underlying fascia

Grade 4

Extensive destruction, tissue necrosis or damage to muscle,

bone or supporting structures with or without full thickness skin loss

  1. *At the time that this pilot trial was conducted, pressure ulcers were referred to as grades by the European Pressure Ulcer Advisory Panel. They are now classified as categories and stages, e.g. category/stage IV: full thickness tissue loss [16].