Decubitus grade and classification

Decubitus ulcers are classified according to W. O. Seiler into four grades and three stages:
– Grade 1: non-blanchable, circumscribed reddening of the skin with intact skin. Other clinical signs may include oedema, induration and local overheating.
– Grade 2: Partial loss of the skin; epidermis up to parts of the corium are damaged. The pressure damage is superficial and may present clinically as a blister, skin abrasion or shallow ulcer.
– Grade 3: Loss of all skin layers including damage or necrosis of subcutaneous tissue, which may extend to, but not below, the underlying fascia. The pressure ulcer presents clinically as a deep, open ulcer.
– Grade 4: Loss of all skin layers with extensive destruction, tissue necrosis or damage to muscles, bones or supporting structures such as tendons or joint capsules, with or without loss of all skin layers.
– Stage A: Wound “clean”, granulation tissue, no necroses
– Stage B: Wound greasily covered, residual necroses, no infiltration of the surrounding tissue, granulation tissue, no necroses
– Stage C: Wound like stage B with infiltration of the surrounding tissue and/or general infection (sepsis)

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