Pressure Injury Classification
-:- If the deepest type of tissue is visible (or directly palpable), the
pressure injury can be classified as Stage 1, 2, 3 or 4.
If the deepest tissue is not visible, the pressure injury is classified as unstageable (i.e. deepest
tissue obscured by slough or e...
Skin pallor on foot elevation; dusky rubor on dependency
Dystrophic toenails
Low Ankle-Brachial Index (ABI)
Arterial Ulcer Characteristics
✓ -:- Round and regular in shape
Pale wound bed
Can be shallow in depth or relatively deep
3|P a g e | G r a d e A + | 2 0 2 0 2 5
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