Pressure-injury staging is a depth decision, not a severity adjective.
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In 30 seconds
- 1Ask what tissue is visible and whether the base can be seen.
- 2Stages 1–4 move from intact skin to exposed fascia, muscle, tendon, cartilage or bone.
- 3Unstageable and deep-tissue pressure injury answer different questions; neither is “stage 5”.
The staging ladder
The numbered stages move from intact skin to deeper tissue loss. Classify by the deepest visible tissue, the same habit the head-to-toe assessment builds: look first, then name it.
Staging by depth
Stage = the deepest tissue you can see
Stage 1
Intact skin, non-blanchable
Stage 2
Partial thickness, dermis exposed
Stage 3
Full thickness, adipose may show
Stage 4
Deeper structures exposed
Unstageable
Slough or eschar hides the base
Depths per the NPIAP staging resources, checked September 9, 2026.
Stage 1: intact skin with non-blanchable color change. In darker skin, compare color, temperature, firmness, and sensation rather than relying on redness alone.
Stage 2: partial-thickness skin loss with exposed dermis; a shallow open area or serum-filled blister, without deeper tissue visible.
Stage 3: full-thickness skin loss with adipose potentially visible, but no exposed fascia, muscle, tendon, cartilage, or bone.
Stage 4: full-thickness skin and tissue loss with exposed or directly palpable deeper structures such as fascia, muscle, tendon, cartilage, or bone.
Unstageable: full-thickness loss is present, but slough or eschar obscures the depth. You cannot assign 3 or 4 until the base is visible.
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Create my free accountThe two categories that are not “stage 5”
- Unstageable: full-thickness loss is present, but slough or eschar obscures the depth. You cannot assign 3 or 4 until the base is visible.
- Deep-tissue pressure injury: persistent deep red, maroon, or purple discoloration—or a blood-filled blister—suggests damage beneath the surface that may evolve rapidly.
Try it · Pressure Injuries
Classify by the deepest visible tissue. The cards reuse the pressure-injury staging ladder planned in the visual-card asset family. Full topic
Staging on NurseSavvy is a ladder card: you place the injury by deepest visible tissue, and a wrong rung is corrected with a read card under 50 words and re-asked in the same session. Prevention is part of the same pressure-injury flow, and wound healing, linked below, is its own flow in the 588-topic corpus, so the staging decision is practiced beside the nursing action it leads to. Why a card comes back after a miss is in spaced repetition for NCLEX prep.
High-yield distinctions
- Stage 1 is intact; stage 2 is open or blistered but partial thickness.
- Granulation tissue and adipose can appear in stage 3; exposed deeper support structures indicate stage 4.
- Slough or eschar that hides the base makes the injury unstageable, not automatically stage 4.
- Mucosal pressure injuries are not staged with this system.
- Do not reverse-stage a healing injury; document its current characteristics and original stage according to policy.
Quick check · no scrolling back
Full-thickness loss, but eschar covers the base. How do you stage it?
Continue with pressure-injury prevention (the same topic’s prevention cards) and wound healing after the depth distinctions are stable. For the rest of the course, see how to pass Fundamentals.
Source: National Pressure Injury Advisory Panel staging resources, checked September 9, 2026.
Clinical-use note: Staging requires a complete skin and wound assessment; use current organizational policy and a qualified wound clinician when findings are unclear.
Common questions
What is a stage 1 pressure injury?
Stage 1 has intact skin with non-blanchable color change. Assessment in darker skin also relies on comparison of color, temperature, firmness, and sensation.
What is the difference between stage 2 and stage 3?
Stage 2 is partial-thickness skin loss with exposed dermis and no deeper tissue visible. Stage 3 is full-thickness skin loss in which adipose and granulation tissue may be visible.
What makes a pressure injury stage 4?
Stage 4 has full-thickness skin and tissue loss with exposed or directly palpable deeper structures such as fascia, muscle, tendon, cartilage, or bone.
Is unstageable the same as stage 4?
No. Unstageable means slough or eschar obscures the base, so the depth cannot yet be confirmed as stage 3 or stage 4.