Pressure Injury Staging Explained for Nursing Students

Pressure-injury staging is a depth decision, not a severity adjective. Ask what tissue is visible and whether the base can be seen. The numbered stages move from intact skin to deeper tissue loss; unstageable and deep-tissue pressure injury answer different questions and do not belong on that numeric ladder.

The staging ladder

1. Stage 1: intact skin with non-blanchable color change. In darker skin, compare color, temperature, firmness, and sensation rather than relying on redness alone.
2. Stage 2: partial-thickness skin loss with exposed dermis; a shallow open area or serum-filled blister, without deeper tissue visible.
3. Stage 3: full-thickness skin loss with adipose potentially visible, but no exposed fascia, muscle, tendon, cartilage, or bone.
4. Stage 4: full-thickness skin and tissue loss with exposed or directly palpable deeper structures such as fascia, muscle, tendon, cartilage, or bone.

The 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.

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 and wound healing, linked below, are their own flows in the 853-topic corpus, so the staging decision is practiced beside the nursing action it leads to.

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.

Continue with pressure-injury prevention and wound healing after the depth distinctions are stable.

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.