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What are the Stages of Pressure Ulcers in Feet?

Dr. Eman Elmi
December 5, 2022
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Pressure ulcers in your feet are among the most serious and uncomfortable conditions your feet may experience. A pressure ulcer is a wound or sore in the skin of the feet caused by excessive pressure on the foot. Foot ulcers are most common on the soles of the feet, but can occur on any part of the foot.

Treating pressure ulcers becomes more difficult as the ulcer worsens. As such, it is always important to seek medical treatment quickly if you suspect you have a pressure ulcer on your foot.

What Causes Pressure Ulcers?

Pressure ulcers are caused by excessive pressure against the skin of the foot.  With too much pressure, the skin can begin to crack or tear, opening up into a wound. Once formed, an ulcer can expose your foot to harmful bacteria, causing infection.

Pressure on the foot can come from several sources. Poorly fitted shoes, bed sheets, and mattresses are leading causes of foot ulcers. The first sign that a pressure ulcer is developing is often a sharp pain or the development of blisters.

There are several important risk factors to be aware of when it comes to pressure ulcers. Diabetics, for example, are significantly more susceptible to pressure ulcers. Additionally, heart disease, obesity, kidney disease, and circulation issues may all elevate the risk of developing pressure ulcers.

While these risk factors increase the chances of developing a pressure ulcer, everyone is susceptible. Therefore, it is important to know the signs and treatment methods for pressure ulcers. Treating a pressure ulcer can vary depending on the staging of your pressure ulcer.

Pressure Ulcer Stage Breakdown

The pressure ulcer stage refers to the level of severity of the pressure ulcer itself. Stage I is the least severe while Stage IV and unstageable pressure ulcers are the most severe. Knowing the signs and symptoms of each pressure ulcer stage can help if you are seeking treatment.

Stage I Pressure Ulcer

A pressure ulcer at Stage I will have nonblanchable erythema. In other words, the skin will be discolored and will not turn white when pressure is applied. Applying pressure to healthy skin will ordinarily cause it to briefly turn white as blood is dispersed in the area. With a Stage I pressure ulcer, the skin will remain red or another color, depending on the discoloration. 

Stage I pressure ulcers can usually be treated with at-home remedies. However, it is advised to seek medical attention to receive a diagnosis and treatment plan and prevent worsening symptoms.

Stage II Pressure Ulcer

A pressure ulcer reaches stage II when partial-thickness skin loss sets in. This will look like a shallow open wound, typically red or brown in coloration. Treating a pressure ulcer at stage II requires frequent covering and disinfecting of the area to avoid infection, as well as avoiding pressure. Some doctors may also recommend dietary changes if nutrition is a concern.

Stage III Pressure Ulcer

Stage III pressure ulcers produce full-thickness skin loss. This means the open sore will extend to the subcutaneous tissue layer. Stage III pressure ulcers are very painful and very serious and require direct urgent medical attention.

Stage IV Pressure Ulcer

Stage IV pressure ulcers have full-thickness skin loss beyond the fascia, which is the layer of tissue connecting your bone to your foot tissue. A stage IV pressure ulcer is highly serious and requires immediate medical intervention.

Unstageable Pressure Ulcer

An unstageable pressure ulcer has full-thickness skin loss but is covered by a layer of necrotic tissue. Some surgical procedures are available to remove necrotic tissue. In some cases, unstageable pressure ulcers must be treated with foot amputation.

The podiatrists at Diablo Foot & Ankle have extensive experience treating foot pain of all types. If you need treatment for foot ulcers or other foot ailments, contact us today.

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