What stage is a Stage 4 pressure ulcer considered at discharge if it shows improvement but is not healed?

A Stage 4 pressure ulcer is classified as such at discharge when it shows improvement but has not yet healed because pressure ulcers are not "reverse staged." Once a pressure ulcer has developed to a certain stage, it retains that designation throughout the healing process, regardless of the degree of improvement observed. This is a fundamental principle in wound care, emphasizing the importance of recognizing the severity of tissue damage that has occurred.

This approach helps healthcare providers communicate effectively about the severity of the ulcer and guide appropriate treatment and care interventions. The terminology and staging system serves to ensure that there is a consistent understanding of the patient's condition and potential risks, particularly with Stage 4 ulcers, which involve full-thickness tissue loss and may expose muscle, bone, or supporting structures.

While options that suggest changing the stage based on characteristics or expected improvement may seem intuitive, they do not align with the established definitions and protocols for staging pressure ulcers, which maintain the highest stage observed until complete healing is achieved. Additionally, labeling a pressure ulcer as unstageable would only apply if there is insufficient information to assess the wound, usually due to slough or eschar obscuring the base of the ulcer. However, if the ulcer is a Stage 4 and changes in characteristics as improvement occurs,