Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining and/or tunneling often occur. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.
Pressure ulcer of trochanter – Stage IV; 80% – 90% slough; undermining 3 cm at 10 o’clock; margins with re-epithelialization; edible (rolled edges).