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Grade 4

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Grade 4 pressure ulcers present as full thickness wounds penetrating through the subcutaneous tissue, exposing muscle and bone or supporting structures (e.g., tendon, joint capsule) with extensive destruction¹. Grade 4 pressure ulcers often lead to systemic infection and may be life-threatening.
These wounds are often associated with high levels of necrotic tissue that can be difficult and painful to debride surgically. Other methods of debridement such as enzyme preparations, hydrogels and alginates, where there is high exudate, may take longer, but provide autolytic debridement, which may be less uncomfortable to the patient.
Holistic treatment not only involves suitable wound management such as the control of exudate and relief of pressure, but also consideration of the patients nutritional, physical and psychological status.
These deep cavity wounds can often be dressed with alginates such as 3M™ Tegaderm™ Alginate Dressing to help encourage granulation to replace lost tissue. Polyurethane foam dressings such as 3M™ Tegaderm™ Foam Dressing and hydrocolloid dressings can be used as secondary dressings in this context to absorb any excess exudate.

1. European Pressure Ulcer Advisory Panel. Pressure Ulcer Treatment Guideline
Information provided with support from the Wound Healing Research Unit, Cardiff.

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