Stage IV – full thickness tissue loss with muscle, bone, or tendon exposed. There may be dry dead tissue, called eschar – better known to you as a tough scab, over some parts of the sore. The depth will depend on the affected body part and area. Because Stage IV sores increase the risk of osteomyelitis (infection in the bone, which is very difficult to heal, especially if you have diabetes).

Unstageable – full thickness tissue loss in which the base of the sore is covered by slough or eschar, so that it can't be seen to stage. It is recommended to remove the slough and eschar to expose the wound, except on the heels when there is dry, intact eschar, without heat or fluctuance (bubbling).

*Adapted from the National Pressure Ulcer Advisory Panel, Update, 2007


Pressure sores are for the most part preventable. The most important prevention for pressure sores is to relieve pressure, friction, shear, and moisture in a timely manner.

It is important that you understand and recognize the symptoms early. I'll tell you more next time about specific prevention and treatment, but for now:

  • Understand what causes a pressure sore. If it's from immobility, get the pressure off, use pressure relieving devices, and change positions at least every two hours. Wear shoes that don't cause pressure, shearing, or friction.
  • Carefully look at all parts of your or your loved one's feet – ankles, heels, tips of toes, between toes, tops of toes, tops and soles of feet – at least daily to make sure there is no redness or open areas. If there is a sore, and/or if redness does not go away when the pressure is off, or any of the above signs or symptoms, contact your health care professional right away.

Take care of your feet, so you can EnJOY! them for a lifetime.

Read Joy's bio here.

Read more of Joy Pape's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.



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Last Modified Date: July 08, 2013

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by Brenda Bell
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...
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