Category 3 (FIG. 1)
Category 3 is now deeper than the dermis and may expose fat or muscle (see muscle in Fig 1). This is a serious pressure injury and could be life threatening.
In the beginning, the wound will be filled with slough or necrotic (dead) tissue (Fig 2) which can be malodorous (terrible odour). If the wound bed cannot be visualised (as in Fig 1, then it must be classified as ungradable. No one should be persuaded to report this as a category 3 (or even category 4) until the necrotic tissue has been removed.
It is now the same for both paler and darker skins.
The wound here (Fig 1) is below the dermis which can clearly be seen at the edges of the wound and the muscle is clearly exposed.
There is no bone in the base of the wound. Therefore, this is a category 3.
This wound (Fig 2) is full of dead (necrotic) tissue and the wound bed cannot be visualised. Therefore, it can be classified as ungradable / unstageable / unclassified but never as a Category.
Sylvie Hampton, 27 September 2019