Clinical photograph of a Grade IV sacral pressure sore on a patient with dark skin. The image demonstrates a deep, roughly oval-shaped ulcer in the sacral region. The wound bed shows extensive tissue loss with visible red granulation tissue and central areas of white-yellowish tissue, consistent with slough or exposed deep structures such as fascia or bone. The wound margins are irregular and slightly raised, with pale, macerated edges. The periwound skin exhibits hyperpigmentation and inflammatory changes. Adjacent to the ulcer, on the left side of the image, surgical markings are present, including a dashed curvilinear line and a central circular mark, indicating preoperative planning for a reconstructive skin flap (such as a superior gluteal artery perforator flap). The photograph serves as a visual reference for chronic wound assessment, staging of pressure injuries, and surgical flap design in plastic and reconstructive surgery.

This clinical photographic comparison illustrates the diverse visual presentations of pressure injuries (decubitus ulcers) according to the National Pressure Injury Advisory Panel (NPIAP) staging system. The image is organized into a six-panel grid. Stage I: Shows intact skin with localized non-blanchable erythema. Stage II: Displays partial-thickness skin loss with a shallow, open ulcer and a red-pink wound bed. Stage III: Exhibits full-thickness skin loss where subcutaneous fat is visible within a deeper, crater-like wound. Stage IV: Demonstrates extensive full-thickness tissue loss with exposed muscle, tendon, or fascia. The Unstageable Pressure Injury panel shows a wound bed completely obscured by dark eschar or yellow slough, preventing depth assessment. The Deep Tissue Pressure Injury (DTPI) panel presents as a localized area of intact skin with deep purple or maroon discoloration, indicating underlying soft tissue damage. This educational resource is intended for dermatology and nursing students to assist in the clinical classification, wound assessment, and management of pressure-related skin lesions.

A multi-panel clinical photograph illustrating the four-stage classification of pressure ulcers (decubitus ulcers) in human skin. Panel 'Stage I' depicts intact skin with localized non-blanchable erythema and significant surrounding discoloration. Panel 'Stage II' shows a partial-thickness skin loss involving the epidermis and dermis, presenting as a shallow open ulcer with a red-pink wound bed and visible slough. Panel 'Stage III' demonstrates full-thickness tissue loss with visible subcutaneous involvement; the wound is deeper with evidence of necrotic tissue and dark eschar. Panel 'Stage IV' illustrates advanced full-thickness tissue loss with extensive destruction, revealing deep structures such as muscle or fascia, and potentially exposing bone or tendon. This educational resource is used in dermatology and nursing education to differentiate wound severity and guide staging based on tissue depth, color morphology, and integrity of anatomical layers.