Which stage of pressure injury is described as full-thickness loss with tissue destruction extending to the fascia, often with undermining or tunneling?

• A. Stage 1 pressure ulcer
• B. Stage 4 pressure ulcer
• C. Stage 3 pressure injury
• D. Unstageable pressure ulcer

Answer: (C)

Understanding how pressure injuries are classified by depth helps make sense of this description. A full-thickness loss means the injury extends through the epidermis and dermis and into deeper tissues. Saying that tissue destruction extends to the fascia places the depth beyond superficial layers into the subcutaneous tissue area, but not into muscle or bone. The fascia is the layer just beneath subcutaneous tissue, so reaching it qualifies as deeper tissue destruction without exposing muscle or bone. Undermining or tunneling is common in this stage, reflecting that tissue damage can run beneath intact skin edges.

This is why the described wound aligns with a stage where there is full-thickness tissue loss into the subcutaneous layer (potentially down to the fascia) but without exposure of bone, tendon, or muscle. If bone, tendon, or muscle were exposed, it would be a more severe stage. If depth isn’t visible because slough or eschar obscures it, the wound would be unstageable. If only the superficial layers are involved (epidermis and part of the dermis), that would be a less severe stage.