Bed sore Stages

Classification
The definitions of the four pressure ulcer stages are revised periodically by the National Pressure Ulcer Advisory Panel (NPUAP) in the United States. Briefly, however, they are as follows:

Stage I is the most superficial, indicated by non blanchable redness that does not subside after pressure is relieved. This stage is visually similar to reactive hyperemia seen in skin after prolonged application of pressure. Stage I pressure ulcers can be distinguished from reactive hyperemia in two ways: a) reactive hyperemia resolves itself within 3/4 of the time pressure was applied, and b) reactive hyperemia blanches when pressure is applied, whereas a Stage I pressure ulcer does not. The skin may be hotter or cooler than normal, have an odd texture, or perhaps be painful to the patient. Although easy to identify on a light-skinned patient, ulcers on darker-skinned individuals may show up as shades of purple or blue in comparison to lighter skin tones.

Stage II is damage to the epidermis extending into, but no deeper than, the dermis. In this stage, the ulcer may be referred to as a blister or abrasion.

Stage III involves the full thickness of the skin and may extend into the subcutaneous tissue layer. This layer has a relatively poor blood supply and can be difficult to heal. At this stage, there may be undermining damage that makes the wound much larger than it may seem on the surface.

Stage IV pressure ulcerStage IV is the deepest, extending into the muscle, tendon or even bone.

Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so the depth cannot be determined.

RHINOPLASTY: Cosmetic Surgery

Rhinoplasty
Rhinoplasty, also referred to as a ‘nose job,’ can reduce or increase the size of the nose, reshape the nose, or correct bumps on the bridge of the nose. For those who are self-conscious about the appearance of their nose, rhinoplasty at our St. Louis-area facility offers an excellent solution.
Several different approaches can be taken to perform rhinoplasty at our office near St. Louis. For instance, incisions can be made either inside or outside of the nose and several different reshaping or recontouring techniques can be used depending on each patient’s unique situation. Dr. Jeffrey Copeland will determine which surgical method will work best for you.
Rhinoplasty can be performed under general or local anesthesia and the surgery can usually be completed in one to two hours. Most people can return to sedentary activities within a few days following rhinoplasty surgery. Rhinoplasty patients at our St. Louis-area practice often choose to combine procedures to further enhance their results. During an initial consultation, Dr. Copeland will discuss the surgical procedure with you and will also go over the potential risks and benefits.
Contact our cosmetic surgery staff in St. Peters if you are interested in learning more about rhinoplasty.