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Stage 4 pressure ulcers are characterized by full-thickness tissue loss, where necrosis of soft tissue extends down to underlying muscle, bone, or even tendons. This advanced stage indicates a severe level of damage; the ulcer can be deep, and often additional tissues involved are visibly exposed. Recognizing this stage is crucial for treatment planning since it poses the highest risk for complications, including infection and severe functional impairments. The medical team must deploy aggressive interventions and possibly surgical options to treat such extensive damage effectively.

In contrast, the earlier stages involve less severe tissue loss and do not extend beyond certain levels: Stage 1 involves skin intact but reddened, Stage 2 shows partial-thickness loss, and Stage 3 features full-thickness skin loss without exposing underlying muscle or bone. Each subsequent stage indicates a worsening condition, highlighting the importance of early detection and intervention.