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3.4 Stage 4 Pressure Injury Clinical Characteristics Exposure of muscle, tendon, or bone High infection risk Heavy exudate Dressing Options Negative pressure wound therapy (NPWT) adjuncts Antimicrobial dressings (silver, iodine) Advanced foam or hydrofiber systems Clinical Considerations Osteomyelitis risk Need for surgical consultation Evidence-based discussion Stage 4 pressure injury represents advanced full-thickness tissue destruction, often with undermining, tunneling, exposed deep structures, and a substantially increased probability of deep infection

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