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What Are the Stages of Bedsores?

persona laying in bed with caption: What Are the Stages of Bedsores?

Bedsores cause more than just pain and scarring, they can also lead to infection, sepsis, and death, especially in elderly nursing home residents and those with compromised immunity. Bedsores—or pressure sores—develop in patients, paralyzed individuals, or nursing home residents with mobility problems. Recognizing and promptly addressing bedsores with appropriate medical treatment is essential to prevent a worsened medical condition. Preventing bedsores from developing is the best way to protect vulnerable individuals but recognizing the stages of bedsores is the key to providing appropriate care.

Signs of Stage One Bedsores

When an individual is immobile or has limited mobility, the unrelieved pressure leads to damaged tissue, especially over bony areas like the tailbone. Bedsores are most common in bedridden patients and paralyzed individuals who spend their days in wheelchairs. The pressure causes a lack of circulation in the area, resulting in the death of skin cells. An individual with stage one bedsores may have symptoms such as the following:

  • Red, inflamed skin in one or more spots, or spots that appear darkened or purple on those with dark skin
  • Mild pain and discomfort
  • Skin that feels warmer than the surrounding area

Proper medical attention applied promptly to a stage one bedsore helps prevent them from progressing to stage two. Proper care includes relieving the pressure by frequent position changes, washing the area with mild soap and water, and then keeping the area clean and dry. When left untreated, stage one bedsores progress to the second stage.

Recognizing Stage Two Bedsores

As bedsores advance to stage two, the damaged skin worsens and breaks down, forming an open sore or ulcer. The signs of stage two bedsores include:

  • An open sore that resembles an open blister
  • Seeping
  • Redness and inflammation in the surrounding area
  • Pain

Open, stage-two bedsores allow bacteria to enter the wound, often leading to infection. Treatment of stage two blisters requires frequent repositioning for pressure relief, gentle cleansing with a saline solution, and debriding. Debriding a wound is the process of removing the dead skin to promote healing and prevent infection.

Understanding Stage Three Bedsores

When an open bedsore penetrates through the skin layers down to the fat layer below, the sore has reached stage three. Symptoms of stage three bedsores include:

  • The open sore is deep enough to expose the fat layer and shows necrosis or tissue death (blackened, dead skin)
  • Redness and inflammation in the area surrounding the sore
  • Oozing fluid or pus
  • Fever
  • Extreme pain

Treatment for stage three bedsores includes tissue debriding and often surgery to close the wound, followed by covering with a sterile dressing. The patient also requires antibiotic treatments to heal infection and prevent sepsis. They must remain in a position that relieves pressure from the injured area.

What Are Stage Four Bedsores?

In stage four, tissue death occurs in the bedsore and is allowed to penetrate through the layer of fat to the muscle and bone. Stage four bedsores show the following symptoms:

  • The sore has become a widened, deepened crater exposing the bone below
  • The wound has uneven edges of dead blackened skin
  • The flesh surrounding the bedsore is reddened, swollen, and hot
  • Fever
  • Oozing foul-smelling pus
  • Severe pain

Stage four bedsores require surgical debriding followed by a sterile dressing with frequent changes. Many affected individuals receive IV antibiotics to address the infection and prevent or treat sepsis. In some cases, stage four bedsores lead to sepsis and death.

Are Bedsores a Sign of Negligence?

Caregivers must frequently reposition immobile patients or residents to prevent bedsores. When an individual develops symptoms of stage-one bedsores, their caregiver has a duty to promptly address the problem with proper care to prevent them from advancing to the later stages. Failing to prevent bedsores or provide curative treatment in stage one is neglect, and leaves caregivers liable for damages to victims. If you suspect that bedsores are a sign of negligence, consulting with a skilled Phoenix nursing home abuse attorney can help you understand your legal options.

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