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Pressure Sore Stages - From Mild Reddening To Damaged Tissues

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Those dealing with pressure sores (also called pressure ulcers and more commonly as bedsores) should know about pressure sore stages.

Pressure sores are categorized into four key stages depending on their age and severity.

It is always wise to seek medical advice from a doctor or health care giver if you suspect the start of a pressure sore when away from a hospital environment.

As with most potential complications it is best to intervene as early as possible to prevent the problem worsening.

Stages of Bed sores | Pressure Sores

COPYRIGHT_SPINE: Published on https://spinal-injury.net/pressure-sore-stages/ by Dr. Bill Butcher on 2022-10-28T02:00:12.551Z

Pressure Sore Stages - Stage One

How To Recognize Stage One

Skin is not broken but is red or discolored. The redness or change in color does not fade within 30 minutes after pressure is removed.

What To Do

1. Keep pressure off the sore!

2. Maintain good hygiene. Wash with mild soap and water, rinse well, pat dry carefully (but gently). Do not rub vigorously directly over the wound.

3. Evaluate your diet.

Ask yourself: “Am I getting enough protein, calories, vitamins A and C, zinc and iron?”

All of these are necessary for healthy skin.

4. Review your mattress, wheelchair cushion, transfers, pressure releases, and turning techniques for possible cause of the problem.

A basket full of fruits, including green grapes, lemons, pears, strawberries and red and green apples
A basket full of fruits, including green grapes, lemons, pears, strawberries and red and green apples

Pressure Sore Stages - Stage Two

How To Recognize

The epidermis or topmost layer of the skin is broken, creating a shallow open sore. Drainage may or may not be present.

What To Do

Follow steps 1-4 under Stage One. Consult your healthcare provider for further treatment, which may include the following:

1. Cleanse the wound with saline solution only and dry carefully.

Apply either a transparent dressing (such as Op-Site or Tegaderm), a hydrocolloid dressing (such as DuoDERM), or saline-dampened gauze.

The first two types of dressing can be left on until they wrinkle or loosen (up to 5 days).

If using gauze, it should be changed twice a day and should remain damp between dressing changes.

2. Check for signs of wound healing with each dressing change.

If there are signs of infection, a doctor or health care provider for alternative wound care ideas and review of possible causes (see step 4 under Stage One).

3. If the sore seems to be caused by friction, sometimes a protective transparent dressing (such as Op-Site or Tegaderm) may help protect the area by allowing the skin to slide easily.

4. If the sore does not heal in a few days or recurs, consult your doctor or health care provider.

Pressure Sore Stages - Stage Three

How To Recognize

The break in the skin extends through the dermis (second skin layer) into the subcutaneous and fat tissue. The wound is deeper than in Stage Two.

What To Do

1. Follow steps 1-4 under Stage One and the additional steps under Stage Two.

2. Always consult your healthcare provider.

3. Wounds in this stage frequently need additional wound care with special cleaning or debriding agents. Different packing agents, and occasionally, antibiotics (creams or oral pills) may be required.

4. You may also qualify for a special bed or pressure-relieving mattress that can be ordered by your doctor or health care provider.

A Caucasian male adult in man sporting a hair bun consulting with an African female doctor
A Caucasian male adult in man sporting a hair bun consulting with an African female doctor

Pressure Sore Stages - Stage Four

How To Recognize

The breakdown extends into the muscle and can extend as far down as the bone. Usually, lots of dead tissue and drainage are present.

What To Do

Consult your doctor or health care provider right away. Surgery is frequently required for this type of wound.

Signs Of A Healing Sore

How to know if the sore is healing:

1. The sore will get smaller.

2. Pinkish tissue usually starts forming along the edges of the sore and moves toward the center. You may notice either smooth or bumpy surfaces of new tissue.

3. Some bleeding may be present.

This shows that there is good blood circulation to the area, which helps to heal.

An adult woman in black long sleeve clothes with fever lying on a gray sofa bed and with white blanket on her
An adult woman in black long sleeve clothes with fever lying on a gray sofa bed and with white blanket on her

Warning Signs

You need to seek further medical help if any of the following occur:

1. An increase in the size or drainage of the sore.

2. Increased redness around the sore or black areas starting to form.

3. The sore starts smelling and/or the drainage becomes a greenish color.

4. You develop a fever.

Complications

The following are some of the possible complications that can be caused by pressure sores:

  • can be life-threatening
  • infection can spread to the blood, heart, bone
  • amputations
  • prolonged bed rest
  • autonomic dysreflexia
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About The Authors

Dr. Bill Butcher

Dr. Bill Butcher - With more than two decades of experience, Dr. Bill Butcher aims to provide a repository for educational materials, sources of information, details of forthcoming events, and original articles related to the medical field and about health subjects that matter to you. His goal is to help make your life better, to help you find your way when faced with healthcare decisions, and to help you feel better about your health and that of your family. Bill received his medical degree at Boston University School of Medicine and spent his entire career helping people find the health and medical information, support, and services they need. His mission is to help millions of people feel fantastic by restoring them to optimal health.

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