Bedsore Stages

Written By: Kenneth LaBore | Published On: 3rd February 2017

Wound Care After Bed Sore Stages Injury

Bedsore Stages of Injury

Bedsore stages is the same as the stages of a pressure injury.  There are many different names for bedsores, including the same word split into bed sore, pressure injuries, pressure sores, pressure ulcer and decubitus ulcer all are a way of explaining skin breakdown which and the related wound which is then set into stages.  All of these wounds are considered preventable in most cases with proper care and treatment.

According to the Mayo clinic, bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone. People most at risk of bedsores are those with a medical condition that limits their ability to change positions, requires them to use a wheelchair or confines them to a bed for a long time.
Bedsores can develop quickly and are often difficult to treat. Several things can help prevent some bedsores and help with healing.

Wound Characteristics Determine Bedsore Stages

The stages of the bedsore injuries is determined on the characteristics of the wound.  To determine the stage of a wound the provider needs to examine and measure the wound and chart related characteristics such as size (length x width x depth), as well as, the color of the skin and surrounding area, smell, texture and other specifics needed to analysis the wounds origin and progress towards healing.

According to Wikipedia, pressure ulcers occur due to pressure applied to soft tissue resulting in completely or partially obstructed blood flow to the soft tissue. Shear is also a cause, as it can pull on blood vessels that feed the skin. Pressure ulcers most commonly develop in individuals who are not moving about, such as those being bedridden or confined to a wheelchair. It is widely believed that other factors can influence the tolerance of skin for pressure and shear, thereby increasing the risk of pressure ulcer development. These factors are protein-calorie malnutrition, microclimate (skin wetness caused by sweating or incontinence), diseases that reduce blood flow to the skin, such as arteriosclerosis, or diseases that reduce the sensation in the skin, such as paralysis or neuropathy. The healing of pressure ulcers may be slowed by the age of the person, medical conditions (such as arteriosclerosis, diabetes or infection), smoking or medications such as anti-inflammatory drugs.

Information About Bedsore Stages

According to St.Luke’s Health System, the stages of pressure sores bedsores is as follows:

Stage 1

The unbroken skin is red and nonblanchable. Note: It may be difficult to determine blanching in darker skin tones. The affected area may differ in color from the surrounding skin.

  • Goal: Prevent further progression of the injury and support blood flow.
  • Implement treatment plan for (Suspected) Deep Tissue Injury.
  • Cleanse and lightly moisturize the skin. Note: Never massage the affected area. This can cause further damage to tissue. Allow the moisturizer to dry before placing any additional pressure on the area.
    Apply protective dressing, if indicated.
  • Evaluate nutritional intake

Stage 2

Partial-thickness skin loss has occurred and the wound bed is red-pink in color. Slough is not present, but a broken or intact serum-filled blister may be evident.

  • Goal: Prevent full-thickness injury and continue to promote healing.
  • Implement treatment plan for previous stages.
  • Apply dressing to keep wound bed moist and promote healing.
  • Protect fragile skin from adhesives.
  • Reevaluate nutritional intake.

Stage 3

Full-thickness skin loss has occurred. Slough may be present. Subcutaneous fat may be visible, but bone, tendon, or muscle are not. Undermining or tunneling may also be present.

  • Goal: Maintain a clean, moist wound bed to prevent infection and promote new tissue growth (granulation).
  • Implement treatment plans for previous stages.
  • Remove dead tissue (debridement), if needed.
  • Absorb drainage.
  • Fill the injury cavity with appropriate dressing.
  • Evaluate the need for nutritional consultation.

Stage 4

Full-thickness skin loss has occurred. Bone, tendon, or muscle is exposed. Slough or eschar may be present, but the base of the wound can be seen. Undermining and tunneling are often present.

  • Goal: Reduce drainage, remove dead tissue, and establish an environment for new tissue growth.
  • Implement treatment plans for previous stages.
  • Report bone involvement.
  • Treat infection with antibiotics, if indicated.
  • Discuss with the healthcare provider whether surgery is needed.

Unstageable

Full-thickness skin loss has occurred. Slough or eschar covers the wound base. The wound depth cannot be determined because of the slough or eschar.

  • Goal: Determine stage, provide moist environment, and prevent further breakdown.
  • Debride the wound. Do not debride the heel unless signs of infection are present.
  • Reassess injury stage once base is visible.
  • Manage pain of injury.
  • Assess for infection.
  • Discuss pressure injury with the healthcare provider.

For more information see pressures injury stages

Worsening Bedsore Stages Neglect Attorney

If you have questions about bedsore injuries nursing home abuse and neglect contact Kenneth LaBore for a free consultation.  There is no fee unless there is a verdict or settlement offer from the wrongdoer.  Mr. LaBore has handled dozens of bed sore and pressure injury cases and can be reached directly at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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