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Bedsore Stages & Development

A bedsore, also referred to as a pressure sore, pressure ulcer and decubitus ulcer, is a localized injury on skin or underlying tissue, usually occurring over a bony area. 

The bedsore is often caused by pressure, friction or shearing of soft tissue on the body, resulting in partial or complete blood flow obstruction. Shearing can stretch and tear blood vessels feeding the skin.

If your loved one has a stage three or stage four pressure sore during a nursing home admission, you may be entitled to pursue a case against the facility for negligence. Free legal case reviews.

Bed Sore Development


Common areas for bed sore development can include the buttocks, sacrum, tailbone, ankles, knees, hips, heels, shoulders, shoulder blades and the back and sides of the head. Individuals most susceptible to developing pressure ulcers are the elderly, disabled, bed bound and wheelchair-bound individuals, and those that do not have the ability to reposition themselves without assistance.

Those that are malnourished, dehydrated or with fragile skin, bowel incontinence, urinary incontinence or suffering Alzheimer’s disease have an increased potential of developing a pressure ulcer. 

Though decubitus ulcers can be serious and life-threatening, they are highly treatable, especially in early stages, and recovery can be complete with proper diagnosis and care.

The staging process for decubitus ulcers was developed by the National Pressure Ulcer Advisory Panel to assist practitioners and healthcare providers in properly diagnosing and treating bedsores. Below is a complete list of bed sore stages and development.

Stage One Bedsores

Recognizing a bedsore at stage one allows the caregiver to intervene and take quick action as early as possible to prevent the condition from becoming worse. Indicators of a stage one pressure sore include:

  • The skin is intact (unbroken) but discolored. A reddened area will appear on individuals will light complexion and purple, bluish or white on people with darker complexions.

  • There is a detectable change in skin temperature – either cool or warm when compared to surrounding skin areas.

Stage Two Bedsores

Stage two pressure ulcers are advancing sores where the condition is significantly worse than stage one. Common indicators include:

  • The skin appears warm to the touch and has the indicating signs of stage one in addition to,
  • The skin is broken at the uppermost layer (epidermis), which creates an open, shallow sore
  • At this stage, drainage could be present

Stage Three Bedsores

At this stage, there is significant progress of a serious pressure ulcer, and proper medical treatment using proven methods, devices and dressings is required. Indicators include:

  • The skin show signs of ulceration extending through the second skin layer (dermis) into fat and subcutaneous tissue
  • The sore is significantly deeper as compared to a stage two ulcer

Stage Four Bedsores

Stage four bedsores are often life threatening, where serious infection is likely to occur. Common indicators include:

  • The ulcerated tissue breakdown now extends deep into the muscle and possibly the bone
  • There is typically a significant amount of dead (necrotic) tissue
  • The wound is open

At this stage, the wound is usually draining. It is imperative to seek immediate medical care. More than likely surgery or debridement will be required to manage the wound. Most stage four bedsores take up to one year to heal, when healing is possible.

What to Do If Your Loved One Has an Advanced Stage Bed Sore?

On the first sign of a pressure sore, it is essential to relieve the pressure for up to 30 minutes to allow blood flow to be restored to the area. Note that just because the sore appears small in size, it may not present a little problem. This is because skin damage often starts below the top layers.

In addition to treatment, typical steps to avoid or minimize the progression of the condition to advancing bed sore stages include:

  • Keep the pressure off the area
  • Maintain good hygiene to the area
  • Improve diet and hydration
  • Minimize friction when moving or repositioning
  • Seek medical care from a wound care expert

Hiring an Attorney to Prosecute an Advanced Bed Sore

Stage three and stage four bedsores are serious conditions that can take the life of the individual. This is because these sores are challenging to heal and restore health. Healthcare providers recognize that advancing bedsore stages never need to occur, and are often the result of negligence by caregivers. Because of that, many families hire an attorney to stop the neglect of their loved one suffering from an advancing pressure sore.

Nursing Home Law Center LLC at (800) 926-7565 can assist you in recovering damages if a loved one has been neglected in a nursing home, hospital, assistant living facility, resident home, group home or other medical center. Our network of attorneys specializes in medical malpractice and elder abuse cases, and have assisted many victims seeking justice and financial compensation. We offer a free initial consultation to discuss your claim and provide valuable legal options on how to proceed.

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