Stage 2 Pressure Ulcer

stage-2-pressure-ulcer-nursing-home-residentA decubitus ulcer, commonly called a pressure ulcer, is an injury to the soft tissue caused by prolonged pressure on the skin. A stage 2 pressure ulcer is a bedsore that has progressed to form an open wound on the surface of the skin.

Stage 2 pressure ulcers cause immense pain, and ongoing health complications, and can be life-threatening if left untreated. Severe complications such as infection, cellulitis, and sepsis can occur resulting in prolonged pain and suffering as the condition progresses. Inadequate care and attention in a nursing home can leave residents at risk for developing stage 2 pressure ulcers.

If you suspect that a loved one has developed a pressure sore as a result of neglect in a nursing home contact the nursing home abuse lawyers at the Nursing Home Law Center, LLC today at (800) 926-7565 (toll-free phone call) or through the contact form to schedule a free consultation.

Our nursing home abuse attorneys have many years of experience representing clients who have been injured due to someone else's carelessness.

We understand the laws that apply to these cases, and we know how to get our clients the maximum compensation possible. We work on a contingency fee basis, so you don't have to pay us unless we recover money for you.

What are Pressure Ulcers?

Decubitus ulcers, known as pressure ulcers, are soft tissue injuries that result from prolonged pressure on the skin. Pressure ulcers are categorized by four stages based on the severity of symptoms, caused by varying lengths or stages of pressure.

Stage 1 Pressure Sores

Stage I bedsores are characterized by skin changes, appearing as pink or red discoloration, or possibly an ashen color in darker skin tones. Stage 1 bedsores in elderly patients with darker skin may be harder to identify, so careful attention needs to be paid to avoid the sore progressing. In a darker-skinned person, the surrounding skin may appear as a different color but lack the characteristic redness typically observed in a stage 1 bedsore.

Stage 2 Pressure Sores

Stage ii pressure ulcers present as tissue damage that has broken the skin surface. Surrounding tissues of the affected area will be red and inflamed and the topmost layer of skin tears, causing visible dead tissue and an open wound. A stage 2 pressure sore may also form a blister filled with clear fluid that penetrates the second layer of skin.

Stage 3 Pressure Sores

Stage III pressure ulcers may present as an open wound with dead tissue damage in the wound bed that penetrates the subcutaneous fat. However, damage to the deeper tissues such as the bone, muscles, and tendons will not be visible. Signs of infection such as pus, odor, or green discharge may be present.

Stage 4 Pressure Sores

Stage IV pressure ulcers are pressure injuries where there has been full-thickness tissue loss. This severity of pressure injury occurs when proper treatment was not provided in the earlier stages of the bedsore. The wound bed may have a maroon localized area of discolored intact skin and a blood-filled blister may form in the underlying soft tissue. A suspected deep tissue injury is a serious medical condition involving infection that can lead to health complications such as sepsis and sadly death.

What Causes Stage 2 Bed Sores?

The risk of stage 2 pressure ulcers is increased in elderly nursing home residents who may have limited mobility and are forced to be in one position for prolonged periods. Bedsores typically form in bony areas that have prolonged contact with an external surface.

Centers for Disease Control and Prevention (CDC) statistics state that over 2.5 million people in the United States will develop bedsores each year.

Treating pressure sores in the early stages is crucial to avoid deep tissue injury and infection. Bony prominences in the patient should be checked regularly.

Many risk factors can increase a patient’s risk of a stage 2 pressure sore forming.

  • Limited mobility caused by poor health or injury
  • A spinal cord or skeletal bone injury that leaves a patient paralyzed
  • A medical condition that impacts blood flow such as diabetes or vascular disease
  • Incontinence causing irritation of tissue through contact with urine or stools
  • Decreased sensory perception causing an inability to feel pain or discomfort
  • Poor nutrition and hydration can lead to increased susceptibility
  • Obesity can lead to increased pressure on soft tissue
  • Shear (movement of two forces in opposite directions) may cause damage to fragile tissue when a patient’s bone moves in the opposite direction to their skin

Common Locations of Pressure Ulcers

Nursing home residents are at higher risk for developing bedsores. Nursing home staff must be trained in recognizing and treating pressure-related tissue damage to the skin and seek professional medical advice promptly.

A pressure ulcer usually develops in locations where the soft tissue is compressed between a bony prominence and a surface such as a bed for a prolonged time.

If the patient has limited mobility and spends a lot of time in bed or a wheelchair they may be at higher risk for developing bedsores in the following locations.

  • Shoulder blades or shoulders
  • Hipbones
  • Lower back or tailbone
  • Sides and backs of the knee
  • Ankles, heels, and toes
  • Back or sides of the head
  • Elbows
  • Buttocks
Symptoms and Risk Factors of a Stage 2 Pressure Ulcer

A stage ii pressure ulcer will occur if a stage 1 bedsore was not recognized and treatment was not provided. If a stage 1 bedsore is suspected, the area should be assessed for visible blanching.

A test for visible blanching involves moving the patient into a position where the blood vessels of the affected area of discolored skin are not under any pressure. If the area of discoloration remains after 30 minutes then it may be the development of a stage 1 pressure sore.

Blood vessels in healthy tissue will turn white (visible blanching) when pressure is applied and then return to a normal color when the pressure is released. An area of skin that remains red and discolored when pressure is released might be a stage 1 pressure ulcer.

The skin remaining red is a sign that blood flow has been impaired in the surrounding tissues and has resulted in a pressure injury.

Complications from Stage II Pressure Ulcers

A stage 2 pressure sore or suspected deep tissue injury is a serious medical condition. Johns Hopkins University states that patients with stage 2 bedsores experience significant levels of pain and can go on to develop further life-threatening complications such as infections, cellulitis, and sepsis.

Joint Infections

An infection caused by the development of a stage 2 bedsore can infiltrate into the joints and bones. An infection in the bone is also known as osteomyelitis. Joint infections from stage 2 pressure ulcers can damage cartilage and connective tissue and are more likely to occur in pressure ulcers that have not been treated early.

Urinary Tract Infections

The Model Systems Knowledge Translation Centre (MSKTC) states that patients recovering from stage 2 pressure ulcers are at risk of developing a urinary tract infection. Patients should be monitored closely for this health condition as early treatment is essential.

Permanent Tissue Damage

Pressure ulcers that impact the deeper layers of tissue may not ever heal completely. This can cause ongoing pain and suffering and the need for constant medical attention.


Cellulitis is a deep infection of the skin that is caused by bacteria entering a wound. Patients who develop stage 2 pressure sores may be susceptible to cellulitis in the surrounding skin tissue. Signs of infection include fever, pus, and or a green discharge from the skin surface. It is essential that proper wound care is provided in treating pressure sores to stop the progression of the infection.


Sepsis is a life-threatening condition that develops from an untreated infection. This condition causes the body’s immune system to destruct tissues and organs in a response to the infection. An untreated infection from a stage 2 bedsore may lead to the development of sepsis and result in septic shock, organ failure, or even death.

Preventing a Pressure Sore and Deep Tissue Injury

It is estimated that 95% of all pressure ulcers are preventable. Nursing home staff should be trained in the detection of pressure injuries. Preventing pressure ulcers and providing medical treatment to prevent further development of sores through the four stages of injury is critical.

Recognizing and treating stage 2 pressure ulcers is essential to avoid ongoing complications such as infection and unnecessary pain and suffering. 

Common strategies for preventing stage 2 pressure ulcers include;

  • Ensure that the patient is not in the same position for longer than 2 hours
  • Conduct frequent visual skin assessments to check for signs of discoloration
  • Using a special bed that has a pump to provide constant airflow
  • Use of pressure sensing mats placed under the wheelchair or bed
  • Ensure proper skin care and hygiene by keeping the skin clean with mild soap
  • Use of foam pads and pillows to remove pressure from bony prominences
  • Avoid friction when moving the patient that could damage fragile irritated skin
  • Ensure proper nutrition and fluid intake
Treating Pressure Sores

Recognizing and treating pressure injuries with established wound healing guidelines is vital to avoid ongoing health complications. The wound healing time of stage 2 pressure ulcers ranges from three weeks through to several months depending on the treatment provided and the pre-existing health of the patient.

A clinical practice guideline for the treatment of bedsores is available from the American College of Physicians. Further information is also available from the:

  • Centers for Medicare and Medicaid Services
  • Department of Health and Human Services
  • National Pressure Ulcer Advisory Panel

Common treatment strategies to reduce the healing time for stage 2 pressure ulcers include;

  • Quality wound care with proper cleaning and specialized dressings
  • Bandaging of the pressure sore and surrounding tissues
  • Treatment of any infections with both oral and topical antibiotics
  • Removal of dead or infected tissue (debridement) - all dead tissue must be removed for the pressure sore to heal appropriately.
  • Skin care routines that involve keeping the skin adequately moisturized to reduce further damage
  • Treatment of pain with medication to relieve discomfort
  • Avoid massaging bony prominences in the affected area
  • Ensure quality nutrition is maintained - Johns Hopkins University states that dietary intake is important in reducing wound healing time. A diet rich in vitamin A and C, protein, zinc, and iron is recommended.
  • Reducing pressure around the bone and tissue with pillows and foam pads
Pressure Ulcers and Nursing Home Abuse

A nursing home provides 24-hour care and assistance with activities of daily living such as bathing, dressing, and grooming. Nursing homes are regulated by the government and must adhere to specific standards of quality and care.

The main cause of pressure ulcers in the elderly is nursing home neglect. Neglect in a nursing home can be defined as the failure of staff to provide proper care and attention that results in the injury or harm of an elderly resident.

Nursing homes and assisted living centers have a duty of care to the residents and patients that live in the facilities. The nursing staff has a responsibility to ensure pressure ulcers do not develop in patients who are at higher risk due to immobility.

Whilst most nursing homes provide professional and compassionate care, the unfortunate fact is, that elderly abuse is common. Multiple factors can contribute to negligent care in a nursing home.

Factors that can contribute to an increased risk of negligence include:

  • Insufficient training of staff
  • A lack of staff supervision from management
  • Not having enough staff on duty to ensure that elderly residents get the required level of care and attention they need

Medical Malpractice in Nursing Homes

Medical malpractice is defined as professional negligence that occurs when a healthcare provider, such as a doctor or nurse, fails to meet the appropriate standard of care required, causing harm or injury to a patient.

Examples of medical malpractice may include:

  • Failing to diagnose or recognize a condition
  • Mishandling a medical procedure
  • Prescription of incorrect medication
  • Failing to provide adequate post-operative care
  • Neglecting to provide adequate attention to a patient’s condition
How Do I Claim Compensation for Pressure Ulcers?

Did you or a loved one suffer from a pressure ulcer that you believe was caused by the negligence or abuse of a nursing home or hospital staff member?

If so, you may be able to hold the nursing home or hospital responsible and recover compensation for your losses, including medical expenses, pain, and suffering.

You must contact a nursing home abuse attorney right away to ensure that you receive the compensation you or your loved one deserve.

Compensation can cover;

  • Medical bills
  • Physical pain and suffering
  • Emotional and psychological distress
  • Cost of relocating to another nursing home
  • Rehabilitation program expenses
  • Loss of consortium
  • Funeral expenses
How Much is a Nursing Home Pressure Sore Lawsuit Worth?

Pressure sore lawsuits vary in settlement value depending on the severity of the injury sustained and the level of negligence involved. They average as much as several hundreds of thousands of dollars in Illinois, however, an Illinois nursing home pressure sore lawsuit might be worth more than a million dollars in some cases.

Pressure sore lawsuits not only provide compensation to the injured patient, but they also punish the at-fault party for their negligent misconduct so that similar harmful acts can be prevented in the future.

What Steps Do I Take to Start the Compensation Process?

You must contact the Nursing Home Law Center, LLC today at (800) 926-7565 (toll-free phone call) or through the contact form to schedule a free consultation.

Our nursing home abuse attorneys have many years of experience representing clients who have been injured due to someone else's carelessness. We understand the laws that apply to these cases, and we know how to get our clients the maximum compensation possible.

Our nursing home facility abuse lawyers operate on a contingency fee basis. We aren’t paid until we win your case.

All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.


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