Stage 4 Pressure Ulcer

stage-four-bed-sore-in-nursing-home-patientPressure ulcers are a severe problem in nursing homes, with one study finding that nearly half of all nursing home residents have pressure ulcers. These wounds can be excruciating and often lead to infection, invasive surgeries, and death.

The nursing home abuse attorneys at Nursing Home Law Center can help. We provide a free legal case review and consultations to nursing home residents and their families who have been affected by pressure ulcers.

Our attorneys have years of experience fighting for the rights of nursing home residents, and we're ready to help you too. Call us at (800) 926-7565 or use the contact form today to schedule a free legal case review.

What are Stage 4 Bedsores?

Stage 4 Bedsores, also referred to as pressure wounds, pressure ulcers, and decubitus ulcers, are caused by prolonged pressure to any part of the body or friction to the skin.

The compromised state of the person can be due to:

  • Age
  • Impaired sensory perception (numbness)
  • Impaired mobility (paralysis)
  • Illness

These lead to a decrease in blood supply and poor nutrition, making the person susceptible to stage 4 bedsores.

According to the CDC (Centers for Disease Control and Prevention), health statistics show that most patients are at risk of severe bedsores, especially those with neurological impairment, and individuals who cannot feel pain.

A High Incident Bedsore Rate

The Department of Human Services shows that pressure ulcers in long-term care facilities are high, with a study finding that 44% of care home residents have at least one stage 3 or 4 pressure wounds.

Stage 4 bedsores are also seen in patients confined to bed for extended periods, especially if they are obese or have a compromised immune system.

Other factors that may reduce blood flow or blood supply leading to pressure ulcers include poor skin integrity (thickening skin), smoking, paralysis, and prolonged exposure to moisture.

Were you or a loved one injured by a facility-acquired bedsore? Causes Of Pressure Ulcers

A pressure ulcer is a wound that develops when the skin and soft deeper tissues are compressed for an extended time against an object, such as a wheelchair or bed. The causes include:

  • Pressure from external sources
  • Shearing-the sliding of the skin’s surface over an object such as bedsheets
  • Moisture-related skin breakdown
  • Poor nutrition
The Beginning Stages of BedSores

A pressure sore appears as warmer or reddened, darker skin than the surrounding area in its initial stage. However, the pressure sore could develop into a skin ulcer with a yellow or white color in an advanced stage.

Johns Hopkins reports that pressure ulcers are the second most common type of hospital-acquired infection. Stage 4 bedsores are the most serious due to significant dead tissue damage.

The Stages of Pressure Sores in a Nursing Home

According to National Pressure Ulcer Advisory Panel (NPUAP), Pressure wounds affecting healthy skin can be further classified as:

Stage 1 Bedsore

Early-stage bedsores involve the topmost layer of the skin and are considered a minor injury requiring minimal treatment by competent health care providers.

Stage 2 Bedsore

It involves damage to both the epidermis and dermis, thus causing fatty tissue bleeding. With this type of pressure wound, there may or may not be tenderness and pain in the affected area.

Stage 3 Bedsore

It involves suspected deep tissue injury below the dermis and subcutaneous fat; these type of pressure ulcer stages causes extreme pain and may lead to serious infection; there is also a possibility that it may involve:

  • Bone
  • Tendon
  • Muscle fatty tissue

Stage 4 Bedsore

This pressure wound involves destroying all deeper tissues beneath the skin and can be life-threatening. Fat may show in the sore along with muscle, tendon, or bone.

These stages of pressure sores are essential to understand because they provide a guideline for healthcare professionals when treating patients. Nurses should also be keenly aware of these stages and report any changes in the patient's condition to a doctor immediately.

Some Common Symptoms

The symptoms of stage 4 bedsores which are typically called pressure sores, can include:

  • Blisters on pressure point areas on the body
  • Bright red, purple, or black discoloration of the affected area
  • Skin breaks open with no blisters present
  • The sensation of intense pain in the affected area
  • A large wound that has a white or yellow color
  • An open wound that does not bleed

A failure to recognize and treat stage 4 bedsores in nursing homes could be the first sign of elder abuse, mistreatment, or negligence. Treatment is essential in the early stages of stage 4 bedsores to save the patient’s life.

Why Are Stage 4 Bedsores So Dangerous?

Stage 4 bedsore at this stage indicates that the skin has been so damaged by being unrelieved from pressure or shear factor for extended periods that the dermis and underlying layers have essentially died.

Tissue destruction can destroy muscles and bone (osteomyelitis, a bone infection). It can cause septic shock and death in severe cases.

Locations for Stage 4 Bedsores

Any location on the body can experience a stage 4 bedsore. However, pressure wounds most commonly appear on bony areas such as the heels, spine, and hips. They can also occur on many other sites, including the buttocks and shoulders.

In many cases, the location of the Stage 4 bedsore is based on the patient's health condition or mobility issues. Any individual remaining in one position for an extended period of time could be at significant risk of developing pressure ulcers. The most affected areas include:

  • Heels
  • Buttocks
  • Shoulders and shoulder blades
  • Elbows
  • Back of the head
Prevention and Treatment of Bed Sores

Nurses involved in patients' wound care should follow proper precautions to ensure that stage 4 bedsores don't develop. The following are some safety measures used to prevent pressure ulcers:

  • Adequate repositioning for the patient every 2 hours using pillows or other positions that redistribute pressure
  • Use of beds that redistributes weight and assist in proper blood flow
  • Use foam wedges
  • Keeping the skin clean and moist with lotion while observing cracks, blisters, or redness in the skin
  • Proper nutrition

Medical treatment for Stage 4 bedsores will include debridement (removal devices like mattresses, cushions, etc).

Skincare is another crucial aspect of treating pressure sores. The damaged area tends to be black or dark brown due to clotting, restricting blood flow underneath the healthy skin tissue.

The proper treatment could include:

  • Antibiotics, pain relievers, and other medication
  • Sterilized gauze and dressings
  • Skin grafting
  • Vacuum-assisted closure (negative pressure wound therapy)
  • Hyperbaric oxygen therapy

It might take several months for a patient suffering from stage 4 severe bedsores to experience healing, especially if there are health conditions. However, many patients' pressure injuries heal well and return to normal activities.

Health Prognosis for Nursing Home Residents with a Stage 4 Bedsore

A study done at the Department of Veterans Affairs showed that patients with stage 4 ulcers had a higher mortality rate if they were age 75 or older, had an acute illness, and suffered malnutrition.

Many patients with degrading sores will recover completely. However, for others, stage 4 ulcers could have a deadly outcome.

According to the National Institutes of Health, Stage II and Stage III sores have a better prognosis than those with stage 4 bedsores and are at a very high risk of infections.

Examples of health prognosis for individuals with progressive serious pressure wounds include:

  • Serious stage 4 bedsore on heels of a patient with multiple sclerosis.
  • A large wound on the heels of a patient with Crohn's disease.
  • Stage III decubitus ulcers, sacral area of a patient with spinal cord injury.
  • Dermatitis on the right ankle harmed a bed-ridden patient for three months due to pressure from the edge of the mattress and friction from the sheet. Dermatitis started as a blister and progressed to Stage II before being recognized.
  • Patient with leukemia in remission lying in bed. Decubitus ulcer (stage 4 bed sore) on the scrotum, with necrosis, where the skin dies, undermining the scrotal skin. The skin ulcer was caused by a benign tumor which prevented the patient from rolling over in bed until it was surgically removed several weeks later.
  • Positioning devices prevent the development of stage 4 bedsores and nursing home abuse residents with mobility challenges.
  • A patient with chronic lung disease lies in bed at home with a pressure sore on the bottom of the foot.
How much is your nursing home What is My Stage 4 Bedsore Injury Case Worth?

The evidence, facts, and medical conditions involved in every stage 4 bedsore event make every case unique. Because of that, it is difficult to identify the case's merits and value without an extensive assessment.

However, our personal injury attorneys use your specific valuation tools to determine a claim's value. Typically, we will determine the value of your case on certain factors, including:

  • Cost of medical expenses and hospitalization bills
  • Pain and suffering endured as a result of the injury
  • Mental and emotional distress
  • Payment of any future treatment
  • Funeral & burial costs in wrongful death cases

Our abuse attorneys at Nursing Home Law Center LLC provide a free legal case review for any individual or loved one who has been the victim of nursing home abuse or neglect.

How Long Does a Personal Injury Case Take?

We understand how difficult this question can be to answer. It is not always easy to predict how long a case might take because many factors are involved. Typically, the time it takes to resolve a matter depends on:

  • The severity of your pressure injuries
  • Strength of the evidence supporting your claim
  • Any complicated legal issues or procedures that come up during the litigation process

Typically, a personal injury case involving a simple car accident takes a few months to resolve. In contrast, a case involving nursing home abuse, neglect, or wrongful death may take several years.

Call us today if you suspect abuse or neglect at a nursing home! We have years of experience helping families get justice for victims abused by nursing home abuse pressure ulcer management in America!

Our team of experienced attorneys will fight hard on your behalf so that you can focus on what matters most – getting better wound care for your loved ones while holding abusers accountable!

Don't wait another day. Contact our office right now so we can start working together towards justice today!

Nursing home abuse lawyers ready to work on your behalh Hiring a Nursing Home Abuse Lawyer to Resolve a Compensation Claim

Our goal is to give you immediate legal assistance and representation as soon as possible after your injury.

When you come in for your free consultation, our experienced nursing home abuse attorneys will go over the details of your case and answer all your questions. In addition, we will provide you with highly confidential legal advice tailored to your case and specific circumstances.

Please call a nursing home abuse lawyer to schedule a free, no-obligation consultation with an attorney specializing in personal injury cases. Let us provide legal help and discuss receiving financial compensation for your damages.


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