Any patient confined to their bed or a wheelchair is in danger of developing bedsores if the right care is not taken to move them regularly. Bedsores, or pressure ulcers, are wounds that develop due to ongoing pressure, usually against a bony protrusion, and the reduction of blood flow and air circulation to the area. They can quickly grow from minor to serious and even life-threatening, as well.
The Four Stages of Bedsores
Bedsores are graded according to four different stages. Each stage carries with it its complications and potential injuries.
Stage 1: In a stage 1 bedsore, there is no actual open wound. The skin will appear red in paler skinned patients. In darker skinned patients, the area will appear a different color (but not red). In both lighter and darker skinned patients, the affected area may feel softer than the area around it, or it may feel firmer than the surrounding area. Note that the skin is not broken in a stage 1 sore, but it will likely be painful and tender. Treatment for stage 1 bedsores is the simplest and usually, consists of ensuring the patient is constantly moved.
Stage 2: In a stage 2 bedsore, the outer layer of the skin is damaged or lost completely. This is the beginning of the “open wound” stage, and the wound itself may be pink or red. It will be shallow at this point. In some patients, stage 2 sores appear to be blisters, although larger than blisters that might form on the hands or feet due to friction. It may also appear to be a “crater”. Under this layer, the wound goes deeper, with further tissue deterioration that is invisible to the naked eye. It is possible for skin to be damaged beyond repair even at this early stage, which makes it even more vital for proper medical care to be provided. Moving and wound treatment can be used to heal the sore.
Stage 3: In a stage 3 bedsore, the wound deepens and now extends into the tissue below the skin. Even if the wound looked like a blister during stage 2, by stage 3, it would resemble a crater in the skin. It is possible that the wound will show a layer of fat (or part of a layer of fat), although the muscle or bone will not be visible yet. At the bottom of the sore, you may notice yellowed, dead tissue. It’s also possible that bedsore now extends beyond the edges of the visible sore, beneath the seemingly healthy skin, which will eventually die as well. During stage 3, the potential for serious infection increases. Surgery will be needed, coupled with an in-wound pump to remove the infection.
Stage 4: In a stage 4 bedsore, the wound will likely show not just tissue and fat, but also tendons, muscle and possibly bone. At the bottom of the wound (the deepest point), you will likely notice dark, discolored, dead tissue. This tissue will likely be hard, forming a crust at the bottom of the wound. The ulcer extends to the sides below the healthy skin, and will continue to enlarge. Depending on the location of the ulcer, it is possible for permanent damage to be caused to the bone and joints (if any are affected). Significant infection is also now very likely, which can become life-threatening.
Symptoms of Bedsores
Note that in stage one; bedsore will be uncomfortable, but it is only in stage 2 that it becomes very painful. Stage 3 and stage 4 bedsores are usually not very painful because of the significant death of tissue. As bedsores grow, it is possible for any infection to spread from the dying tissues to the bone, as well as the blood. In these cases, increased pain will be noticed, and the potential for lethality increases dramatically.
If your loved one is suffering from bedsores as a result of neglect within a nursing home, it is vital that you report it to the government, and that you contact an experienced elder abuse attorney to determine if you have a case against the nursing home or staff.