What Are Bedsores or Pressure Ulcers and How Do They Develop?

Bedsores are also called pressure ulcers or decubitus ulcers. Bedsores develop when a patient is left lying or sitting in the same position for too long, restricting the flow of blood to the area of the body that is bearing the patient’s weight. Once blood stops flowing to any area of the body, the skin and surrounding tissues begin to die. The primary cause of a stage 3 or stage 4 ulcer is neglect.

Bedsores are classified in four stages:

Stage 1:

The skin appears discolored. On light skin, a bedsore will usually appear pink or red. On dark skin, it may appear ashen or slightly darker than usual. The skin may also feel slightly itchy or tender.

Stage 2: Stage 2 Bedsore

The skin is red, swollen, and has blistered or progressed to an open wound.

Stage 3: Stage 3 Bedsore

A stage 3 bed sore involves destruction of a full layer of skin and extends into the underlying subcutaneous tissue layer. Necrotic (dead) tissue may be present which is usually black in color, but may appear to be hard red or white tissue. Neglect is the primary cause of a stage 3 ulcer.

Stage 4: Stage 4 Bedsore

A stage 4 ulcer extends down into deeper soft tissues (muscle and ligaments) and may proceed all the way down to the bone. Sometimes, the ulcer is covered by a thick black scab (eschar). Neglect is the primary cause of a stage 4 ulcer.

Not all patients complain of severe pain when a bedsore is developing. A vague complaint such as “My back is sore” may be an early warning sign. Sometimes, medication prescribed for other injuries dulls the pain of a bedsore and prevents early detection. Or, if a patient has suffered nerve damage, the patient may not experience any pain at all. For all of these reasons, it is important that caregivers regularly perform thorough “skin checks” on their patients, whether they complain of pain or not. Do not assume that because your loved one is in a nursing home, he or she is being examined on any regular basis.

Continue to:

Where on the body are bedsores most likely to develop?

What can I do to prevent this from happening?

When is a bedsore the result of neglectful care?

What can I do if I think my loved one developed a pressure sore because of neglect?

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Disclaimer: The information on this site is for informational and educational purposes only. None of the medical information is intended to be a substitute for professional medical judgment. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

Injured Elder