What Do Bedsores (Pressure Ulcers) Look Like In 4 Stages

Bedsores (pressure ulcers) are preventable injuries that occur when individuals do not receive appropriate care. Consequently, if an individual develops bedsores in a healthcare facility or a nursing home, the establishment may have been negligent and did not provide adequate care.

You or your loved one can hold such a facility liable for damages.

However, to better help you understand why these bedsore injuries can result in legal action, we have created the following blog. In it, we will dive into everything you need to know about these injuries, including the different stages associated with them and how severe they can get.

Bedsores An Overview

Bedsores, also called pressure ulcers or decubitus ulcers, are injuries to the skin and the underlying tissues, which result from prolonged pressure on the skin.

Typically, these bedsores tend to develop on the areas of the skin that cover the bony areas of the body, including the:

• Tailbone
• Buttocks
• Shoulder blades
• Spine
• Back of the legs and arms
• Back or sides of the head
• Hips or lower back
• Heels, skin behind the knees and ankles

Bedsores can generally develop over a few hours or days. However, even though most of these sores can heal with treatment, some will never completely recover and may even result in devastating consequences.

Who Is Most at Risk of Developing a Bedsore?

Individuals who are often most at risk of developing these bedsore injuries are those with a medical condition that limits their ability to change positions or causes them to spend most of their time in a chair or bed.

As a result, those most vulnerable of developing a bedsore are those who cannot move themselves, including people who:

• Suffer from paralysis
• Suffered a spinal cord injury
• Suffered a stroke
• Have a nerve disease
• Have decreased mental awareness

Generally, most of these bedsores occur in those over the age of 70, as the skin of older people is often thinner and heals more slowly. Thus, people in a nursing home tend to develop bedsores more frequently than others. In addition, those who are malnourished, undernourished, smoke, have problems with bladder or bowel control, blood circulation issues, and diabetes are also at an increased risk of developing these bedsores.

Symptoms of a Bedsore

There are often various warning signs that a pressure ulcer is developing, including:

• Skin swelling
• Pus-like draining
• Changes in the skin’s texture or skin color
• Tender areas
• An area that feels warmer or cooler to the touch than other areas

As these bedsores develop, the damages will often range from red, unbroken skin to a severe injury involving muscles and bones. However, the extent of the injury will depend on which stage the bedsore falls into based on the injury’s depth, severity, and other characteristics.

Causes of Bedsores

Bedsores are often caused by pressure against the skin that ends up limiting blood flow to the area. There are generally three primary contributing factors that tend to cause these pressure ulcers.

They include:

• Constant Pressure: When part of the body experiences continuous pressure, it can lessen the blood flow to the tissues. Because this blood flow is essential for delivering nutrients and oxygen to the tissues, the nearby tissue and the skin will die without these nutrients.
• Shear: A shear occurs when two surfaces move in opposite directions. For instance, if an individual slides down in their bed, their tailbone will likely move down, as their skin over the bone will stay in place. This will result in these surfaces moving in opposite directions.
• Friction: Friction occurs when the skin rubs against the bedding or a person’s clothing. This friction can cause fragile skin to become more vulnerable to injury, especially if the skin is moist.

Different Stages of Bedsores

A bedsore injury will often be broken up into four different stages, based on how deep the sores are and the required treatment plan. These stages include:

#1. Stage One

The first stage is considered the mildest stage and occurs when the bedsores only affect the upper layer of the skin. Symptoms at this stage often include burning, pain, or itching. However, the bedsore may also feel different from the surrounding area, either having a softer or firmer feel or feeling cooler or warmer to the touch.

In addition, you may notice a red area on the skin, or if you have darker skin, the site can become discolored, but it may be harder to see. However, one key indicator that these spots are bedsores is they will not get lighter when you press on them, and they will often remain there even 30 minutes after you stop putting pressure on that part of the skin. Again, this is due to there being less blood getting to the area.

That is why it is so important that nursing home staff or health care professionals move individuals who are bedridden every two hours and those who are in a chair every 15 minutes.

The Recovery Period: At stage one, bedsores tend to go away in as little as two or three days when proper action is taken.

#2. Stage Two

At this stage, the bedsores dig deeper below the skin’s surface and often leave broken skin, open wounds, and blisters. The bedsore will also appear swollen, red, and warm, and the blisters may ooze clear fluid or pus. These bedsores can also be incredibly painful.

Generally, treatment for a bedsore at this stage involves making sure the injury site is kept clean, and you reach out to a doctor for further treatment, such as pain medication.

The Recovery Period: If a bedsore is considered a stage two pressure ulcer, the injury can take anywhere from three days to three weeks to heal with proper care.

#3. Stage Three

At stage three, the bedsore will have gone through the second layer of the skin into the fat tissue. These sores will look like craters and may give off a foul odor. The sore may also give off signs of an infection, including pus, red edges, drainage, and heat. The tissue in or around the sore may also appear black as if it has died.

If the bedsore has reached stage three, it needs proper medical care, including antibiotics to fight infection, special mattresses to help with the constant pressure, and even the removal of dead tissue.

The Recovery Period: At stage three, pressure ulcers will take at least one week to heal but can take up to four months.

#4. Stage Four

Stage four sores are considered to be the most severe, often affecting the ligaments and the muscles. These bedsores are usually deep and large, cause the skin to turn black, and tend to show signs of infection, including a foul odor, heat, pus, red edges, and drainage. In addition, you may also see the muscles, tendons, and bones once doctors clean the bedsore out.

Individuals with a stage four bedsore will need immediate medical attention and may even require surgery to heal the wound.

The Recovery Period: A stage four pressure ulcer could take anywhere from three months to even years to heal.

#5. Other Stages

In addition to the four main stages, a bedsore can fall into two other stages:

• Unstageable pressure ulcers, which are ulcers where you cannot see the bottom of the sore, so you do not know how deep they are. Consequently, a doctor can only stage it once it has been cleaned out.
• A Suspected Deep Tissue Injury (SDTI), which is a bedsore that looks like it is stage one or stage two on the skin’s surface, but underneath the surface, the bedsore is at stage three or four.

If your loved one suffered a bedsore injury in a nursing home facility, you must reach out to an experienced bedsore lawyer as soon as possible.

Complications of Bedsores

Even though bedsores are often associated with pain, itching, and skin discoloration, they can also result in complications, some of which can kill patients.

These complications include:

• Cellulitis: This is an infection of the skin and the connected soft tissues, which can cause warmth, swelling, and redness of the affected area. Individuals with nerve damage often do not feel pain in the area that is affected by cellulitis.
• Infections: An infection from a bedsore can burrow into a person’s bones and joints. These joint infections (or septic arthritis) can damage the cartilage and tissue, while a bone infection (or osteomyelitis) can reduce a person’s function of their limbs and joints.
• Cancer: Typically, long-term, non-healing wounds can develop into a type of squamous cell carcinoma.
• Sepsis: Although rare, a pressure ulcer can often develop into sepsis.

Actions to Take After You Notice a Bedsore

If your loved one is in a nursing home facility and develops a pressure ulcer due to the facility’s negligence, you need to act fast. Not only to make sure your family member gets the immediate medical help they need but also to protect their legal rights.

Once you discover a bedsore, you need to contact a lawyer, who might:

• Take photos of the bedsore and write down the date of each of these sores.
• Request paperwork and documentation from the nursing home, including performance reports of the staff involved in the care of your loved one.
• Obtain copies of any former claims or negligent allegations against the nursing home.
• Request a thorough explanation of the residents’ care steps.
• Request a list of warnings, reprimands, or violations that the staff or the nursing home had in the past.

Gathering these documents can play an important role in a legal claim if you choose to pursue one. However, if you cannot obtain this paperwork or run into dead ends, do not worry. Once you retain an experienced bedsore attorney to take on your case, your lawyer can gather the evidence required to prove how your loved one obtained a bedsore injury and the extent of damages that resulted.

After Developing a Bedsore, How Can an Experienced Bedsore Attorney Help You?

Because bedsores are avoidable injuries, they are often associated with hospital negligence or nursing home abuse or neglect. That is why, if you or a loved one suffered a bedsore injury in a nursing home facility, you must reach out to an experienced bedsore attorney as soon as possible. Your lawyer can promptly get to work figuring out how this bedsore injury occurred, who was at fault for this injury, and what they need to do to get you the damages you and your loved one deserves.

To get you this justice, your lawyer can:

• Go over the incident in question with you in detail, evaluate your case, and determine if you have a viable legal claim.
• Answer any questions you have about the incident and the legal process involved.
• Help you figure out your legal options and which one you should pursue.
• Investigate the incident and secure the evidence required to show fault and damages.
• Hold all the wrongful parties accountable for the harm and losses you sustained.
• Bring in experts such as doctors to substantiate your claims.
• Handle all the discussions and negotiations with the other side, including the insurance company, and fight for a fair settlement offer.
• Take your case to trial, if required, and go after the maximum damages you deserve.

If you or a loved one suffered a bedsore injury because of another person’s wrongful, reckless, or negligent actions, do not wait any longer to get the legal help you need. Instead, contact an experienced bedsore attorney today for a free case evaluation and let these lawyers show you how they can go after the financial recovery you deserve.

Nathan Hughey

Nathan Hughey, an attorney and fourth-generation South Carolinian, founded Hughey Law Firm in 2007. Before that, he spent five years defending nursing homes and insurance companies. Leveraging his experience, he now advocates for those injured or wronged by such entities, securing over $220 million in verdicts and settlements.