Stage I Bedsore: The skin reddens, but it remains unbroken.
Stage II Bedsore: Redness, swelling, and blisters develop.
There is possibly peeling of the outer layer of the skin.
Stage III Bedsore: A shallow open wound develops on the skin.
Stage IV Bedsore: The sore deepens, spreading through layers of skin and fat down to muscle tissue.
Stage V Bedsore: Muscle tissue is broken down.
Stage VI Bedsore: The underlying bone is exposed, and there is danger of severe damage and infection.
More information about Bedsores , Pressure Ulcers, Decubitus Ulcers and what causes them.
Pressure ulcers may be caused by inadequate blood supply and resulting reperfusion injury when blood re-enters tissue. A simple example of a mild pressure sore may be experienced by healthy individuals while sitting in the same position for extended periods of time: the dull ache experienced is indicative of impeded blood flow to affected areas. Within hours, this shortage of blood supply, called ischemia, may lead to tissue damage and cell death. The sore will initially start as a red, painful area, which eventually turns purple. Left untreated, the skin may break open and become infected. Moist skin is more sensitive to tissue ischemia and necrosis, and is also more likely to get infected. Shear is a separate mechanism of tissue damage that results in ripping of deeper tissue layers, and it may not immediately cause a visible change in skin condition. Shear injury may manifest as bruising or changes in tissue temperature and color and, later, tissue sloughing and necrosis. Unlike friction, shear injury may cause deep tissue damage. Pressure ulcers involving sub-dermal tissue damage, where damage originates in muscle tissue, were recently (2005) termed "deep tissue injury" (DTI) by the US National Pressure Ulcer Advisory Panel, and are attracting growing attention by the medical community.
Some studies suggest that 3 to 10 percent of hospitalized patients have pressure sores, with two-thirds occurring to patients over the age of 70. Younger people with neurological impairments also develop pressure sores, because they remain in one position and cannot feel irritation or building pressure. Between five and eight percent of these people have pressure sores during a year.
The condition is prevalent in sedentary individuals, such as those living with paralysis or confined to a bed because of illness or impairment.
Nursing homes and hospitals usually set programs to avoid the development of bedsores in bedridden patients (e.g. moving them every two hours, using a standing frame to reduce pressure, ensuring dry sheets, or the use of a medical air mattress etc.). Poor nutrition is also a major factor in the formation of pressure sores. In particular, Zinc and Vitamin C deficiency and hypoalbuminaemia. For individuals with paralysis, pressure shifting on a regular basis and using a gel cushion featuring pressure relief components can help prevent pressure wounds.
Pressure-distributive mattresses, alternating pressure, and low air loss mattresses are used to reduce high values of pressure on prominent or bony areas of the body. Methods to evaluate the efficacy of these products have only been developed in recent years (Bain et al 1999).