Types of Bedsores
What is a Bedsore?
Bedsores are wounds that form from skin breakdown on an individual’s body. They are also referred to as pressure ulcers or decubitus ulcers. They can be extremely painful and could lead to serious life-threatening infections if left unchecked. They are most commonly formed on areas of the body where the bone and skin are in close proximity, such as the sacrum (lower back and upper buttocks), hips, and heels. Elderly people and those who are immobile are at the highest susceptibility to obtaining such injuries. These injuries occur when there is constant and continual pressure to a part of an individual’s body, like that created when a person remains in bed or a wheelchair for an unreasonable amount of time. Many times, these bed sores form as the result of neglect, where individuals who cannot help themselves are being cared for by others or an institution. Incredibly, a study from the National Pressure Ulcer Advisory Panel has found that as many as one in three individuals who have been placed in a nursing home will develop a bedsore at some point during their residency.
Types of Bedsores
Wound specialists in the medical profession categorize bedsore injuries by diagnosing them in different stages and measuring their size. The higher the stage number the more severe and painful the injury.
Stage 1 Bedsores – The skin is characteristically warm and tender when touched and visually has a reddish or purplish color. The pressure ulcer is usually smaller in size and no underlying tissue has been injured.
Stage 2 Bedsores – The skin appears blistered or has developed abrasions. A shallow wound has developed, and the underlying skin tissue has begun to become damaged. The size of this wound is usually under four (4) inches in diameter.
Stage 3 Bedsores – Skin breakdown has continued to progress, and the size of the wound can be as large as six (6) inches in diameter. The wound itself is deeper with significantly damaged skin tissue. The area surrounding the pressure injury is extremely inflamed. At this point, there may even be black spots on the skin tissue adjacent to the wound. Medical professionals refer to these spots as eschar.
Stage 4 Bedsores – There is severe skin breakdown that has punctured all three levels of the body’s skin. At this point, bone, tendons, ligaments, and muscles may be directly exposed and damaged. At this stage, the wound usually has a foul-smelling odor. Medical professionals may refer to the skin itself as necrotic, meaning that the tissue is dead.
Unstageable Bedsores – Bedsores are sometimes referenced by medical professionals as “unstageable” as the necrotic tissue is so pervasive that it obscures the damage to skin tissue. A surgical intervention known as debridement is necessary to determine the extent of the damage and to appropriately “stage” the bedsore.
Bedsores that occur in nursing homes are in many cases preventable. Contributing conditions to these pressure-related injuries include prolonged contact with moisture (including urine and stool), poor or inadequate nutrition, and a failure to regularly turn or reposition individuals who are predominantly confined to their bed or wheelchair.
Individuals who are largely confined to a wheelchair or seated position should have their position changed every fifteen (15) minutes. Individuals who are confined to their bed should have their position changed, at a minimum, every two (2) hours. Pressure-relieving devices such as pillows, wedges, and/or foam blocks should be used to accomplish this practice. Many times, the “Care Plans” of a nursing home call for people who have a high risk for skin breakdown to have a special type of mattress that decreases the chance of a bedsore developing.
Unfortunately, many nursing homes do not follow their own “Care Plans” even when they know that the risk of a bed sore is high. Nursing homes are frequently understaffed, and their immobile residents are too frequently left unattended for hours at a time creating the conditions that directly cause these pressure ulcers to develop. Moreover, a nursing home’s inattention to the care of its residents can lead to continued skin breakdown once a pressure ulcer has developed. Failing to take appropriate “interventions” directly contributes to a bed sore getting worse and is dangerous.
If you or somebody that you care about has suffered an injury due to nursing home neglect, Don’t Be a Victim Twice, call 1-800-VICTIM2 (1-800-842-8462) for a confidential and informed consultation. The call and consultation are free, of course. Greenstein & Milbauer, LLP represents their clients on a contingency basis.