When it comes to developing bedsores, also known as pressure ulcers, you may have a few questions about where they come from or how it happened. Bedsores are sadly all too common- particularly within a nursing home or residential care setting, and whilst they are treatable they’re also completely preventable. With many family members sharing their concerns with our attorneys on neglect and nursing home care levels, our team has gained a lot of knowledge and experience on the topic of bedsores.

Tragically, some bedsores go on to cause further health complications and have even resulted in death, with the nursing home becoming responsible. We’ve worked on many bedsore cases and recognize the importance of raising awareness about them for our clients. Our FAQ covers many of the questions we face when handling bedsore cases.

What Are Bedsores?

Bedsores are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. These kinds of injuries are very common in older people with restricted mobility who tend to spend a long time sitting down or lying in bed. There are steps to help prevent bedsores and help them heal, but some never heal completely.

What causes bedsores?

The majority of causes for bedsores have to do with two things – pressure and contact with the skin. From friction to failure to reposition a patient, ulcers appear due to failure of taking precautions or care and can happen within a matter of hours if someone is left alone in the same position. In a nursing home, bedsores are most commonly caused by;

Immobility-  This might be due to poor health, injury, or other health conditions but the inability to move will often result in more pressure on the skin for longer periods of time, putting them at greater risk.

Incontinence- Incontinence can cause the skin to become more vulnerable, as it’s exposed to urine and feces for a longer period of time. Keeping skin clean and dry is key to stop bedsores 

Lack of sensory perception– Spinal cord injuries, neurological disorders, and other conditions can result in a loss of sensation which means someone is unable to feel pain or discomfort. This can lead to someone being unaware of warning signs and the need to change position.

Poor nutrition and dehydration– In order to maintain healthy skin and prevent the breakdown of tissues, we all need a healthy combination of a good diet with vegetables and proteins, sunlight, and plenty of water. Sadly, these don’t often 

Medical conditions affecting blood flow- Health problems that can affect blood flow, such as diabetes and vascular disease, can increase the risk of tissue damage such as bedsores.

Where can bedsores develop?

Pressure sores can develop anywhere on the body that comes in contact with pressure or friction. For residents who use wheelchairs, or are mostly chair bound, bedsores often appear on the:

  • Tailbone or “coccyx”
  • Buttocks
  • Shoulder blades
  • Spine
  • Backs of arms and legs 

For people who need to stay in bed, pressure sores often develop on:

  • Back or sides of the head
  • Shoulder blades
  • Hip
  • Lower back
  • Tailbone or “Coccyx”
  • Heels of the feet
  • Ankles
  • The skin behind the knees

How bedsores are diagnosed

A healthcare provider will diagnose a pressure sore into one of the four stages, by inspecting the skin before staging them according to their appearance and symptoms. Pressure sores are categorized into 4 different medical stages:

Stage I bedsores

The mildest stage as it’s the onset of a pressure sore, a stage one sore affects the upper layer of the skin with symptoms that include:

  • Pain, burning, and/or itching sensation
  • Firmer or softer than the surrounding skin
  • Warmer or cooler to the touch, compared to the surrounding skin
  • Visibly red skin

Stage 2 bedsores

At stage 2, the skin starts to die and peel away due to a lack of oxygen, as the blood that provides oxygen has been cut off by the pressure. Stage 2 pressure sores are open wounds and the risk for infection is great if left untreated, with symptoms like;

  • Looks like a blister, sometimes pus-filled
  • Broken skin
  • The area is swollen, warm, and/or red
  • May ooze clear fluid or pus
  • Painful 

Stage 3 bedsores

OnCe a pressure ulcer reaches stage 3 it will have gone through the second layer of skin and into the fat tissue. This stage is identified by the tissue loss accelerating and ligaments and tendons now beginning to deteriorate. The sore will start to look visibly infected with symptoms including; 

  • Looks like a crater
  • May start to smell
  • Red edges
  • Pus
  • Heat
  • Drainage
  • Dead tissue may appear black
  • May also see body fat in the middle

Stage 4 bedsores

At this point, the pressure sore has reached the bone as stage 4 pressure sores can affect the bones, muscles, ligaments, tendons, and joints. Aside from infection in the body being obvious and the pain clearly taking effect, symptoms will include;

  • The sore being visibly deep 
  • The skin has turned black
  • Red edges
  • Pus
  • Odor
  • Heat
  • Drainage
  • Tendons, muscles, and bone may also be visible
  • Significant pain

How to treat bedsores?

As we’ve mentioned, bedsores at all stages are treatable and must be dealt with sooner rather than later. Stage one sores can be easily treated by removing the pressure on the surrounding area and allowing the area to heal itself. A gentle wash with mild soap and water can help keep the area clean to allow for self-healing. If necessary, using a moisture barrier cream can be applied to protect the area from bodily fluids.

Stage two caught in the early stages is still straight forward, starting with a gentle flush with salt water to remove loose, dead tissue. Then, a special dressing is applied to help protect against unwanted agents that can cause an infection whilst helping to keep the area moist enough to heal. When a sore reaches stage three, the most important treatment involves cleaning and dressing the wound properly. Ulcers at this point are very painful so it’s best to have a healthcare professional treat it with medication to help the pain. The damage at this stage can be intense and skin grafts may also need to be used.

Despite being the most serious level of bedsores, stage four sores are treated the same by removing the pressure, cleaning and removing any debris. However, because of the extent of the damage surgery will probably be required as well. One method of surgical repair is to use a pad of muscle, skin, or other tissue to cover the wound and cushion the affected bone, known as ‘flap surgery’.

Can bedsores be prevented?

Yes, bedsores can be prevented by the regular movement to help reduce stress on the skin. Other strategies include taking good care of the skin, maintaining good nutrition and fluid intake, quitting smoking, managing stress, and exercising daily. Anyone at risk of bedsores should be taken care of with regular routines to be moved to help blood circulation and airflow to all parts of the skin. Bedridden patients should be repositioned on either side at least once every 15 minutes, while anyone seated for a long time should be repositioned about once an hour. Using donut cushions or particular mattresses that relieve pressure can also help prevent the development of bedsores. 

 Can pressure sores be left untreated?

No. While the treatment for pressure sores in its early stages is relatively simple, it can’t heal without treatment. If left untreated, pressure sores will advance through the stages, becoming extremely difficult to treat and can even lead to death. 

The information available about bedsores is vast and can feel overwhelming, but for those impacted by poor treatment or general neglect that has caused a pressure ulcer, this information can be vital. If you or a loved one is a victim of this kind of maltreatment or neglect, call Thompson Law Firm today for a free case consultation.

Our experienced attorneys offer comprehensive guidance on all personal injury matters by phone or video conference call.

Our team of lawyers work closely with their injury clients across Arizona, communicating clearly whilst offering reassurance and empathy through an often very difficult and emotional process. During the free consultation, our lawyers will discuss your concerns before creating a comprehensive plan for you, while also assessing the strength of your claim.

Call (480) 634-7480 & Speak To One Of Our Attorneys

Submit your information and we will reach out soon