Home Health & Wellness Bedsores: Symptoms, Stages, Treatments, and Actions to Take

Bedsores: Symptoms, Stages, Treatments, and Actions to Take

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Have you ever noticed a reddened area on your skin after sitting or lying down for a long time? These are pressure ulcers, also known as bedsores.

Pressure ulcers are harmful, and if left untreated, they can develop into serious wounds.

Early detection and prevention are key when it comes to bedsores. Understanding the signs and taking proactive steps can minimise the risk of developing them altogether. In some cases, bedsores can also lead to legal issues, so staying informed is crucial.

This guide will discuss everything you need to know about bedsores, from understanding the stages and symptoms to treatment options and preventive measures. 

Understanding bedsores

Bedsores, also known as pressure ulcers, develop due to prolonged skin pressure, which impairs blood flow to the affected areas. This lack of blood circulation deprives tissues of essential oxygen and nutrients, causing skin cells to die and leading to ulcer formation. Bedsores commonly occur over bony prominences such as the hips, heels, and tailbone, where the pressure is most intense.

Several risk factors increase the likelihood of developing bedsores:

  • Limited mobility. Bedridden Individuals who use a wheelchair or are otherwise immobile for extended periods are at higher risk. Regular movement is essential to maintain healthy blood flow and prevent pressure buildup.
  • Incontinence. Exposure to moisture from urine or faeces can soften the skin, making it more susceptible to damage from pressure and friction. Incontinence management is crucial to preventing skin breakdown.
  • Malnutrition. Proper nutrition is vital for skin integrity and healing. Malnourished individuals may have thinner skin and weaker immune systems, making them more prone to developing bedsores. Ensuring an adequate intake of vitamins and proteins is essential to reducing risk.
  • Older age. As we age, our skin becomes more fragile and less able to withstand prolonged pressure. This makes older adults more susceptible to bedsores.

Understanding these factors is the first step in taking preventive measures to protect against bedsores. Regular repositioning, skincare, and nutritional support are key components in minimising the risk for those most vulnerable.

Stages of bedsores

Bedsores are classified into four stages, depending on their severity. Each stage represents a different level of tissue damage, and the treatment approaches may vary. It’s essential to note that bedsores can progress quickly from one stage to another, so early detection is crucial.

Stage 1: Non-blanchable reddening of the skin

Non-blanchable redness is a defining feature of the initial bedsore stage. This means that when pressure is applied to the reddened area, it does not turn white (blanch). The skin may appear discoloured but remains intact. It could feel warmer or cooler than the surrounding tissue and may be painful or itchy. Early detection and relieving pressure from the affected area can prevent further progression.

Stage 2: Shallow open wound involving the epidermis or dermis

In stage two, the bedsore evolves into a shallow, open wound that affects the epidermis (the outer layer of skin) or the dermis (the layer beneath the epidermis). The area may also present as a blister, either intact or ruptured. The wound bed appears pink or red and is moist. Prompt cleaning and wound dressing are necessary to prevent infection and promote healing.

Stage 3: Deeper wounds reaching the subcutaneous fat layer

A stage three bedsore is characterised by a deeper wound that extends through the dermis and into the subcutaneous fat layer. The ulcer appears as a deep crater with or without undermining adjacent tissue.

Fat may be visible at this stage, but muscle, tendon, and bone are not exposed. The risk of infection is significantly higher, and advanced wound care, including debridement and specialised dressings, is required to manage the wound effectively.

Stage 4: Extensive tissue damage involving muscle or bone

The most severe stage, stage four, involves extensive tissue damage that reaches muscles, tendons, or bones. These deep wounds often present with significant necrosis (dead tissue) and may have areas of tunnelling, where the wound extends further beneath the skin than is visible on the surface.

This stage carries a high risk of serious infections, such as osteomyelitis or sepsis. Comprehensive medical treatment, which may include surgery, is crucial for managing stage four bedsores.

Symptoms of bedsores

While the severity of symptoms increases with each stage of bedsore, some common signs can appear early on. Here’s what to watch out for:

  • Skin discolouration. Look for changes in skin colour, especially redness that doesn’t fade when pressed. The area might turn purple or become a deeper shade in darker skin tones. The skin might look pale or even black in later stages due to tissue death.
  • Temperature changes. The affected area might feel warmer or cooler than the surrounding skin.
  • Pain or tenderness. People with bedsores often experience pain, burning, or tenderness at the pressure point.
  • Broken skin. Blisters or open wounds may develop as the condition progresses.
  • Drainage. In later stages, pus or fluid may ooze from the wound, which could indicate infection.

If you or a loved one experience any of these symptoms, seeking medical attention is crucial, as early treatment can prevent further progression and complications.

Treatment options for bedsores

Fortunately, bedsores are treatable, but the approach depends on their severity. The main goal is to relieve pressure and promote healing. This might involve:

  • Frequent repositioning. Regular weight shifts are key. For those with limited mobility, carers can help with repositioning every few hours.
  • Specialised support surfaces. Special mattresses, cushions, and pillows can help distribute pressure more evenly.
  • Wound care. Keeping the wound clean and properly dressed is crucial. This might involve gentle cleaning and using specific dressings to promote healing.
  • Nutritional support. A healthy diet of protein and vitamins helps the body heal. Supplements might be necessary in some cases.
  • Treating underlying conditions. It is also important to address any underlying medical conditions contributing to bedsores, like diabetes or malnutrition.

In more severe cases, surgery may be necessary to remove dead tissue and promote healing. It’s essential to work closely with a medical professional to determine the best course of treatment for each individual.

Protecting yourself from bedsores

The good news is that bedsores are largely preventable! By taking some proactive steps, you can significantly reduce your risk. Here are some key strategies:

  • Regular skin checks. Inspect your skin daily, especially areas prone to pressure, like your tailbone, heels, and elbows. Look for any signs of discoloration, warmth, or swelling.
  • Fuel your body. Eating a balanced diet rich in protein and fluids keeps your skin healthy and promotes healing.
  • Move it or lose it. Regularly shift your weight to relieve pressure. If you have limited mobility, set a timer for repositioning every two hours or as directed by your doctor.
  • Pressure relief is your friend. To distribute pressure more evenly, consider using pressure-relieving devices like specialised mattresses, wedges, or cushions.
  • Manage incontinence. Address incontinence issues promptly. Wet or soiled skin is more prone to breakdown and infection.

When to seek legal help

In some cases, bedsores occur due to negligence or inadequate care in nursing homes or healthcare facilities. If you or a loved one experienced bedsores while under the care of medical professionals, it’s crucial to seek legal help.

A skilled attorney can help you understand your rights and options for seeking justice and compensation for any pain and suffering caused by negligent care. Don’t hesitate to reach out for support if you believe your loved one’s bedsores were preventable and caused by neglect.

Most bedsores can heal successfully with proper care. However, it’s essential to remain vigilant and address any symptoms promptly to prevent further complications and promote healing.




Tim Williamson, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.

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