Stages of pressure sores and how to care for them: Pressure
sores are categorised into four key stages depending on their age
and severity. It is always wise to seek medical advice
from a Doctor or health care giver if you suspect the start of a
pressure sore when away from a hospital environment. As
with most potential complications it is best to intervene as
early as possible to prevent the problem worsening.
How to recognise: Skin is
not broken but is red or discoloured. The redness or change in colour
does not fade within 30 minutes after pressure is removed.
What to do:
- Keep pressure off the sore!
- Maintain good hygiene. Wash with mild soap and water, rinse
well, pat dry carefully (but gently). Do not rub vigorously directly
over the wound.
- Evaluate your diet -- are you getting enough protein, calories,
vitamins A and C, zinc and iron? All of these are necessary for
- Review your mattress, wheelchair cushion, transfers, pressure
releases, and turning techniques for possible cause of the problem.
- If the sore seems to be caused by friction, sometimes a protective
transparent dressing such as Op-Site or Tegaderm may help protect
the area by allowing the skin to slide easily.
- If the sore does not heal in a few days or recurs, consult
your Doctor or health care provider.
How to recognise: The epidermis or topmost layer of the
skin is broken, creating a shallow open sore. Drainage may or may
not be present.
What to do: Follow steps
1-4 under Stage One. Consult your health care provider for further
treatment, which may include the following:
- Cleanse the wound with saline solution only and dry carefully.
Apply either a transparent dressing (such as Op-Site or Tegaderm),
a hydrocolloid dressing (such as DuoDERM), or saline dampened
gauze. The first two types of dressing can be left on until they
wrinkle or loosen (up to 5 days). If using gauze, it should be
changed twice a day and should remain damp between dressing changes.
- Check for signs of wound healing with each dressing change.
- If there are signs of infection (see Signs of trouble),
Doctor or health care provider for alternative wound care ideas and
review of possible causes (see step 4 under Stage One).
How to recognise: The break
in the skin extends through the dermis (second skin layer) into
the subcutaneous and fat tissue. The wound is deeper than in Stage
What to do: Follow steps
1-4 under Stage One and the additional steps under Stage Two. Always
consult your health care provider. Wounds in this stage frequently
need additional wound care with special cleaning or debriding
agents. Different packing agents, and occasionally, antibiotics
(creams or oral pills) may be required. You may also qualify for
a special bed or pressure-relieving mattress that can be ordered
by your Doctor or health care provider.
How to recognize: The breakdown
extends into the muscle and can extend as far down as the bone.
Usually lots of dead tissue and drainage are present.
What to do: Consult your
Doctor or health care provider right away. Surgery is frequently required
for this type of wound.
to know if the sore is healing
- The sore will get smaller.
- Pinkish tissue usually starts forming along the edges of the
sore and moves toward the centre; you may notice either smooth
or bumpy surfaces of new tissue.
- Some bleeding may be present. This shows that there is good
blood circulation to the area, which helps healing.
need to seek further medical help if any of the following occur:
An increase in the size or
drainage of the sore.
Increased redness around the sore
or black areas starting to form.
The sore starts smelling and/or
the drainage becomes a greenish colour.
You develop a fever.
What kind of complications
can be caused by pressure sores?
Can be life threatening.
Infection can spread to the
blood, heart, bone.
Prolonged bed rest.
Stages of Pressure Sores