Spinal-Injury.net :  Pressure Sore Stages


Pressure Sore StagesPressure Sores Stages

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.

Pressure Sore Stage 1 STAGE ONE

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:

  1. Keep pressure off the sore!
  2. Maintain good hygiene. Wash with mild soap and water, rinse well, pat dry carefully (but gently). Do not rub vigorously directly over the wound.
  3. Evaluate your diet -- are you getting enough protein, calories, vitamins A and C, zinc and iron? All of these are necessary for healthy skin.
  4. Review your mattress, wheelchair cushion, transfers, pressure releases, and turning techniques for possible cause of the problem.
  5. 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.
  6. If the sore does not heal in a few days or recurs, consult your Doctor or health care provider.

Pressure Sore Stage 2 STAGE TWO

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).

Pressure Sore Stage 3 STAGE THREE

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 Two.

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.

Pressure Sore Stage 4 STAGE FOUR

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.

How 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.

Pressure Sores - Warning Signs

You 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.
  • Amputations.
  • Prolonged bed rest.
  • Autonomic dysreflexia.

Pressure Sores
Stages of Pressure Sores
Reapplying Pressure
Skin Management
Prevention Tips

Back to top

Spinal-Injury.net :  Pressure Sore Stages



Copyright 2002-2015 Spinal-Injury Network. All rights reserved. Cookie Policy