The Stages of a Pressure Ulcer and Treatment:
By: Kristen Ianuzzi and Danae Abel-Templin
Description and Illustration
Treatment and Photograph
Sores are not yet open wounds, the skin may be painful but it has no breaks or tears. The skin appears reddened but doesn’t blanche. The stage 1 sore can feel firmer or softer than the area around it.
● Keep pressure off of the sore using foam or similar pressure redistribution surfaces
● Minimize seating time
● Modify sitting-time schedules and posture
● Protect the sore from any future tissue damage
● Gently wash the wound with mild soap and water and pat dry
● Evaluate the diet for proper nutrients
● Review mattresses, wheelchair cushions, pressure releases, and transfers for a possible cause
● Potentially use a protective dressing like Tegaderm
Stage 2: The skin breaks open, wears away, or forms an ulcer which is usually tender or painful. The sore expands into deeper layers of the skin. At this stage, some skin may be damaged beyond repair or die.
● Follow the same steps as above but use a saltwater solution for cleaning as the skin is open.
● Check for wound healing with each dressing change
● Check for signs of infection
Stage 3: The sore gets worse and extends into the tissue underneath the skin, forming a small crater. Fat may show in the sore, but not muscle, tendon, or bone yet.
● Follow the previous stages but be mindful of the fact that these wounds may need additional care with special cleaning and debriding agents. Antibiotics may be required.
Stage 4: The sore is very deep, extending into muscle and bone, causing excessive damage and sometimes extending to tendons and joints.
**In stage 3 and 4 there may be no pain due to significant tissue damage. Serious complications can occur if sore progresses**
Illustrations Retrieved from:
● The healing of these ulcers may take more than 6 months and sometimes never heal
● Stage 4 pressure ulcers often require skin grafting and surgeries for debridement.
● Special beds are most necessary at this stage
Images Retrieved From: http://www.msktc.org/sci/factsheets/skincare/Recognizing-and-Treating-Pressure-Sores