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  • Writer's pictureAdam Funk

Understanding the Different Stages of Bed Sores: A Guide for Prevention and Legal Action

Understanding the Different Stages of Bed Sores: A Guide for Prevention and Legal Action

Bed sores, also known as pressure ulcers, are a serious medical issue that can develop in individuals who are unable to move or reposition themselves for extended periods. These sores are caused by unrelieved pressure on the skin, which cuts off blood flow and leads to tissue damage.

While bed sores are most commonly associated with hospital stays or nursing home care, they can also occur in any situation where someone is immobile for long periods, such as after a spinal cord injury or stroke.

The Importance of Early Detection

Early detection and intervention are crucial for preventing bed sores from worsening. However, many facilities fail to properly monitor patients for signs of pressure ulcers, leading to unnecessary pain and suffering.

If you or a loved one has developed bed sores due to inadequate care in a healthcare setting, you may have grounds for legal action. Understanding the different stages of bed sores is the first step in recognizing potential negligence and seeking compensation for damages.

The Stages of Bed Sores

Bed sores are classified into five stages, each representing a worsening level of tissue damage:

Stage 1: Non-Blanchable Erythema

This is the earliest stage of a bed sore and often serves as a warning sign. The skin in the affected area will appear red or discolored, typically over bony prominences like the heels, tailbone, hips, or shoulders. When pressed, the redness will not blanch (turn white) and may feel warm or tender to the touch.

At this stage, the damage is confined to the top layer of skin (epidermis). Prompt intervention through pressure relief, skin hygiene, and repositioning can prevent the sore from progressing further.

Stage 2: Partial-Thickness Skin Loss

If left untreated, a stage 1 bed sore can develop into a stage 2 sore. This stage is characterized by an open wound involving the epidermis and possibly the dermis (second layer of skin). The wound may appear as a blister, abrasion, or shallow crater.

The surrounding skin may be red, swollen, and painful. At this stage, healing is still possible with proper wound care and pressure relief strategies.

Stage 3: Full-Thickness Skin Loss

A stage 3 bed sore is a more serious condition where the damage extends through all layers of the skin, exposing the underlying fatty tissue. The wound may appear as a deep crater with a yellow, sloughy (dead tissue) base.

There may be significant pain and swelling around the wound. Healing at this stage becomes more difficult and may require specialized wound care techniques.

Stage 4: Tissue Necrosis (Death)

This is the most severe stage of a bed sore. The damage extends beyond the skin and underlying fat, involving muscle,bone, or even tendons. The wound may appear very deep and have a black, eschar (dead tissue) covering.

Stage 4 bed sores are extremely painful and have a high risk of infection. Extensive surgery and wound care may be necessary, and the potential for permanent tissue damage is significant.


In some cases, a bed sore may be covered by a thick layer of dead tissue, making it difficult to determine the depth of the wound. This is referred to as an unstageable pressure ulcer. Once the dead tissue is removed, the true stage of the bed sore can be determined.

Suspected Deep Tissue Injury

Another classification is a suspected deep tissue injury. This occurs when the surface skin appears like a stage 1 or 2 sore,but there is underlying damage to deeper tissues. This type of injury requires immediate medical attention to prevent further tissue destruction.

The Legal Implications of Bed Sores

Bed sores are preventable with proper care. Healthcare facilities have a legal obligation to take steps to prevent pressure ulcers in their patients. This includes:

  • Regularly assessing patients for risk factors of bed sores

  • Implementing a pressure relief plan, including frequent repositioning

  • Maintaining good skin hygiene

  • Providing proper nutrition and hydration

If a healthcare facility fails to meet these standards of care, and a patient develops bed sores as a result, they may be liable for damages. These damages can include:

  • Medical expenses for treating the bed sores

  • Pain and suffering

  • Emotional distress

  • Long-term care needs

  • Lost wages

What to Do If You Notice Bed Sores

If you or a loved one develops bed sores in a healthcare setting, it is important to take action immediately. Here's what you should do:

  • Document the bed sores: Take pictures of the sores and note the date they were first noticed.

  • Report the bed sores to the facility staff: Inform them of the problem and request immediate medical attention.

  • Keep a record of your concerns: Document any interactions you have with facility staff regarding the bed sores.


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