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Stages of Decubitus Ulcers

written by: Emjay Annavi Baclay • edited by: dianahardin • updated: 11/29/2010

The stages of decubitus ulcers are easily identified through visual inspection of the skin. Once identified, patients must immediately employ key first aid and prescribed treatment methods to prevent severe infections.

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    Decubitus ulcers, also referred to as pressure ulcers or pressure sores, are skin areas that experience breakage due to staying too long in a single position without shifting the weight. Stages of pressure ulcers will vary depending on the symptoms that appear, and individuals must immediately seek medical help once severe symptoms and infection start to occur.

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    Understanding Decubitus Ulcers

    Despite the “decubitus ulcer” label, derived from a Latin word that means “to lie down," ulcerations can occur as a result of other body positions — such as ischial tuberosity ulcer which occurs due to extended sitting in one position.

    When a part of the skin is subject to constant pressure, the blood supply to the area is reduced, resulting in the death of the affected tissue. Decubitus ulcers begin when the affected skin turns red in color and then continues to become worse. Over time, this results in a blister formation, the presence of an open sore and then a crater. Places where pressure sores commonly occur are in places where bones are located close to the skin, such as heels, ankles, elbows and hips.

    Being bedridden following injuries or surgical procedure, or staying put on a wheel chair even for a short time period, can result in ulceration. Other risk factors for decubitus ulcers are malnourishment, having a chronic illness that inhibits proper blood flow reception, old age, mental degenerative conditions and immobility due to injury or neuromuscular disease.

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    Stages of Decubitus Ulcers

    Stages of decubitus ulcers are classified from Stage I to Stage IV according to the severity of symptoms.

    Stage I— In fair-skinned individuals, a defined skin area is characterized by persistent redness. Darker skin may come with hues of red, purple of blue. Compared to the other adjacent body area, the changes in the defined area involve skin temperature, sensation, and palpable or felt tissue consistency. When the define area is pressed, the skin does not turn to white— a key indicator that decubitus ulcer has already started to occur.

    Stage II— At this stage, the decubitus ulcer is still superficial. A blister, an abrasion, or a shallow crater or open sore has formed; the surrounding area of which may appear to be irritated and red in color.

    Stage III— The superficial ulcer appears like a deep crater, where thick skin loss involves impairment in the skin’s underlying tissue. The depth of damage may reach the fascia, but does not pass through it.

    Stage IV— Further impairment takes place along with the fully thick skin loss. The depth of damage reaches the bone, muscle, or the supporting tendons and joint capsule. Furthermore, sinus tracts may also characterize Stage IV decubitus ulcers.

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    First aid and medical assistance

    It is imperative for individuals to discuss any sighting or experience of a changing or developing pressure sore to health care professionals. After determining the presence of decubitus ulcer, first aid measures must be employed. These include reducing any pressure on the defined area, avoiding friction and other forms of trauma, and enhancing nutritional intake in order to speed up the process of healing and recovery.

    It is also important to contact health care providers once the area appears to form an open sore or blisters, and also when signs of infection are identified— such as foul odor, fever, and tenderness on surrounding area. Medical treatment, as prescribed, will be based on the pressure ulcer’s stage. Health care providers will take charge of instructing patients on how to take care and cleanse open ulcers, which must be strictly followed in order to prevent infection from occurring.