In an attempt to provide some standardization as to the severity of pressure sores, medical facilities (nursing homes and hospitals) have adopted a staging system. Using a numerical scale of 1 to 4, pressure sores meeting certain characteristics can be categorized to help caregivers with the treatment and healing process.
A Simple Scale. An Important Patient Assessment Tool.
Widely accepted, The National Pressure Ulcer Advisory Panel developed pressure sore scale used at nursing homes and hospitals across the country. Below is a description of each stage pressure sore as set forth by the NPUAP:
Characteristics for Each Stage of Bed Sore
Stage 1 – Initially, a pressure sore appears as a persistent area of red skin that may itch or hurt and feel warm and spongy or firm to the touch. In blacks, Hispanics and other people with darker skin, the mark may appear to have a blue or purple cast, or look flaky or ashen. Stage I wounds are superficial and go away shortly after the pressure is relieved.
Stage 2 – At this point, some skin loss has already occurred — either in the epidermis, the outermost layer of skin, in the dermis, the skin’s deeper layer, or in both. The wound is now an open sore
that looks like a blister or an abrasion, and the surrounding tissues may show red or purple discoloration. If treated promptly, stage II sores usually heal fairly quickly.
Stage 3 – By the time a pressure ulcer reaches this stage, it has extended through all the skin layers down to the muscle, damaging or destroying the affected tissue and creating a deep, crater-like
Stage 4 – In the most serious and advanced stage, a large-scale loss of skin occurs, along with damage to muscle, bone, and even supporting structures such as tendons and joints. Stage 4 wounds are extremely difficult to heal and can lead to lethal infections commonly identified as sepsis. Particularly in patients with physical disabilities stage 4 pressure sores may develop on:
- Tailbone or buttocks
- Shoulder blades and spine
- Back of the head or ears
Occasionally, a bed sore may be categorized as ‘unstageable’. Unstageable pressure sores are usually referred to as an extremely advanced wound where there is involvement of skin, muscle and bone and the amount of dead tissue simply makes evaluation of the wound impossible.
Treatment Options for Patients With Pressure Sores
The stage levels are important in knowing what type of treatment is needed for a pressure sore. Medical staff should be well aware of the proper treatment procedures for treatment of pressure sores or ulcers. In the early stages, treatment is generally a matter of dressing the wound, protective in stage 1 and possibly a moist dressing in stage 2. The most important aspect is relieving the pressure that is causing the sore to develop. Healing at these stages can be a matter of days or a few weeks if handled properly.
If a pressure sore continues to worsen and reaches the 3rd or 4th stage, the treatment becomes much more difficult and lengthy. There is often medication needed as well as continuous cleansing and debridement of the wound as well as pressure reduction on the site. If a loved one started with no pressure sores or only minor staged sores and they are allowed to progress, there may be a possibility that the medical staff is not adequately treating their condition.
Lawyers helping those who have needlessly developed advanced pressure sores at medical facilities
If your loved one has developed an advanced pressure sore (stage 3 or 4) during an admission to medical facility, it may very well be due to neglect and improper care.
Rosenfeld Injury Lawyers represents individuals who have developed severe pressure sores in all types of care arrangements (nursing homes, hospitals and assisted living facilities) within Illinois and throughout the country. In these cases we may be able to recover damages for pain, disability, lost wages and medical expenses. As with all of our cases, we provide free, confidential case evaluations and only earn a fee when there is a recovery for you.
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