Bedsores

Ø are also called decubitus ulcers, pressure ulcers, or pressure sores. These tender or inflamed
patches develop when skin covering a weight-bearing part of the body is squeezed between bone and
another body part, or a bed, chair, splint, or other hard object.



                                             Bedsores
                                  Common sites in pressure ulcers

                                         The Norton Scale
                     Note: Scores of 14 or less rate the patient as “at risk”

                                       Modified Norton/Scale
                                     Risk for pressure ulcers
     acc. to modified Norton-Scale: low (25 - 24 points) high (18 - 14 points) medium (23 - 19
                                 points)very high (13 - 9 points)



                                              Stage 1

Ø  The skin is intact but shows a persistent pink or red area that does not turn white when you
press it with your finger. The wound may look like a mild sunburn. The affected skin may be tender,
painful or itchy.

   It may feel warm, spongy or firm to the touch.

                                              Stage 2

Ø  The skin outer layer is broken, red and painful.  Surrounding tissues may show areas of pale,
red or purple discoloration. Some swelling and/or oozing may be present.

   The wound is no longer superficial and the ulcer is an open sore that does not extend through
the full thickness of the skin.


                                              Stage 3

Ø  The skin has broken down and the wound now extends through all layers of the skin. The ulcer has
become a crater involving damage or necrosis of subcutaneous tissues.  The pressure ulcer has
become deeper and very difficult to heal. At this stage, a large percentage of patients may require
treatment of up to one year. The wound is now a primary site for a serious infection to occur.

                                              Stage 4

Ø   There is full-thickness skin loss with extension beyond the deep fascia and involvement of
muscle, underlying organs, bone, and tendon or joint space. This deep open wound may show blackened
tissue called eschar.  The decubitus ulcer is now extremely deep, having gone through the muscle
layers and now involving underlying organs and bone. Surgical removal of the necrotic or decayed
tissue is often used on wounds of larger diameter. Surgery is the normal course of treatment.

    The wound is very serious and can produce a life threatening infection, especially if not
treated aggressively.