Pressure sores, or decubitus ulcers, occur when pressure cuts off circulation to skin and tissue. People who are in a wheelchair or are bedridden are at high risk to develop decubitus ulcers. The most common areas for pressure ulcers to form are over bony prominences such as the elbow, ankles, heels and hips. A person at risk for developing pressure ulcers should change position every two hours and use protective devices such as padding or sheepskin to prevent pressure. The Mayo Clinic suggests daily skin inspections for high risk patients to prevent sores from forming.
Stage 1
According to Merk.com, decubitus ulcers begin to form within as little as two hours after the blood flow is cut off from pressure to the skin. The initial stage includes a change in the skin's coloration. Light pigmented skin appears red or pink, and dark pigmented skin has a red, blue or purple hues. The affected area is warm or cool to the touch---the temperature will differ from the surrounding skin, states The National Pressure Ulcer Advisory Panel. There may be pain upon touching the area. The area may also feel firm or boggy, according to www.Merck.com. The skin remains intact.
Stage 2
The skin is open in a stage 2 pressure ulcer; the opening is shallow revealing pink tissue. Skin loss has occurred in the outer layers of the skin or deeper in the dermis, according to The Mayo Clinic. The wound area may look like an open blister or abrasion with surrounding irritated red and purple tissue.
Stage 3
The wound begins to crater deeper into the skin and form a tunnel or hole. Subcutaneous fat may be visible in some stage 3 decubitus ulcers; however, bone and muscle are not visible. How deep the wound tunnels or undermines depends on the area where it is forming. Pressure ulcers in the nose or ear will be shallower than wounds on the foot or buttocks area.
Stage 4
Bone, muscle and tendons are visible in a stage 4 decubitus ulcer. The National Pressure Ulcer Advisory Panel reports a stage 4 ulcer may extend into muscles, fascia or joint capsules. The base of the ulcer is covered by yellow, gray, green or brown slough. Dead tissue may be present and appears black, brown or tan in coloration. There is a high risk the patient may contract osteomyelitis, an infection of the bone.
