(also known as Decubitus Ulcers or Pressure Ulcers)
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If a family member is suffering from, or has died as a result of, Stage 4 Bed Sores.
Pressure ulcers (also known as bedsores or decubitis
ulcers) is an area of skin and tissue that becomes
injured or broken down. Pressure sores develop
when the skin and underlying tissue is squeezed
between a bone and an external surface, such as a bed
or chair. The most common places for pressure ulcers
are over bony prominences (bones close to the skin),
such as the elbow, heels, hips, tailbone, ankles,
shoulders, back, and the back of the head. Generally,
pressure ulcers occur when a person is in a sitting
or lying position for too long without shifting his
or her weight. Thus, Anyone confined to a chair or
bed is at risk. Incontinence and decreased sensory
perception (due to a stroke, for example) also increase
the likelihood of developing bedsores. The constant
pressure against the skin squeezes the blood vessels that
supply nutrients and oxygen to the skin and nearby
tissue, causing a decreased blood supply to the area.
Subsequently, the skin can no longer survive and dies.
Left untreated, nearby tissue begins to die, eventually
resulting in an ulcer that reaches the bone, leaving
an open cavity with resulting secondary infections that
can cause death.
Factors that increase the risk for pressure ulcers include:
- Age -- elderly people are at higher risk
- Inability to move certain parts of the body
without assistance, such as with spinal or
brain injury patients, and patients with
- Being bedridden or in a wheelchair
- Having a chronic condition such as diabetes
or artery disease that prevents areas of
the body from receiving proper blood flow and
- Urinary incontinence or bowel incontinence
(moisture next to the skin for long periods
of time can cause skin irritation that may
lead to skin breakdown)
- Fragile skin
- Mental disability from conditions such as
Alzheimer’s (some patients may not be capable
of taking the proper steps toward prevention
and may not seek appropriate treatment when
an ulcer has formed)
Preventing Pressure Ulcers
Education of at-risk patients and their families is the
most productive way to prevent pressure ulcers. Steps
toward prevention include:
- Identifying individuals at high risk for pressure
- Ensuring that immobile patients change their
position at least every two hours to relieve
- Using items that can help reduce pressure caused
by bedsheets and wheelchairs (e.g., use pillows,
sheepskin, foam padding, and powder to relieve
- Making sure patients eat healthy, well-balanced meals.
- Encouraging daily exercise, including range-of-motion
exercises for immobile patients.
- Following good skin care, including inspecting the
skin every day and keeping skin clean and dry.
Incontinent people need to take extra steps to limit
areas of moisture.
Bed-bound individuals should be moved at least every two
hours. Chair-bound individuals should change positions
every 15 minutes if possible. The patient or the caretaker
should take care to wash the patient properly, especially
if the patient is incontinent. Over-washing, and certain
types of cleansers, can irritate the skin, and should be
A variety of pressure-reducing beds and cushions are
available, as are lifting devices that help minimize
friction when moving chair- or bed-bound individuals.
These include lift sheets, belts, sliding boards and
Staging a Pressure Ulcer
The National Pressure Ulcer Advisory Panel (NPUAP) created
a process for evaluating pressure sores based on a system
that spans from Stage I (earliest signs) to Stage IV (most
- Stage I: A reddened area on the
skin that when pressed is "non-blanchable"
(does not turn white). This indicates that
a pressure ulcer is starting to develop.
- Stage II: The skin blisters or forms an open sore.
The area around the sore may be red and irritated.
- Stage III: The skin breakdown now looks like a
crater, where there is damage to the tissue below
- Stage IV: The pressure ulcer has become so deep that
there is damage to the muscle and bone, and sometimes
tendons and joints.
Treating a Pressure Ulcer
The protocol for treating a pressure ulcer is based
upon the ulcer’s stage,. In the early stages (Stage 1
and 2), characterized by redness (Stage 1), and
blistering and cracking (Stage 2), the area is
generally kept exposed, free from pressure, and dry.
Gentle massage may facilitate healing. By Stage 3,
when the ulcer is a crater-like sore and bacterial
infection may be present, treatment may focus on
draining and dressing the wound, and using topical
ointments to promote healing.
If you or someone you love have suffered from a
stage 3 or stage 4 Bed Sore due
to the neglect of a caregiver (such as a hospital,
nursing home, or assisted living provider), you
should immediately contact a competent attorney.
attorney will work with you to determine
the legal options that may be available.
Call or email for a Free Attorney Consultation
Law Office of Joseph A. Hernandez, P.C.
Phone: (781) 461-9400
Toll Free: (866) 461-9400
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