The Different Stages of Bedsores and Their Treatment

The stages of bedsores differ according to the severity of these wounds that are produced on the skin by pressure or friction exerted by a hard surface.
The Different Stages of Bedsores and Their Treatment

Last update: 18 June, 2021

The evolution of a bedsore will depend on its severity. Today, we’ll tell you what bedsores are, explain the different stages of bedsores, and talk about their treatment.

Bedsores (also called pressure sores) are damage to the skin and the underlying tissue due to prolonged pressure or friction against a hard surface. They occur frequently in patients who are bedridden for long periods of time.

In addition, the stages of bedsores are greater in the elderly, as these ulcers cause serious problems among this age group.

They’re very painful and produce a high number of local and general infections. They’re located in the most prominent parts of the body, sacrum, trochanters (bony prominences that are located in the upper limb or epiphysis of the femur), heels, scapulae, and the occipital region.

Its severity varies from reddening of the skin to the loss of the skin and may expose the underlying bone.

The stages of bedsores

A nurse caring for a bedridden male patient.
Bedsores can significantly diminish quality of life.

Healthcare professionals use a classification system to describe the severity and stages of bedsores. Thus, 4 categories are distinguished:

  • Stage 1: A stage 1 bedsore is the most superficial type of injury. The affected skin area appears discolored and reddish in white patients and bruised or bluish in patients with darker skin. In a stage-1 bedsore, the skin remains intact but may be painful, itchy, and either warm and soft or hard to the touch.
  • Stage 2: In stage 2 pressure ulcers, part of the outer surface of the skin, i.e. the epidermis, or the innermost part of the skin or dermis, suffers from damage. This results in a loss of skin tissue. The ulcer appears as an open wound or blister.
  • Stage 3: In this category, skin loss occurs throughout the thickness of the skin. In addition, there’s also damage to the underlying tissue. However, there’s no damage to the muscles or the bones. The sore appears as a deep, hollowed-out wound.
  • Stage 4: Of the four stages of bedsores, this is the most severe. In this situation, there’s severe damage to the skin and the adjacent tissue suffers necrosis, i.e. it dies. In addition, there may also be damage to the underlying muscle or bone. Patients with this type of pressure ulcer have a high risk of developing serious infections.


Since bedsores are a complex health problem caused by a number of interrelated factors, different types of professionals need to care for the patient. Some techniques and treatments for bedsores are as follows:

Changing positions

Moving the body and changing positions at regular intervals is one of the best ways to prevent the occurrence of these injuries. It relieves pressure in cases of stage 1 and 2 bedsores.

Mattresses and cushions

A pillow-top mattress.
All of these measures can be helpful.

A wide range of special mattresses and cushions are available to relieve pressure on vulnerable parts of the body. Patients with more severe bedsores need a more sophisticated mattress or even a bed system.

For example, there are mattresses that you can connect to a continuous flow of air that’s automatically regulated to reduce pressure at the necessary times.


Some examples of this type of products are:

  • Hydrocolloids: These are dressings containing a special gel that promotes the growth of new skin cells.
  • Alginates: These are dressings made from seaweed containing sodium and calcium. Studies have shown that they accelerate the healing process.

Topical preparations

Doctors can also prescribe creams or ointments to speed up the healing process. At the same time, they also prevent further skin damage. A type of chemical known as free radical scavengers can also be useful in preventing cell damage at a genetic level.


Antibiotics are useful in preventing bacterial infection and, as a precaution, also prevent the development of secondary infections.

In the same way, the direct application of an antiseptic ointment can also cleanse them of any bacteria that are already present.


Sometimes it’s not possible to heal these wounds and doctors will need to resort to surgery to seal the bedsore and prevent further tissue damage. Graft replacement is the most common technique. Professionals take a skin and muscle graft from another part of the body and use it to seal the ulcer.

Bedsores: A complex pathology

As you’ve come to learn, bedsores are very common, appear easily, and, moreover, involve complicated treatment. In patients with risk factors – mainly those bedridden due to chronic illnesses – multiple anti-scarring measures should be taken into account to improve the prognosis of these lesions.

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