What Are the Stages of Bed Sore Development?


Bed sores, also known as pressure sores, are open wounds that develop as a result of damaged skin and tissue. When continuous pressure is applied to the skin, this can result in your circulation being cut off, and eventually the damaged skin and tissue dies. People who are bedridden or cannot move to change their position in bed are at a high risk of developing bed sores. According to the Mayo Clinic, once sores develop, they progress quickly and it is difficult to heal them. There are four stages of bed-sore development, and, if left untreated, complications can occur.

The First Stage

  • When a sore begins to develop, the infected area initially becomes red. In this nascent stage, the sore may cause you itchiness and intense pain when pressure is applied to the area. The site may be warm when touched, or feel spongy in texture. If the area is properly cared for, and prevented from progressing further, a sore at this stage can heal.

Stage II

  • However, if the infection advances, skin loss will start to occur. The outermost layer (the epidermis), the skin's deeper layer (the dermis) or even both layers will begin to shed cells. According to the Mayo Clinic, at this stage your wound will begin to open into a sore that is similar in appearance to a blister or abrasion. The tissue around the sore will look red or purple, signaling that damage to your tissue has begun.

Stage III

  • Stage III is a crucial point in the development of a bed sore. Once the sore has reached this stage, damage has reached the deeper levels of your skin and your skin's natural protection is virtually eradicated. According to Lippincott's Nursing Center, subcutaneous fat may be visible but, at this stage, the bone, tendons and muscle are not exposed. Areas of ulcers may begin to tunnel down into the bone and muscle.

Stage IV

  • By stage IV, the advancement of sore development has become serious. By now, necrosis---or tissue death---of the skin has occurred. Muscle, bone, and the tendons and joints can also suffer damage. The skin begins to peel away from the exposed wound. This damaged skin is described as "slough" or "eschar," depending on the severity of tissue damage. Slough is yellow, tan, gray, green or brown in appearance. Eschar is tan, brown or black in appearance.


  • If bed sores are left untreated, serious complications can result, including cellulitis, an infection of the skin that can cause swelling and severe pain. Cellulitis can lead to sepsis or to meningitis, an infection of the brain and spinal cord. Your bone or joints can also develop infections. According to the Mayo Clinic, sepsis is one of the gravest dangers in bed-sore development. Sepsis occurs when bacteria enters into your bloodstream, leading in some cases to shock and organ failure.


  • Photo Credit http://commons.wikimedia.org/wiki/File:Nekrose_dekubitus02.jpg, http://en.wikipedia.org/wiki/File:Nekrose_dekubitus01.jpg, http://en.wikipedia.org/wiki/File:Decubitus_ulcer_stage_4.jpg
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