stage 2 pressure ulcer buttocks


If you want to find out more about bed sores or pressure ulcer, we recommend that you read on.


What you will read next:




In what areas do pressure ulcers occur?

What patients are prone to bed sores?

some notes


Therapeutic team

pressure ulcer staging

New methods of treating bed sores





Bed sores are sometimes called pressure ulcer. They are wounds that cause damage to the skin and subcutaneous tissue following prolonged pressure on one part of the body. Bed sores are usually on the parts that are under pressure when the person is lying down for a long time. The people who are most at risk for this complication are people whose medical condition and general health is not normal and they are not able to change their body position.

For example, people who are paralyzed and have to spend most of their time in bed and in a wheelchair and cannot change their body position themselves.

Bed sores can develop in a very short time and progress rapidly, Most pressure ulcers, if diagnosed early, heal with standard treatments, but often will never heal completely.

In this article, we are going to talk about grading bed sores.



The general symptoms of bed sores and pressure ulcers, regardless of the degree of wound, are as follows:


Warning signs of bed sores include:

Swelling, Unusual changes in the appearance of skin, texture and skin color in a particular area, and purulent discharge from it, blurring of the skin and a warmer area of ​​skin than other areas of the body.


In what areas do pressure ulcers occur?

In people who use a wheelchair and are constantly in one position and cannot change the position of their body, pressure ulcers often appear on the skin in the following areas: buttocks, pelvis, shoulder blades, spine, back of the legs, back of the hands, that leans on a chair.

People who lie on the bed for a long time in a horizontal position will be involved in the following areas:

The back or both sides of the head and their shoulder blades, buttocks, hips, and ankles.


What patients are prone to bed sores?

Older people, People with mobility problems, such as people who have paralysis of one side of the body, and are unable to walk and move around in bed and chairs. In other words, any type of mobility disorder can make a person prone to bed sores. Stroke is one of the most common and debilitating diseases associated with bed sores.


some notes

bed sores affect people who are unable to move and they stay in one position for long periods of time. These sores form on the bony parts of the body that are under pressure.

The stages of growth of this wound are very different. The identification of bed sores in the early stages should be done to accelerate the healing process of the wound and reduce the incidence of complications significantly.



The diagnosis should be made carefully by the doctor. The doctor will carefully examine the wound and determine if the person has a pressure ulcer or not. The severity of the injury should be estimated by the doctor.

Diagnosis of the extent of the injury is made in the first session of the examination visit. Usually in the first session, the following questions are asked: What is the amount of pain in the area where the wound was created? How have you treated your bed sores in the past?

Do you have a history of pressure ulcers?

Diet and fluid intake must be reported to the physician.


Therapeutic team

The important point is that a team of therapists is needed to manage the various aspects of bed care, examination and treatment of bed sores.

The treatment members of this team are as follows: A primary care physician who writes and monitors the treatment plan.

A ‌doctor who specializes in wound care and wound dressing, a nurse who specializes in wound care and wound dressing, a Physiotherapist to help improve mobility

Assisted and trained wound management physician assistant


Nutritionist to adjust diet

And in cases where the symptoms are very severe and the condition is very serious, a neurosurgeon, orthopedic surgeon and plastic surgeon may be needed in the treatment team.


Wound staging

The tissue involved during bed sores includes the skin beneath the underlying layer, muscle and bone fat.

  • Bed sores in the first stage:

Wounds are erythema and redness of healthy skin in the area of ​​pressure. In a person with light skin, it is usually characterized by a redness. The skin may be more pigmented in people with dark skin. Discoloration, heat, swelling, and stiffness can also be indicators of wound diagnosis. The treatment of primary bed sores takes 3 to 4 days.

  • Second stage bed sores:

Skin lesions include damage to the epidermis, dermis and skin appendages. The sore is characterized by a hollow center and abrasion. It may be red and the second degree may last for 4 to 3 weeks. The skin pressure in this area should be relieved by frequent changes of body position and the use of medical mattress, pads and cushions so that it does not progress to the third stage.

  • Third stage bed sores:

This ulcer can cover the entire thickness of the skin and under the skin. It can cause damage or necrosis or death of the subcutaneous tissue of the skin, but the point is that the bed sore of the third phase does not pass through the fascia. It has a deep opening in appearance, The area around it is red and hard and there is a discharge of the wound and it smells bad. These wounds will definitely damage the skin and the underlying tissues.

Healing this wound can take one to four months with proper treatment.

  • Bed sores of the fourth stage:

This wound is characterized by full-thickness skin damage with extensive damage, tissue death, and damage to bone muscles as well as supporting tissues and structures. This wound is very difficult to treat and the treatment of this wound should be planned to reduce pressure, along with the care of a wound care team.

A deep cavity with noticeable discharge is observed. It has an unpleasant odor and the tissue around the wound is black.

Stage IV bed sores are a serious problem because your body is prone to bacterial contamination and infection. It can take 2 to 6 months for these wounds to heal with proper treatments.

Grade 4 bed sores require frequent care and supervision of the wound care team and if they left untreated, stage 4 sores can be life threatening.


New methods of treating bed sores

  • Regular position change:

Frequent shifts and positions changes are needed to reduce pressure on the wounds and also, to prevent new wounds. For some people, this time interval, for position change, may be every 15 minutes, and for others it may be necessary to move once every two to four hours. There are tables that show how often each person needs to change position, so it is best to know how often your patient changes position. Get help from your doctor to find out how often your patient needs to change their position.

  • New bandages:

Today there are new wound bandages for bedsores to protect against wounds. Some dressings include an alginate dressing. This dressing is made from seaweed containing sodium and calcium, which is good for speeding up wound healing.

Another type is hydrocolloid dressing.

They are jelly like and keep the healthy skin around the wound dry. It moisturizes the wound, exchanges air, and promotes the growth of new cells at the wound site.

Other types of dressings such as foams, films, Hydrofibers or hydrogels and antibacterials may also be used.

  • creams:

It is interesting to note that topical creams and ointments are not used to treat ulcers, but protective creams may be used to care for skin that is damaged and irritated around the affected area.

The place of antibiotics in the treatment of bed sores:

  • Treatment of infectious wounds (bacterial infections)
  • Blood poisoning or septicemia
  • Cellulite
  • Bacterial infections of deeper tissues
  • Bone infections or osteomyelitis


  • Especially in fourth-degree bed sores.
  • Diet and nutrition:

A balanced diet contains all three food groups. Proteins, vitamins and essential minerals will also have a special place in this program. This set can accelerate the process of difficult recovery. If you have an improper diet, you must receive a program from a nutritionist. dehydration slows down wound healing, so we need to get enough water.

  • Debridement:

Dead tissue and contaminants must be removed from the bed sore and then we should treat it. Debridement plays an essential role in the treatment. If the dead tissue is small, debridement can be done with the help of washing and special dressings, but in wider injuries, debridement should be done with one of the following methods.

In larger contaminants, debridement is performed by the following methods:

  • High pressure jets
  • Ultrasound debridement
  • And surgery and surgical treatment
  • Bed sore vacuum therapy

Negative pressure is created and local negative pressure helps to improve wound healing. Negative pressure clears wound secretions and helps increase blood flow.

  • Wavy Medicine Mattresses:

Patients with bed sores may have less trouble using a medical mattress that helps reduce pressure on key parts of the body. Special mattresses are made with air tubes and can take care of specific parts of the body that are under pressure, including of the lower back, hips, ankles and elbows.

  • And finally surgery:

Severe wounds that may not heal. Stage IV, etc. In such cases, surgery is needed to improve wound healing and minimize the possibility of infection. Surgery involves cleaning the wound.

  • Close the wound by bending the sides of the wound

Wound cleansing and the use of healthy skin tissue near the wound and wound closure.

Wound surgery can be challenging because most people who need it are not in good general health. The risks after surgery are:

  • Blood poisoning
  • Bone infections
  • Abscesses
  • And tissue death or grafted skin rejection
  • As well as clots in deep veins
  • Or deep vein thrombosis

Therefore, we must say that surgery to treat fourth-degree bed sores on the buttocks and other parts of the body due to its risks should be performed only after the surgeon has estimated the benefits and when the surgeon recommends it.

share this content in :
Address: 393 University Avenue,Suite 200,Toronto ON MG5 2M2,CANADA

Phone: +1(647)303 0740

All Rights Reserved © By MarsoClinic

Terms of Use