Bedsores (decubitus ulcers) are associated with necrosis of the tissues due to a number of factors, including but not limited to pressure, friction, shear, moisture and ischemia. The application of high pressure on the specific body area is not required for the creation of pressure sores, but it is possible to create lesions by application of moderate pressure which acts continuously for a long time. The development of decubitus ulcers is relatively common.
Population groups that are most at risk of developing pressure sores include people with reduced mobility, impaired sensory perception and people undergoing hours of surgery. In summary high-risk groups are the elderly, patients hospitalized in intensive care units, people with neurological problems, patients with trauma (including injury of the spine) and patients undergoing several hours of surgery. The points with the greatest incidence of decubitus ulcers are areas of concentrated body weight over bony protuberances (such as hips, sacrum, heels and elbows)
To assess the progression of decubitus ulcers staging is necessary. The prevailing scale staging of pressure ulcers is the scale by Shea, whereby pressure ulcers are classified into four stages.
- STAGE I: Redness without imprint to intact skin. Skin discoloration, warmth, swelling and hardening can be used as markers, especially in people with dark skin.
- STAGE II: Partial loss of skin thickness, wherein either the skin or the dermis is involved or both. The ulcer is superficial and clinically appears as abrasion or blister.
- STAGE III: Loss of whole skin thickness comprising of destruction or necrosis of the underlying tissue without tunneling.
- STAGE IV: Extended skin destruction, tissue necrosis or muscle and bone damage, tunneling formation.