How to Stage a Bedsore

A bedsore, also referred to as a “decubitus ulcer,” is a pressure sore usually caused from lying in the same position too long. It is a common condition of the elderly, particularly those in nursing homes and long-term care facilities. Common areas where bedsores occur include: the tailbone, hips, heels, spine and elbows. The backs of the feet and legs are also fairly common, especially in people with limited mobility. Bedsores are similar to burns in that they can be mild with only redness of the skin or more severe with a deep wound containing blackened tissue (eschar). To stage bedsores, following the steps below.


  1. Image titled Stage a Bedsore Step 1
    Understand how bedsores can develop
    • Areas of the body that are just over a bone are susceptible to these sores. The weight of the body presses against the bone, the bone then presses the tissue and skin above it against the surface of the bed, chair, etc. and the tissue gets trapped. As a result, the tissue will start to become damaged and decay due to the lack of circulation to that area of the body.
    • Another way that a bedsore can develop is by friction. Constant rubbing against a sheet, cast, brace, etc., will produce a similar process, eventually developing the sore.
  2. Image titled Stage a Bedsore Step 2
    Know the degree of severity of a bedsore. Before you can correctly stage a bedsore, you must first be able to tell how severe it is.
    • Bedsores are categorized based on their severity by the use of stages. The staging system is used for burns, bedsores (or decubitus ulcers) and several other types of wounds.
    • It is important to start treatment immediately to prevent further complications and to prevent the sore from progressing to the next stage. Stages range from 1 to 4.
  3. Image titled Stage a Bedsore Step 3
    Prepare to examine the person with bedsores.
    • Wear protective clothing since some wounds have drainage.
    • Wash your hands thoroughly with warm water.
    • Determine if the person is allergic to latex.
    • Use medical gloves either latex or non latex.
  4. Image titled Stage a Bedsore Step 4
    Make sure to have proper visibility in the room where you will be doing your exam.
    • Turn on all lights available in the room.
    • If there is a window available, open the blinds before you look at the person’s skin.
    • Use a flashlight if needed. This may be necessary for areas under the body and for wounds that are deeper.
  5. Image titled Stage a Bedsore Step 5
    Assess the patient’s overall skin condition. Look for signs of skin breakdown, red areas and open sores.
    • Notice the face, especially the cheekbones and brow areas.
    • Check each arm on the front and back, especially the wrists and elbows.
    • While they are lying down, gently help them roll to one side and check the backside of their whole body and repeat with the other side.
    • Check the feet by lifting each one up to see the bottoms, especially the heel area.
    • Make sure to notice if the patient feels any pain and try to prevent causing further discomfort during the exam.
  6. Image titled Stage a Bedsore Step 6
    Once you have found a sore or sores, follow the staging process. It’s very helpful to have illustrations or photos of each stage of bedsore to compare it to.
    • Stage I- You will see reddening of the skin (or purple or ashen if the person has very dark skin). The skin will not be broken and will appear to look like a mild sunburn. The area may be painful, firm, spongy, warmer or cooler than the area around it. A stage I bedsore may be hard to notice if there are typical pressure redness or marks from lying down. Once the pressure is taken off of the area, the discoloration will stay. A stage I wound is a sign of a problem and a signal to take further action. Factors to consider in a stage I include the cause and how to alleviate pressure on the area to prevent it from progressing.
    • Stage II- An open wound will appear. There will be a blister or blisters that are either broken or unbroken. A partial layer of the skin has been damaged. The wound will appear as a shallow discolored area with a basin. A stage II wound indicates a lack of intervention of a stage I wound. The goal of treatment is to cover, protect, clean and decrease the pressure to prevent progression.
    • Stage III- The wound is deep with exposure to the fat layer in many cases. Fatty material is yellow in appearance and often shiny. The area also may have a crater-like appearance. The bottom of the wound typically has some yellowish dead tissue. Damage can extend beyond the primary wound below the layers of healthy skin. Infection is a concern and aggressive intervention is needed. The goal is to alleviate pressure, cover and protect the wound, make sure the person stays hydrated and has proper nutrition. Medical care is necessary since this type of wound can progress very rapidly.
    • Stage IV- This is a serious condition which can be life threatening. A stage IV wound extends through the skin and involves underlying muscles, tendons and bone. You may see muscle which is red in appearance and bone which is white or cream in color. There will usually be lots of drainage and dead tissue present. Dead tissue will appear dark in color. The goals are to clean, protect, alleviate pressure, good hydration and nutrition and a skilled person to remove the dead tissue. Surgery may be necessary and as a last resort, amputation.


  • The diameter of bedsores can vary depending on the location, however, the thickness will always help in determining the stage of the wound.
  • Keep appropriate material available to wipe the drainage when needed to see the wound better.
  • It’s very helpful to have illustrations or photos of each stage of bedsore to compare it to.


  • You should seek medical attention if you or your patient exhibits signs of fever, or if the bedsore has an odor or greenish drainage. It’s also important to seek medical attention if you notice increased redness around the sore or the formation of black areas, an increased size of the actual wound or an increased drainage of the wound.

Article Info

Categories: Home Remedies