Escarre et ulcères. Evolution des différents stades.

Pressure ulcer stages 1 to 4 with photos

Aug 18, 2021

Stage 1 pressure sore

The 1st stage of pressure ulcer is erythema also called stage 1 pressure ulcer . Erythema is defined as redness of the skin that does not disappear under finger pressure. This erythema is red , warm and generally painful. It corresponds to damage to the epidermis or even the dermis (upper part of the skin). In people with fair skin, depending on the definition of a pressure sore , it appears as a persistent redness while in people with darker skin, the pressure sore can be a red, blue or even purplish tint. In stage 1, a pressure sore is a slight sore that affects the upper layer of the skin (epidermis). It may be red and swollen, but does not show signs of infection. The skin around the pressure sore may be red and warm to the touch, but the sore itself is not painful.

Photo of a stage 1 pressure ulcer

Photo of a stage 1 pressure ulcer
Stage 1 bedsore photo of redness.

Treating a stage 1 pressure sore

This first stage of the pressure sore is the most benign (less serious) but nevertheless requires special care and attention. This stage is quickly reversible with appropriate care (such as regular position changes, the installation of specialized equipment such as anti-decubitus mattresses or the use of a liquid healing dressing , etc.), hence the need for be vigilant and regularly observe potential pressure areas of patients at risk. If the erythema is not detected early enough, if it is poorly managed, or if the care is not sufficient, it can then progress to a more serious stage: stage 2 of the pressure sore.

Stage 2 pressure sore

Stage 2 of the pressure ulcer corresponds to the deepidermization stage or that of blistering . It is simply the formation of a superficial wound caused by the loss of part of the epidermis and/or dermis. This stage can also appear in the form of a blister (blister) filled with transparent liquid or blood (which can often be reminiscent of the more serious stage of pressure ulcer which is necrosis). Blistering corresponds to a peeling of the epidermis filled with a pocket of fluid or blood. Just like stage 1, this stage can be painful and can quickly progress to more serious stages such as stage 3 and 4 of the pressure sore if it is not taken care of correctly and especially quickly. At this stage, it is important to promote healing of the wound .

Photo of a stage 2 pressure ulcer

Photo of a stage 2 pressure ulcer

Treating a stage 2 pressure sore

To treat a stage 2 pressure ulcer, it is recommended to follow the following steps:
  1. Clean and disinfect the wound : It is important to clean and disinfect the wound to prevent the development of an infection. This can be done by using antiseptic solutions or by performing surgical cleaning of the wound.
  2. Removal of dead tissue: If the wound is deep and contains dead tissue, it may be surgically removed to allow the wound to heal.
  3. Wound protection : It may be necessary to protect the wound with a special dressing or cushion to prevent additional pressure on the affected area.
  4. Treating the underlying cause : It may be necessary to treat the underlying cause of the pressure sore, such as a problem with blood flow or reduced mobility.
  5. Drug treatment: Medications may be used to relieve pain.
  6. You can use Antiscar to effectively promote wound healing (liquid dressing gel based on glycerol, honey and polymers)

Stage 3 pressure sore

Stage 3 is the stage of necrosis , which is the death of living tissues and skin cells. This stage is characterized by the formation of a deep wound in the skin (unlike stage 2 which is characterized by a superficial wound or blistering) this time affecting the epidermis, the dermis and the subcutaneous tissues but without reach the underlying muscles and bones. The skin becomes necrotic, it becomes black and very rigid. This is a serious stage of the pressure sore. Stage 3, a pressure ulcer is a serious wound that affects the deeper layers of the skin and underlying tissues. It can be very painful and may be accompanied by an infection. The skin around the pressure sore may be red, swollen, and warm to the touch, and the wound itself may be deep and oozing. It is important to treat a stage 3 pressure ulcer quickly to avoid complications and promote healing. Treatment may include surgical care to remove dead tissue and protect the wound, as well as medications to relieve pain and treat any infection that may be present

Stage 3 pressure ulcer photo

Photo of a stage 3 pressure ulcer

Stage 4 pressure sore

Finally, the most serious stage is stage 4 , this is ulceration. This ulceration appears after the necrosis stage. This is a deep, even very deep wound . A pressure sore is characterized by a loss of the entire thickness of the skin with significant destruction of tissues, this time going as far as the muscles and bones. There may also be damage to tendons or joints. PaThe bones and muscles are exposed and visible.

Stage 4 pressure ulcer photo (sacrum pressure ulcer)

Photo of a stage 4 pressure ulcer at the sacrum level

Complications of pressure sores

Many complications can follow this stage of ulceration. Among these complications we find:
  • Osteomyelitis (inflammation and destruction of bones caused by bacteria or fungi)
  • Cellulite (inflammation of the skin and subcutaneous tissues caused by bacteria)
  • Bacteremia (presence of bacteria in the blood)
  • Meningitis (inflammation of the meninges located in the brain)
  • Endocarditis (infection caused by bacteria affecting the inner walls of the heart)
The more advanced the stage of the bedsore, the lower the chances of recovery and the longer and more difficult the healing period. It is therefore very important to diagnose this type of lesion early. The physical and psychological consequences for patients can be significant, which is why prevention is essential. Using a liquid dressing like Antiscar is a solution to prevent the appearance of stage 4 bedsores.

Diagram: pressure sore mechanism

Pressure ulcer mechanism diagram

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