Care Facilities & Bed Sores


Pressure ulcers, also known as bed sores, pressure sores, or decubitus ulcers, are wounds caused by unrelieved pressure on the skin. They usually develop over bony prominences, such as the elbow, heel, hip, shoulder, back, and back of the head. Pressure ulcers are serious medical conditions and one of the important measures of the quality of clinical care in nursing homes.


From about 2% to 28% of nursing home residents have pressure ulcers. The most common system for staging pressure ulcers classifies them based on the depth of soft tissue damage, ranging from the least severe  to the most severe. Clinical practice guidelines for pressure ulcers have been developed and provide specific treatment recommendations for stage or higher pressure ulcers, including proper wound care.


More than 1 in 10 Nursing Home Residents had a Pressure Ulcer

In the latest study, of the 1.5 million current U.S. nursing home residents in 2004, about 159,000 (11%) had pressure ulcers of any stage. Stage 2 was the most common (5%), accounting for about 50% of all pressure ulcers. Stages 1, 3, and 4 made up about the other 50% of all ulcers.


Five Categories of Pressure Ulcers

Pressure ulcers are classified into five categories:


 Stage 1: A persistent area of skin redness (without a break in the skin) that does not disappear when pressure is relieved.

 Stage 2: A partial thickness is lost and may appear as an abrasion, blister, or shallow crater

 Stage 3: A full thickness of skin is lost, exposing the subcutaneous tissues-presents as a deep crater with or without undermining adjacent tissue.

 Stage 4: A full thickness of skin and subcutaneous tissues are lost, exposing muscle or bone.

Many Residents Needed Special Care

Among residents with stage 2 or higher pressure ulcers, 35% received wound care by specially trained professionals or staff. The percentage receiving special wound care was slightly higher for those with stage 4 (40%) than those with stage 2 (33%) or stage 3 (37%); however, these differences were not statistically significant.