Stages of Sacral Pressure Ulcers

Sacral Pressure Ulcers are a troubling reality for many elders in nursing homes. Bed-bound elders are at the highest risk, but the risk can be mitigated with steps such as examinations, repositioning every two hours, and other measures to mitigate pressure (extra foam on mattresses). These sores can grow progressively worse as time goes on if not treated. They have four stages, each with increasing complications. How an elder sleeps or lays in bed can determine where they are most likely to develop.

Stages of Sacral Pressure Ulcers / The Steele Law Firm

Sacral Pressure Ulcers are pressure sores that develop at the base of the spine.[1] They are more likely to develop when nursing home residents lay in certain positions. The position where Sacral Pressure Ulcers are most prevalent is when nursing home patients are sitting up in bed.[2] Given that this is a common position for those who are bed-bound, nursing home staff must be extra diligent in watching for this kind of pressure ulcer.

As mentioned above, Sacral Pressure Ulcers have multiple stages.[3] Stage One is called non-blanchable erythema, and refers to the redness of the area just above the buttocks.[4] At this stage ulcers can be difficult to detect, but are very treatable.[5] Stage Two refers to partial thickness, or a mark resembling a rash or as skinned knee. The ulcer is still in the first layer of skin.[6] Stage Three Sacral Pressure Ulcers have full-skin thickness loss and occur when subcutaneous fat are possibly visible but bone, tendon or muscle are not.[7] Stage Four occurs when there is Full Thickness Tissue loss.[8] This means that bone, muscle or tendon may be exposed.[9] At this stage surgery is often needed as there is a great risk of infection, sepsis, necrosis[10] or other complications.[11]

Sacral Pressure Ulcers are easily preventable. Yet all too often they occur, as bed-bound elders commonly sit up in bed. This is despite the fact that nursing home staff can almost entirely prevent them with simple and inexpensive measures. Unfortunately Sacral Pressure Ulcers still occur, and elders are left to death with the pain and complications of the nursing home’s negligence.

[1] Stages of Sacral Pressure Ulcer. Retrieved from

[2] Certified Medical Illlustrations, Common Sites for Pressure Sores. Retrieved from


[4] Stages of Sacral Pressure Ulcer. Retrieved from


[6] Id.

[7] Id.

[8] Id

[9] Id

[10] Stages of Sacral Pressure Ulcer. Retrieved from