Patients can live for months or even years after developing a stage 4 bedsore. Factors such as proper medical care and preventing complications can help patients live longer. That said, roughly 60,000 people die each year due to bedsore-related complications.
The more advanced the bedsore, the greater the possibility that the nursing home resident will pass away from the injury. By some accounts, patients with Stage 4 bedsores have an average life expectancy of just 50 days once the condition has progressed to that level of severity.
With proper treatment, stage 4 bedsore life expectancy is high. According to the Merck Manual, 30% of stage 4 bedsores heal within six months, though some cases of stage 4 bedsores may take anywhere from several months to two years to fully heal.
Grade 3 or 4 pressure ulcers can develop quickly. For example, in susceptible people, a full-thickness pressure ulcer can sometimes develop in just 1 or 2 hours. However, in some cases, the damage will only become apparent a few days after the injury has occurred.
Stage 4 Bedsore Overview. Bedsores that have gotten to stage 4 are severe and life threatening. Data shows the mortality rate for people with stage 4 bedsores is up to 70%. Many of these patients die within 180 days of diagnosis.
Stage 4 bedsores look like deep holes or craters in your skin. The skin around the opening of the bedsore may be reddish and inflamed. Blackened, dead skin may also be present near the affected area. You may see muscles or tendons inside the bedsore.
Remodeling or also known as maturation phase is the fourth and final phase in wound healing and lasts from 21 days up to 2 years. In this final and longest phase, collagen synthesis is ongoing in order to strengthen the tissue. Remodeling occurs as wound continues to contract and fibers are being reorganized.
At this stage, there may be undermining and/or tunneling that makes the wound much larger than it may seem on the surface. Stage 4 pressure ulcers are the deepest, extending into the muscle, tendon, ligament, cartilage or even bone.
Nearly 60,000 people die from complications due to bedsores every year. That's one person every nine minutes. Over 55% of nursing home residents die from bedsores within 6 weeks of the onset of the wound. In fact, nursing home residents with bedsores experience a 6-month mortality rate of over 75%.
When someone is nearing the end of their life, they are at greater risk of pressure ulcers. This is because they may not be moving around or eating and drinking as much. Incontinence can damage the skin, making it harder to keep skin dry and the skin is less able to repair itself.
An infection from a pressure sore can burrow into joints and bones. Joint infections (septic arthritis) can damage cartilage and tissue. Bone infections (osteomyelitis) can reduce the function of joints and limbs.
If untreated, a pressure sore can progress from a small irritated but unbroken skin patch to a potentially life-threatening wound involving extensive tissue death and infection. Treatment of the serious decubitus ulcer may include debriding (excising) the dead tissue and administering systemic antibiotics.
Instead, the full-thickness ulcer is filled with scar tissue composed primarily of endothelial cells, fibroblasts, collagen, and extracellular matrix. A Stage IV pressure ulcer, therefore, can't become a Stage III, Stage II, or subsequently Stage I pressure ulcer.
Stage IV Pressure Ulcer: Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling. The depth of a stage IV pressure ulcer varies by anatomical location.
4. Remodeling. Scar tissue formation characterizes the final Remodeling Phase (also known as Maturation). It may occur over months or years, depending on the initial severity of the wound, its location, and treatment methods.
The typical presentation of a tunneling wound is on with an externally visible lesion that may communicate with one wound site or track beneath the skin surface to end blindly within subcutaneous fat, muscles, or connective tissues.
Class 4 wounds are considered to be dirty-infected. These wounds typically result from improperly cared for traumatic wounds. Class 4 wounds demonstrate devitalized tissue, and they most commonly result from microorganisms present in perforated viscera or the operative field.
An example of a hard-to-heal wound is a pressure ulcer, otherwise known as bedsore. These form on bony prominences, usually in cases where people are immobilized for extended periods of time such as people who are injured or the elderly.
A skin wound that doesn't heal, heals slowly or heals but tends to recur is known as a chronic wound. Some of the many causes of chronic (ongoing) skin wounds can include trauma, burns, skin cancers, infection or underlying medical conditions such as diabetes. Wounds that take a long time to heal need special care.
Phase 2: Inflammation
This phase works to kill bacteria and remove debris with white and other blood cells. Inflammation ensures that your wound is clean and ready for new tissue to start growing. This phase can be the most painful of all.
Stage 4: Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.
A stage 4 pressure sore is very painful and can take months to improve. Treatment for a stage 4 bedsore includes keeping the area dry and clean, applying pressure-relieving dressings, and taking measures to prevent further injury. In some cases, surgery may be necessary to remove dead tissue to help improve the wound.
Stage 4 pressure injuries extend to muscle, tendon, or bone. Unstageable pressure injuries are when the stage is not clear. In these cases, the base of the wound is covered by a layer of dead tissue that may be yellow, grey, green, brown, or black. The doctor cannot see the base of the wound to determine the stage.