Chapter 13 Assisting with Mobility 393 Copyright Goodheart-Willcox Co., Inc. • Stage 3: the ulcer is much deeper than in stage 2 and may affect the underlying connective tissue. The sore looks more like a crater and may ooze, bleed, or contain pus. • Stage 4: the damage is deep and may reach the muscle, tendons, ligaments, joints, and bone. The ulcer will bleed and the skin and tissue become necrotic. Decubitus Ulcer Pressure Points Certain areas of the body are more likely to develop decubitus ulcers than others. These are known as pressure points (Figure 13.28). Pressure points can be found where the skin covers bony areas of the body. Positioning is important to avoid decubitus ulcers, but so is providing good skin care each time you change a patient’s position. This means keeping pressure points dry and clean, changing any wet or creased dressings and bandages, and making sure bed linens are smooth and free from crumbs. Continuous observation is critical, as is noting any existing ulcers prior to admitting the patient to your healthcare facility. necrotic term that describes dead cells or tissues Epidermis Stages of Decubitus Ulcers Dermis Subcutaneous fat Soft tissue Bone Stage 1 Stage 3 Stage 2 Stage 4 Alila Medical Media/Shutterstock.com Figure 13.27 Decubitus ulcers have four stages of severity.