Pressure Injury 101: Stage 2 Pressure Ulcers

These are the signs of stage two ulcer development.


In the fields of healthcare risk assessment and hospital management, pressure injuries remain top-of-mind. Pressure injuries are a common health care issue in hospitals worldwide, and in the United States alone, 2.5 million people experience them every year, and about 60,000 patients die as a direct result of hospital acquired pressure ulcers (HAPUs). It’s important to note that up to 45% of HAPU injuries develop in the operating room. (Berlowitz D, 2014, p.11)

These statistics offer a stark reminder to all health care professionals that pressure injuries should not be taken lightly. When left untreated, they can cause serious injury which could result in death.

Efforts that go into pressure injury prevention are warranted—and effective—but with many health care institutions relying on manual, physical work to prevent sores, staff attention is often being diverted from more critical issues, such as complications from the ongoing COVID-19 crisis.

At XSENSOR, we use high-tech equipment and techniques that enable health care professionals to prevent the development of bed sores efficiently. With equipment built to assess risk, remove pressure and help with diagnosis or treatment, we're creating a future where pressure injuries decrease, and staff can dedicate life-saving attention where it’s most needed.


What are the stages of a pressure sore?

Pressure sores, also known commonly as bedsores or decubitus ulcers, are injuries to the body caused by sustained pressure. Their severity can be categorized according to four main phases—from a stage one ulcer where the skin is just beginning to show damage, to a stage four ulcer with open wounds, sores and signs of infection. Whatever the stage, all should be taken seriously and treated with urgency. Here are the four stages of a pressure sore.

where pressure sores form on the body

Stage 1 Pressure Sores and Ulcers: Early on in pressure ulcer development, the skin is developing injury. While no open sores or broken skin are present yet, skin may appear redder, warmer or firmer than usual. Known as a non-blanchable erythema of intact skin, the color change may indicate the beginnings of a serious injury to the deep tissue. 

Stage 2 Pressure Sores and Ulcers: This is where the true sore, or ulcer, develops as a break in the skin and an open sore. It is often very painful, and can create serious damage within the skin. Known as partial-thickness skin loss with exposed dermis, these bed wounds can quickly become something worse and may even present as a blood filled blister.

Stage 3 Pressure Sores and Ulcers: In stage three, the pressure ulcer has developed into the soft tissue underneath the skin. Known as full-thickness skin loss, this stage may show a deep wound, especially in an area with more adipose tissue. 

Stage 4 Pressure Sores and Ulcers: By the final and most serious stage of a pressure sore, the skin may have receded into the muscle and bone, causing lasting damage to the skin and underlying areas. Known as full-thickness skin and tissue loss, this stage can involve visible or palpable fascia, tendon, muscle and bone, and even dead tissue.


How to identify a stage two pressure ulcerstage-2-pressure-ulcer

When identifying a stage two ulcer, it can be helpful to differentiate it from stage one. During stage one, tissue injury is just beginning, but is not yet visible. However, when a sore develops to stage two, the skin will open, forming a visible ulcer. Health care professionals and patients may see a small abrasion, a blood filled blister or a dip in the skin. Tissue damage may become apparent, causing serious issues if not dealt with quickly.

Here are some signs to keep in mind when monitoring for a stage two pressure ulcer:

  • The skin is itchy and painful, and may feel warmer to the touch.
  • The sore is oozing clear liquid, pus or blood.
  • The skin has developed an open wound.
  • The skin isn’t covered by slough yet, but is showing signs of erosion or blistering up.


How to treat a stage two pressure ulcer

It’s important to treat a stage two pressure ulcer with urgency. By stopping the injury’s development, you may avoid deeper tissue damage or infection.

Step one of treating a stage two pressure ulcer should always include risk assessment technology. (Ideally, this would begin at the start of a patient’s stay.) Sensing technology gives health care professionals the tools to work proactively in mitigating the ulcer’s development or progression.

Technology aside, it is also vital to implement wound care strategies immediately, and take steps such as redistributing (or safely distributing) pressure from the affected areas of the skin, turning the patient regularly and integrating technology that helps the skin.

Because stage two pressure ulcers can move to stage three quickly, health care staff will need to implement these techniques and preventative measures immediately, to prevent further tissue damage and infection.

technology to prevent pressure sores


Equipment to prevent stage two pressure ulcers

Pressure injuries and ulcers are a serious issue in hospital settings. When not identified and treated promptly, they cause unnecessary suffering for patients. And because the efforts to prevent and mitigate them are often labor-intensive, pressure injury care can cause inefficiencies in health care settings, diverting valuable staff attention from more urgent situations.

By implementing technology that helps prevent ulcer development in the first place, your hospital can make great strides in improving patient care and staffing efficiencies. XSENSOR offers continuous pressure monitoring technology, equipping medical professionals with data that aids in the mitigation and complete prevention of pressure injuries.

XSENSOR’s ForeSite technology is designed to prevent pressure sores from forming or progressing, by ensuring safe positioning on three main culprits: surgical tables, hospital beds and wheelchairs.

  • For hospital beds: Our unique ForeSite Intelligent Surface system has more than 1500 sensor cells on the surface of the mattress or overlay to measure patient body surface pressures, displaying data in real time for continuous monitoring. The system includes AI powered body position tracking and a turn clock to track repositioning that informs better patient care.
  • For surgical tables: Our ForeSite OR system carries the same technology through to the operating room, which is excellent for safe positioning and managing risk in longer surgeries.
  • For wheelchairs: Our ForeSite SS system utilizes high accuracy sensing to design safe seating for those in wheelchairs.

At XSENSOR, we’re motivated by the same goal that you are: high quality patient care across the board. Our intelligent, dynamic sensing technology gives you the tools to do that work with excellence. Contact us today, and we’ll elevate your standard of care together.

Ultimate Guide To Preventing Pressure Injuries in the Hospital


Berlowitz D, Lukas CV, Parker V, et al. (2014). Preventing pressure ulcers in hospitals: a toolkit for improving quality of care. Agency for Healthcare Research and Quality.

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