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The final stage in the bed sore classification system is stage 4. In a stage 4 bed sore, the most serious and advanced stage, almost all skin has been lost in the affected area and a very deep wound has occurred. The would itself has extended through the muscles, tendons, organs, and/or bones. Stage 4 bed sores, also termed decubitus ulcers, almost always require surgical intervention to remove the decayed and necrotic tissue. The infection status in a stage 4 bed sore is very serious and can lead to extremity amputation and/or death if not treated properly. A stage 4 bed sore is only seen in the most egregious circumstances of neglect and improper care. In the hospital or nursing home setting, a stage 4 bed sore should NEVER occur. Sadly for thousands of residents and patients each year, however it does time and time again.

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