What are pressure sores?
Pressure sores, often called bedsores, are skin injuries caused by steady pressure on one area of skin. The pressure cuts off blood flow to the area, which can damage the skin.
Pressure sores most often happen on bony parts of the body, like the tailbone, hips, heels, and elbows
Pressure sores are common in people who are bedridden or chairbound, who can’t move normally, or who have a cast or splint that presses too tightly
Changing positions helps prevent pressure sores
People who can’t move themselves should have their position changed every 1 to 2 hours
Most pressure sores can be prevented by changing position often and keeping the skin clean and dry
What causes pressure sores?
Pressure sores are caused by:
Steady pressure against an area of skin, particularly the skin over a bony area
Steady pressure for more than an hour or two, which cuts off blood flow to the skin
People who are awake and able to move constantly shift their position without thinking. If people don't shift position, after an hour or so, the weight of their body shuts off blood flow to the skin they're lying on. The longer the pressure continues, the worse the skin damage.
Common Sites for Pressure Sores
Who is at risk of pressure sores?
People at risk of pressure sores include those who:
Can't shift position because they're unconscious, paralyzed, or have dementia Dementia Dementia is a brain problem that makes it hard to remember, think, and learn. Most dementia begins little by little and starts after age 65. It’s normal for the brain to change with age, but... read more
Can't feel pain
Have a cast or splint that presses on a bony bump such as the ankle bones
Have damp skin, such as from lying on sheets that are wet from sweat, urine, or stool (poop)
Have a poor diet
Pressure sores can form very quickly, sometimes within a few hours.
What are the symptoms of pressure sores?
Pressure sores range from mild (stage 1) to severe (stage 4). Untreated sores get deeper and deeper.
At first, the skin turns red and hurts
Then the top layer of skin blisters or wears off
Eventually, the sore goes all the way through the skin, leaving a hole (ulcer)
The ulcer can be open or covered by a thick scab of dead skin
Ulcers can get infected. Infected ulcers have a red area around them and may drain pus.
How does the doctor know there's a pressure sore?
People who are confused or aren't able to feel pain won't notice a pressure sore developing. If you're taking care of someone at risk, you must watch that person closely for the first sign of a pressure sore.
Doctors recognize a pressure sore by how it looks.
When pressure sores don't heal, doctors may look for infection by:
Sometimes, taking a small piece of tissue and sending it for a lab test
How do doctors treat pressure sores?
Clean the sores with sterile saline (salt water)
Remove dead tissue with scissors and a scalpel
Cover the sores with special bandages to protect them and help them heal
Sometimes, do surgery to close large pressure sores
To help sores heal and prevent more sores, doctors will also:
Make sure the person changes body position more often
Make a written schedule for caregivers for when to change the person's body position
Use tools like pads and pillows to make sure no single body part is getting too much pressure
Give suggestions for a healthier diet
How can pressure sores be prevented?
Doctors try to prevent pressure sores because they’re hard to treat.
For a person who is bedbound or chairbound, caregivers should:
Look at the skin each day
Adjust the person's position every 1 to 2 hours
Keep the skin dry and clean
Carefully check skin for redness or other changes in color at pressure areas
Change bed sheets as soon as they get wet
Cushion bony body parts with protective coverings or pillows
Sometimes use a special mattress or wheelchair cushion that gives pressure relief