Bedsores â also called pressure ulcers and decubitus ulcers â are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone.
People most at risk of bedsores are those with a medical condition that limits their ability to change positions or those who spend most of their time in a bed or chair.
Bedsores can develop quickly. Most sores heal with treatment, but some never heal completely. You can take steps to help prevent bedsores and aid healing.
Warning signs of pressure ulcers are:
Bedsores fall into one of several stages based on their depth, severity and other characteristics. The degree of skin and tissue damage ranges from red, unbroken skin to a deep injury involving muscle and bone.
For people who use a wheelchair, pressure sores often occur on skin over the following sites:
For people who are confined to a bed, common sites include the following:
If you notice warning signs of a bedsore, change your position to relieve the pressure on the area. If you don't see improvement in 24 to 48 hours, contact your doctor.
Seek immediate medical care if you show signs of infection, such as a fever, drainage from a sore, a sore that smells bad, or increased redness, warmth or swelling around a sore.
Bedsores are caused by pressure against the skin that limits blood flow to the skin. Other factors related to limited mobility can make the skin vulnerable to damage and contribute to the development of pressure sores.
Three primary contributing factors for bedsores are:
Pressure. Constant pressure on any part of your body can lessen the blood flow to tissues. Blood flow is essential to delivering oxygen and other nutrients to tissues. Without these essential nutrients, skin and nearby tissues are damaged and might eventually die.
For people with limited mobility, this kind of pressure tends to happen in areas that aren't well-padded with muscle or fat and that lie over a bone, such as the spine, tailbone, shoulder blades, hips, heels and elbows.
Your doctor will look closely at your skin to determine whether you have a pressure ulcer and how bad the damage is. He or she will try to assign a stage to the wound. Staging helps determine what treatment is best for you. He or she might also order a blood test to assess your general health.
Your doctor might ask questions such as:
Complications of pressure ulcers, some life-threatening, include:
You can help prevent bedsores by frequently repositioning yourself to avoid stress on the skin. Other strategies include taking good care of your skin, maintaining good nutrition and fluid intake, quitting smoking, managing stress, and exercising daily.
Consider the following recommendations related to repositioning in a bed or chair:
Consider the following suggestions for skin care:
People with pressure sores might experience discomfort, pain, social isolation or depression. Talk with your care team about your needs for support and comfort. A social worker can help identify community groups that provide services, education and support for people dealing with long-term caregiving or terminal illness.
Parents or caregivers of children with pressure ulcers can talk with a child life specialist for help in coping with stressful health situations.
Family and friends of people living in assisted living facilities can be advocates for the residents and work with nursing staff to ensure proper preventive care.
People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Risk factors include: