What are bedsores?
Bedsores — also called pressure ulcers and decubitus ulcers — 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.
How common are bedsores?
Bedsores are common in people in hospitals and nursing homes and in people being cared for at home. Please discuss with your doctor for further information.
What are the symptoms of bedsores?
The common symptoms of bedsores are:
- Unusual changes in skin color or texture
- Pus-like draining
- An area of skin that feels cooler or warmer to the touch than other areas
- Tender areas
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.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes bedsores?
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:
- 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.
- Friction occurs when the skin rubs against clothing or bedding. It can make fragile skin more vulnerable to injury, especially if the skin is also moist.
- Shear occurs when two surfaces move in the opposite direction. For example, when a bed is elevated at the head, you can slide down in bed. As the tailbone moves down, the skin over the bone might stay in place — essentially pulling in the opposite direction.
What increases my risk for bedsores?
There are many risk factors for bedsores, such as:
- Immobility. This might be due to poor health, spinal cord injury and other causes.
- Lack of sensory perception. Spinal cord injuries, neurological disorders and other conditions can result in a loss of sensation. An inability to feel pain or discomfort can result in not being aware of warning signs and the need to change position.
- Poor nutrition and hydration. People need enough fluids, calories, protein, vitamins and minerals in their daily diet to maintain healthy skin and prevent the breakdown of tissues.
- Medical conditions affecting blood flow. Health problems that can affect blood flow, such as diabetes and vascular disease, increase the risk of tissue damage.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How are bedsores diagnosed?
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.
How are bedsores treated?
If you care for someone with bedsores, your doctor or home care nurse may ask you to help with the treatment by following preventive steps that should stop further damage to vulnerable skin and increase the chances of healing.
Additional treatments, usually done by health care professionals, depend on the stage of the bedsore. First, areas of unbroken skin near the bedsore are covered with a protective film or a lubricant to protect them from injury. Next, special dressings are applied to the injured area to promote healing or to help remove small areas of dead tissue. If necessary, larger areas of dead tissue may be trimmed away surgically or dissolved with a special medication. Deep craters may need skin grafting and other forms of reconstructive surgery.
If the person’s skin shows any signs of possible infection, the doctor may prescribe antibiotics, which may be applied as an ointment, taken as a pill or given intravenously (into a vein).
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage bedsores?
The following lifestyles and home remedies might help you cope with bedsores:
- Shift your weight frequently. If you use a wheelchair, try shifting your weight about every 15 minutes. Ask for help with repositioning about once an hour.
- Lift yourself, if possible. If you have enough upper body strength, do wheelchair pushups — raising your body off the seat by pushing on the arms of the chair.
- Look into a specialty wheelchair. Some wheelchairs allow you to tilt them, which can relieve pressure.
- Select cushions or a mattress that relieves pressure. Use cushions or a special mattress to relieve pressure and help ensure your body is well-positioned. Do not use doughnut cushions, as they can focus pressure on surrounding tissue.
- Adjust the elevation of your bed. If your bed can be elevated at the head, raise it no more than 30 degrees. This helps prevent shearing.
- Keep skin clean and dry. Wash the skin with a gentle cleanser and pat dry. Do this cleansing routine regularly to limit the skin’s exposure to moisture, urine and stool.
- Protect the skin. Use plain talcum powder to protect skin at friction points. Apply lotion to dry skin. Change bedding and clothing frequently if needed. Watch for buttons on the clothing and wrinkles in the bedding that irritate the skin.
- Inspect the skin daily. Look closely at your skin daily for warning signs of a pressure sore.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Bedsores (pressure ulcers). http://www.mayoclinic.org/diseases-conditions/bed-sores/home/ovc-20315615. Accessed August 16, 2017.
Bedsores (Decubitus Ulcers). https://www.health.harvard.edu/diseases-and-conditions/bedsores-decubitus-ulcers-. Accessed August 16, 2017.
Review Date: August 17, 2017 | Last Modified: September 13, 2019