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Pressure Sores
What are pressure sores?
A pressure sore (bed
sore) is an injury to the skin and/or the tissues under the skin. Constant
pressure on an area of skin reduces blood supply to the area. Over time, it can
cause the skin to break down and form an open sore (ulcer).
Pressure sores 
are more likely to form if you or a person you are caring for is
in the hospital or is confined to a chair or bed.
Pressure sores
most often form on the skin over
bony areas where there is little cushion between the bone and the skin. Most
pressure sores form on the lower part of the body, including over the tailbone
and on the back along the spine, on the buttocks, on the hips, and on the
heels. Other common spots are the back of the head; the backs of the ears; the
shoulders, elbows, and ankles; and between the knees where the legs rub
together.
Pressure sores can range from red areas on the surface
of the skin to severe tissue damage that goes deep into muscle and bone. These
sores are hard to treat and slow to heal. Other problems, such as
bone, blood, and
skin infections, can develop when pressure sores do
not heal properly.
What causes pressure sores?
Things that cause pressure sores include:
- Constant pressure on the skin and tissues. This is by far the most common cause of pressure sores.
- Sliding down in a bed or chair, forcing the skin to fold over itself ("shear force").
- Being pulled across bed sheets or other surfaces (friction burns).
- Irritation of the skin from things such as sweat, urine, or feces.
As we get older, our skin gets more thin and dry and less elastic, so it is easier to damage. Poor nutrition—common among older people and people who cannot move easily—makes these natural changes in the skin worse. Skin in this condition may easily develop a pressure sore.
How are they treated?
Treatment focuses on preventing a sore from getting worse and on making the skin healthy again. Treatment includes:
- Relieving pressure on the area by changing positions often and spreading body weight evenly with special mattresses or other support.
- Keeping the sore clean and covered, and not letting it dry out.
- Eating a healthy diet with enough protein to help the skin heal.
- Keeping healthy tissue around a pressure sore clean and dry.
- In most cases, removing dead tissue and applying medicated ointments or creams to reduce the risk of infection. Only use medicines prescribed by the doctor to treat pressure sores, and follow all instructions carefully.
If infection develops, the person will need antibiotics. Severe pressure sores may need surgery.
How can you prevent pressure sores?
These steps can help keep skin healthy:
- Prevent constant pressure on any part of the
body.
- Change positions and turn often to help reduce constant pressure on the skin. Learn the proper way to move yourself or a person you are caring for so that you avoid folding and twisting skin layers.
- Spread body weight. Use pressure-relieving devices or cushions, especially if a person is confined to a bed or chair for any length of time, to help prevent pressure sores. Pad metal parts of a wheelchair to help reduce pressure and friction.
- Eat a healthy diet with enough protein.
- Keep the skin clean and free of body fluids or feces.
- Use skin lotions to keep the skin from drying out and cracking, which makes the skin more likely to get pressure sores. Barrier lotions or creams have ingredients that can act as a shield to help protect the skin from moisture or irritation.
What increases the risk of getting pressure sores?
People at greatest risk for getting pressure sores are those who:
- Are confined to a bed or chair, especially if it’s because of a spinal injury.
- Cannot move without help (as with paralysis, coma, or recovering from surgery or injury).
- Have had a hip fracture. The risk for pressure sores continues even after coming home from the hospital or nursing home.
- Cannot control their bladder or bowels. Excess moisture can irritate or soften skin and lead to pressure sores.
- Are not eating a healthy diet with enough protein. Poor nutrition can lead to unhealthy skin and slow healing.
- Are not as alert as normal due to other health problems, from taking certain medicines, or after surgery. People who are not alert and thinking clearly may not understand why preventing pressure sores is important, or they may not be able to take the prevention steps that are needed.
- Are older. As people age, the soft tissue becomes more fragile. In addition, skin becomes thinner and less elastic, and injures more easily.
- Are smokers. Smoking dries out the skin and reduces blood flow to the skin.
- Have a fever. A higher body temperature puts extra stress on areas of the skin that may already be at risk for pressure sores.
- Have another health problem that makes healing difficult, such as diabetes.
Frequently Asked Questions
Learning about pressure sores: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: |
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