Patient education: Pressure sores (The Basics)

What are pressure sores? — 

These are areas of damage to the skin and the tissue under the skin caused by pressure. This can happen from sitting or lying in the same position for a very long time. Pressure sores are also called "pressure ulcers," "bedsores," or "pressure-induced injuries."

The most common places for pressure sores are where bone is close to the skin. These areas include the back, hips, buttocks, elbows, heels, and ankles.

Pressure sores can also happen where something touches or rubs the skin for a long time. For example, casts, bandages, nose tubes, or oxygen masks can lead to sores.

What does a pressure sore look like? — 

At first, the sore looks like a discolored patch of skin. For example, the skin might look red, purple, or blue. If it gets worse, the skin breaks down and the sore looks like a reddish-pink, shallow crater (picture 1). If the skin breaks down, it can get infected.

Some sores look like a blister and can burst. Some are so deep, they go all the way through the skin to the muscle or bone. Sores can also form scabs that hide how deep the sore is.

Who is at risk of pressure sores? — 

Pressure sores are most common in people who:

●Are older

●Cannot move or shift around easily because of a medical problem or after certain types of surgery

●Are in a hospital or nursing home

Can pressure sores be prevented? — 

Yes. There are a few things you can do to help prevent pressure sores.

If you spend a lot of time in a bed, you can lower your chances of getting pressure sores if you:

●Turn your body at least every 2 hours – For example, turn from your back to 1 side, then the other side.

●Lie with your upper body raised at a slight angle when on your side – This puts less pressure on your hip bone.

●Place pillows or foam wedges between your ankles and knees – You can also place these under your ankles.

Using a special mattress or a pad that goes on top of your mattress might also help. These mattresses or pads can be made of gel, foam, air, or water. There are also special devices that automatically adjust the surface to help relieve pressure when you lie down.

If you spend a lot of time in a chair or use a wheelchair, you can lower your chances of pressure sores if you:

●Do chair "pushups" – Use your arms to raise yourself off the seat, then lower. Try to do this at least once every hour.

●Tilt your body forward or to the side so your bottom lifts off the seat – Do this at least once every hour.

●Use a special seat cushion – Cushions can be filled with air, gel, or foam.

Taking good care of your skin is also important for preventing pressure sores. To help keep your skin as healthy as possible, you should:

●Check your skin regularly for signs of pressure sores – Have another person check areas you cannot see or feel. (If you have nerve damage, you might not be able to feel a sore forming.)

●Clean your skin regularly with mild soap – Do not use hot water. Gently pat the skin dry instead of rubbing it with a towel.

●Use a moisturizing cream – This helps keep your skin from getting dry and flaky.

●Use absorbent pads or underwear if you have incontinence – This means leaking urine or bowel movements. Using special pads or underwear can help keep your skin dry. Change them as soon as possible if they get soiled.

How are pressure sores treated? — 

Treatment can include:

●Medicines to treat pain

●Medicines to treat infection, if your skin is infected

●Special bandages to help the sores heal

●Surgery or other treatments to remove tissue – If there is infected or dead tissue in the sore, this might need to be removed. But not everyone needs this.

Your doctor or nurse will also talk to you about any problems that might have caused your pressure sore. They might suggest changes to help prevent you from getting them again in the future.

When should I call the doctor? — 

Call your doctor or nurse if:

●You get a new pressure sore, or an existing sore gets worse.

●You have signs of infection – These include:

•Fever of 100.4°F (38°C) or higher, or chills

•Swelling, color changes, or warmth around the sore

•Yellow, green, or bloody discharge from the sore

•Bad smell coming from the sore

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