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Pressure sores, or bedsores, can develop if a person spends a long time in the same position.

Also known as pressure ulcers, these sores form due to lasting pressure on specific areas of the body. They can develop anywhere, but the bony parts of the elbows, knees, heels, tailbone, and ankles are often more susceptible.

The sores are treatable, although full healing is not always possible. Without treatment, the sores can eventually lead to potentially fatal complications.

Research from 2015 indicates that pressure sores affect 3 million people in the United States. People with mobility problems have the highest risk.

Skin with pressure soreShare on Pinterest
Image credit: Mironmax Studio/Getty Images

Frequently changing positions can help the sores heal and keep new ones from forming.

When sores are in the early stages, people may be able to treat them at home. A healthcare professional needs to attend to more severe ulcers.

Other specific measures depend on the stage of the sore. But the following are helpful overall strategies:

  • Relieve the pressure: This might involve using foam pads or pillows to prop up affected areas, changing the body’s position.
  • Clean the wound: Gently wash very minor sores with water and mild soap. Clean open sores with a saline solution with each change of dressing.
  • Apply dressings: These protect the wound and accelerate healing. Options that are antimicrobial or hydrocolloid, or that contain alginic acid, may be best. Dressings are available for purchase online.
  • Use topical creams: Antibacterial creams can help combat an infection, while barrier creams can protect damaged or vulnerable skin.
  • Address incontinence: This might involve using cleansers, barrier creams, incontinence pads, and fecal management systems. These products are available for purchase online.
  • Have dead tissue removed: This can help a sore heal. A healthcare provider may use a high-pressure water jet or surgical instruments.
  • Review the bedding: Some mattresses, such as dynamic varieties or those made of static foam, help relieve pressure. Also, some beds have a pump that ensures a constant flow of air into the mattress. A doctor can help recommend the best type. Special mattresses are available for purchase online.
  • Take any required antibiotics: The doctor may prescribe these to treat infections of the skin, bone, or blood.
  • Adjust the diet: While there is limited evidence that any specific diet can help treat pressure sores, protein supplementation may boost healing and reduce wound size. Taking in enough essential nutrients and plenty of water can help maintain overall health.
  • Discuss surgical options: These might include removing dead tissue, cleaning the wound, and closing the edges as far as possible. The surgeon may take tissue from healthy skin to perform the repair.

A person with bedsores may also benefit from:

  • vacuum-assisted wound closure
  • electrical stimulation
  • hyperbaric oxygen therapy

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Pictured above are the varying stages of pressure sore severity.

Pressure sores develop in four stages:

  1. The skin feels warm to the touch. There may be a color change, such as redness, and the area may be itchy.
  2. A painful open sore or blister develops, with discolored skin around it.
  3. The lesion develops a crater-like appearance, due to tissue damage below the skin’s surface.
  4. There is severe damage to the skin and tissue, possibly with an infection. The muscles, bones, and tendons may be visible.

An infected sore takes longer to heal. The infection can spread elsewhere in the body and cause significant harm.

Tips for reducing the risk of pressure sores include:

  • changing positions frequently, between every 15 minutes to every 2 hours, depending on a person’s needs
  • inspecting the skin every day
  • keeping the skin clean and dry
  • maintaining good nutrition
  • quitting smoking and avoiding secondhand smoke
  • doing exercises, even while in bed, to encourage circulation

Anyone who may have a pressure sore should notify their caregiver or a healthcare professional as soon as possible.

Anyone who stays in one position for a long time is at risk of developing pressure sores. They often form in people who need help changing positions.

A person who develops a pressure sore may:

  • spend a lot of time sitting in a chair or lying in bed
  • wear a prosthesis or surgical appliance
  • wear ill-fitting shoes or clothing with elastic

These sores form when tissues and blood vessels become compressed, then distorted. This can lead to poor circulation, resulting in tissue death and infection.

Sores can result from significant pressure over a short period or low pressure over a longer period.

Symptoms of a pressure sore include:

  • Color changes: Dark skin may become bluish, purple, or shiny. Light skin may turn pink or red, or it may darken. If discoloration does not disappear after removing the pressure for 10–30 minutes, this may indicate that a sore is forming.
  • Texture changes: The area may feel hard or spongy and warm.
  • Broken skin: There may be a shallow, open sore with fluid or pus in it. The wound may extend into the deeper layers of tissue.
  • Infection: Signs include a change in color or sensation around the edge of the sore, the presence of more pus, green or black tissue around the sore, and a fever.

Common locations

Sores form in areas of pressure. A person who spends a lot of time sitting may develop sores on the:

  • buttocks and tailbone
  • spine
  • shoulder blades
  • backs of the arms or legs

A person in bed may develop sores on the:

  • ankles
  • heels
  • shoulders
  • tailbone
  • elbows
  • back of the head

The following can increase the chances that sores develop:

  • being unable to move unaided
  • older age, as the skin becomes thinner and more fragile
  • incontinence, which increases the risk of skin damage and infection
  • a low or high body mass index, or BMI, either of which can increase pressure
  • a low body weight, which leads to less padding around the bones
  • a condition, such as diabetes, that reduces feelings of pain
  • prolonged wound healing, as can also happen with diabetes
  • poor blood circulation
  • reduced mental awareness

Complications

Without treatment, pressure sores can lead to complications.

One example is cellulitis, a potentially life threatening bacterial infection from the surface of the skin to its deepest layer.

Cellulitis can also travel to other parts of the body and cause further complications, such as sepsis, a life-threatening infection that can lead to organ failure.

Also, bone and joint infections can develop if a pressure ulcer extends to these areas. This type of infection can damage cartilage and tissue and reduce limb and joint function.

It is often possible to reduce the risk of pressure sores. When a sore is at an early stage, a person can treat it at home, but more advanced pressure ulcers require professional care.

It is best to take every step to prevent these sores and to treat them early if they form.