(Pressure Ulcers; Bed Sores; Decubitus Ulcers)
by Debra Wood, RN
A pressure sore is a lesion that develops on the skin and underlying tissues due to unrelieved pressure usually over a bony prominence. The skin and tissues rely on an adequate blood supply for oxygen and nutrients. When tissues are compressed for an extended period from hours to days, blood supply can be cut off, leading to development of a sore.
Pressure sores result from lying or sitting in one position for too long a time. Prolonged pressure cuts off the blood supply to tissues that are compressed between a bony area and a mattress, chair, or other object. Without oxygen and nutrients, the tissue starts to die.
Several factors contribute to the development of pressure sores including:
Risk Factors TOP
A risk factor is something that increases your chance of getting a disease or condition.
Symptoms of a pressure ulcer may include:
If the redness remains a half hour after the pressure has been removed, the skin will likely break down. The reddened area may blister and a shallow ulcer may develop. Fluid may drain. The wound can deepen and can extend through fat and muscle to the bone. The area may be painful. The wound can become infected, with redness, swelling, odor, pus, warmth, and fever. If untreated, the infection can progress to gangrene, a blood infection, or an infection of the bone beneath.
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will examine the ulcer and note the location, shape, size, depth, stage, and any formation of pockets or cavities. Pressure sores are staged according to the depth and tissues that are involved.
Tests may include:
Treatment aims to relieve pressure on the area, heal the wound, avoid complications, and prevent future pressure sores. In many cases, a caregiver will provide care for your pressure sores.
Clean soiled skin after each bowel movement and urination. Wash with mild soap and warm water. Rinse well. Pat dry. Do not rub. Apply lotion as recommended by the doctor.
A nurse or doctor will teach you or your caregiver how to tend to the wound. Some basic instructions include:
Eat a well-balanced meal. Your doctor may recommend vitamins, minerals, or supplements.
Surgery and Other Procedures
The doctor may surgically remove dead tissue and skin grafts may be needed. In some situations, electrotherapy may be used to stimulate blood flow and promote healing.
If you are diagnosed with pressure sores, follow your doctor's instructions.
Most pressure ulcers can be prevented. Suggestions include:
National Pressure Ulcer Advisory Panel
Canadian Family Physician
Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov.
Cecil Textbook of Medicine. 21st ed. WB Saunders Company; 2000.
Conn's Current Therapy 2001. 53rd ed. WB Saunders Company; 2001.
Practice of Geriatrics. 3rd ed. WB Saunders Company; 1998.
Primary Care Medicine. 4th ed. Lippincott Williams & Wilkins; 2000.
5/27/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: McInnes E, Jammali-Blasi A, Bell-Syer S, Dumville J, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev. 2011;(4):CD001735.
Last reviewed September 2012 by Peter Lucas, MD
Last Updated: 09/30/2012