Pressure sores, bed sores, or pressure ulcers are injuries and irritations to the skin caused by staying in the same position for too long. The pressure of a bed or other object on body parts such as the ankles, back, elbows, heels, and hips can lead to these sores. People most prone to pressure sores are those who remain in a bed, chair, or wheelchair for prolonged periods of time.

What are the symptoms of pressure sores?

There are four stages of pressure sores. The first stage is the mildest, marked by pain, burning, or itching in a specific area. The second stage begins when the sore begins to form below the surface of the skin, forming open wounds or blisters. In stage three, the sore reaches the fat tissue under the skin. Signs of infection may occur at this stage. The final stage is the most severe; the sores may begin to affect muscles and ligaments and express with symptoms such as black skin, deepening of the sore, and further signs of infection.


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Where do pressure sores commonly occur?

Pressure sores are most commonly found where skin covers bone without much tissue between, such as the heels, elbows, back, and hips. For people who spend prolonged periods of time in a wheelchair, pressure sores commonly develop on the tailbone, shoulders, spine, and the back of the legs. For people who spend prolonged periods of time in a bed, pressure sores may develop on the back of the head, shoulders, hip, lower back, tailbone, heels, and ankles.


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When should I see a doctor about my pressure sores?

If you begin to notice the first stage of pressure sores, change your sitting or lying position and see if the signs diminish. Warning signs will include pain, redness, and itching. If an open wound develops or you start to see signs of infection at the site, contact your doctor for further diagnosis and treatment.


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How does pressure cause bed sores?

Pressure from a bed or a chair limits blood flow to the skin and can cause a pressure sore. Blood carries oxygen and other vital nutrients to all parts of the body. When blood flow is limited to a certain area due to pressure, that part of the body does not get the nourishment it needs. This may lead to a pressure sore.


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How does friction contribute to pressure sores?

Different from pressure, friction is the action of a body part moving against clothing, a chair, the bed, or a wheelchair. This can irritate skin and over time lead to pressure sores. Damp skin, such as from sweat, exacerbates friction and the pressure sores will form more quickly.


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What is shear and how does it contribute to pressure sores?

"Shear" refers to the strain when two objects move against each other in opposite directions. Pressure sores may develop due to shear when a hospital bed is higher at the head then the rest of the body. Gravity causes the body to shift down and the rubbing of bones against the skin can lead to bed sores.


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What are the risk factors for pressure sores?

People required to remain in a bed or a chair for long periods of time are generally already dealing with another medical condition. A lack of proper nutrition can lead to vulnerable skin that is more sensitive to bed sores. Certain injuries and disorders may leave a person unable to properly perceive pain. Those with these ailments may not realize they are putting too much pressure on a particular body part and are therefore more prone to pressure sores.


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Do any medical conditions lead to pressure sores?

Medical conditions that affect blood flow may lead to tissue damage and pressure sores. Diabetes is associated with nerve damage and poor circulation, both of which contribute to the presence of pressure sores. Vascular diseases such as blood clotting disorders and peripheral artery disease also affect blood flow.


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What is cellulitis and is it related to pressure sores?

Without treatment, pressure sores may lead to cellulitis, a skin and soft tissue infection caused by bacteria such as staphylococcus. Symptoms include redness, pain, swelling, and warmth of the affected area. A person with cellulitis may develop a fever, and swollen lymph nodes in the area of the infection, and the condition can spread from the initial site.



How can I prevent pressure sores?

If you are confined to a bed or chair for prolonged periods of time, there are two ways you and your caregivers can help prevent pressure sores: repositioning about once every hour and maintaining healthy, clean skin. Wash the skin with a mild cleanser, use talcum powder at points of friction, and moisturize areas of dry skin. These methods can protect against the formation of pressure sores.


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