Pressure ulcers, also known as bedsores, are areas of the skin where pressure cuts off blood flow and circulation to surrounding skin tissue. The weight from lying in bed or sitting in a wheelchair over several hours without moving causes the ulcers to form. People with decreased sensation or those with an inability to shift their bodies are at high risk for developing the sores. According to the Merck Manual, pressure ulcers begin to form in as little as two hours 2. The sores rapidly advance and cause severe, deep infectious wounds if left untreated. Nursing interventions and precautions prevent pressure ulcers from occurring.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Turn Every Two Hours
A person’s position should change every two hours to stop ulcers from forming. Changing positions is encouraged when a person is awake and asleep. If a person is bed bound, move the person from lying on his back to the left side, then the right side, and then back to his back. The Mayo Clinic encourages people to lie at a 30 degree angle when is on their side 1. Bedridden people left to lie on their back commonly forms pressure ulcers on their buttocks. Encourage mobility if possible. Do not raise the head of the bed more than 30 degrees to prevent the patient from sliding down the bed. Use pillows and assistive cushioning to keep proper positioning and body alignment.
- A person’s position should change every two hours to stop ulcers from forming.
- Use pillows and assistive cushioning to keep proper positioning and body alignment.
What Causes Skin Ulcers?
Place soft cushioning between bony prominences. Ankles, wrists and other hard bone areas are common areas where pressure ulcers form. Attach sheepskin to hard surfaces touching the skin such as the sides of a wheelchair or bedrails. Apply soft wraps or cushioning made from cotton or wool to protect bony areas. Add specialized booties and ankle wraps for additional protection to specific joints. Support the legs by always placing cushioning below the knees; never place cushioning or pillows directly under the knees. Replace mattresses with specialty bedding containing water or gel. Frequent repositioning is still required with the use of any cushioning products.
- Place soft cushioning between bony prominences.
- Add specialized booties and ankle wraps for additional protection to specific joints.
Keep the skin dry and moisture free. Dry skin is less likely to stick together and form pressure ulcers. Wash the skin daily; use a washcloth and always pat skin dry. Apply noncaking body powder to areas of the skin touching each other, suggests the Merck Manual 2. Change bedsheets on a daily basis.
- Keep the skin dry and moisture free.
- Apply noncaking body powder to areas of the skin touching each other, suggests the Merck Manual 2.
Inspect Skin Daily
Medicines for Bedsores
Look at all areas of the skin daily. Inspect for areas of redness and warmth, the beginning signs a pressure sore is forming. Stage two signs include formation of craters and blisters. Do not allow a person to lie or sit on the affected area until the symptoms disappear. A person may not feel a pressure sore developing; asking her if an area is painful is not always conclusive in determining if a sore is forming. Often the skin is numb, and decreased sensation to the affected area is present.
- Look at all areas of the skin daily.
- Do not allow a person to lie or sit on the affected area until the symptoms disappear.
What Causes Skin Ulcers?
Medicines for Bedsores
How to Use Micropore Tape on a Scar
About Calluses on Your Thumb
How to Fix Hammer Toe On Children
What Are the Different Types of Splints?
How to Remove Soft Corns Between My Toes
Painful Blisters on the Bottom of a Child's Foot
How to Remove Corns & Bring Skin Color Back
Macerated Wound Symptoms
- Mayo Clinic: Bedsores
- Merck Manual: Pressure Sores
- National Pressure Ulcer Advisory Panel: Pressure Ulcer Prevention
- Gerontologic Nursing; Sue Meiner and Annette Giesler Lueckenotte; 2006.
- Alzheimer’s Society. Pressure Ulcers (Bed Sores). May 2013.
- Hopkins Medicine. Chapter 30- Pressure Sores.
- US Department of Health and Human Services. Agency for Healthcare Research and Quality. Long-Stay Nursing Home Care: Percent of High-Risk Residents With Pressure Ulcers. April 15, 2013.
- US National Library of Medicine. Stages of Pressure Ulcers.
- International Wound Journal. 2015 Nov 20. doi: 10.1111/iwj.12535. Exploration of Pressure Ulcer and Related Skin Problems Across the Spectrum of Health Care Settings in Ontario Using Administrative Data.
- US National Library of Medicine. Preventing Pressure Sores. July 30, 2014.
Julie Hampton has worked as a professional freelance writer since 1999 for various newspapers and websites including "The Florida Sun" and "Pensacola News Journal." She served in the U.S. Army as a combat medic and nurse for over six years and recently worked as the Community Relations Director for a health center. Hampton studied journalism and communications at the University of West Florida.