Skin Problems & Treatments Health Center

What are pressure sores?

A pressure sore (bed sore) is an injury to the skin and/or the tissues under the skin. Constant pressure on an area of skin reduces blood supply to the area. Over time, it can cause the skin to break down and form an open sore (ulcer). Pressure sores are more likely to form if you or a person you are caring for is in the hospital or is confined to a chair or bed.

Pressure sores most often form on the skin over bony areas where there is little cushion between the bone and the skin. Most pressure sores form on the lower part of the body, including over the tailbone and on the back along the spine, on the buttocks, on the hips, and on the heels. Other common spots are the back of the head; the backs of the ears; the shoulders, elbows, and ankles; and between the knees where the legs rub together.

Pressure sores can range from red areas on the surface of the skin to severe tissue damage that goes deep into muscle and bone. These sores are hard to treat and slow to heal. Other problems, such as bone, blood, and skin infections, can develop when pressure sores do not heal properly.

What causes pressure sores?

Things that cause pressure sores include:

• Constant pressure on the skin and tissues. This is by far the most common cause of pressure sores.
• Sliding down in a bed or chair, forcing the skin to fold over itself ("shear force").
• Being pulled across bed sheets or other surfaces (friction burns).
• Irritation of the skin from things such as sweat, urine, or feces.

As we get older, our skin gets more thin and dry and less elastic, so it is easier to damage. Poor nutrition-common among older people and people who cannot move easily-makes these natural changes in the skin worse. Skin in this condition may easily develop a pressure sore.

How are they treated?

Treatment focuses on preventing a sore from getting worse and on making the skin healthy again. Treatment includes:

• Relieving pressure on the area by changing positions often and spreading body weight evenly with special mattresses or other support.
• Keeping the sore clean and covered, and not letting it dry out.
• Eating a healthy diet with enough protein to help the skin heal.
• Keeping healthy tissue around a pressure sore clean and dry.
• In most cases, removing dead tissue and applying medicated ointments or creams to reduce the risk of infection. Only use medicines prescribed by the doctor to treat pressure sores, and follow all instructions carefully.

If infection develops, the person will need antibiotics. Severe pressure sores may need surgery.

How can you prevent pressure sores?