Treatment focuses on preventing pressure sores from getting worse and on restoring healthy skin.

Steps to treat pressure sores include:

• Managing the tissue load. Tissue load includes pressure, shear (such as when you slide down in a chair and your skin pulls and folds), and friction (rubbing).⁷ All of these forces can damage your skin and deeper tissues.
• Keeping the sore area clean and covered, and not letting it dry out.
• Keeping healthy tissue around the sore clean and protecting it from moisture.
• Eating a healthy diet.
• Avoiding smoking. Smoking dries out the skin and reduces blood supply to the skin, so it can help pressure sores form and also slow the healing process.

Early treatment can help prevent damage from pressure sores. After a sore progresses to a more serious stage, it becomes difficult to treat and can lead to complications.

Most stage 1 and stage 2 pressure sores will heal within 60 days with proper treatment.⁴ Stage 3 and 4 pressure sores can take months or even years to heal. Even though progress is slow, continued care and treatment can prevent complications such as further tissue damage, infection, and pain.

Pressure sores occur most frequently in people who are confined to beds or chairs. In many cases, a person with a pressure sore also has one or more medical conditions that may affect treatment and healing. These conditions include diabetes, kidney disease, and heart disease.

Manage tissue load.

Relieving and spreading out pressure is the most important part of preventing and treating pressure sores. When pressure is in one spot for long periods of time, the blood flow to that area is decreased. This damages or kills the cells, and creates a sore. Pressure can be relieved and spread in several ways. Often a combination of these is best. To relieve and spread pressure:

• Use special support surfaces. There are mattresses, bed covers, and chair cushions designed to help reduce and spread pressure. They can use materials including foam, air, water, beads, and fiber. Your doctor and other health professionals, such as nurses and physical therapists, will help find the right support surface for you.
  • Avoid using doughnut-type devices to cushion any area, or boots filled with air to support the heels. These devices may actually cause or aggravate pressure sores.⁵
• Change positions often, or help a person at risk of pressure sores change often. Most people change positions many times an hour, even if they are sitting down. All these movements and adjustments help relieve pressure. A person who cannot easily move themselves or who does not have normal feeling in their body or mental awareness to tell them when to change positions is at risk of pressure sores. These people need a regular schedule for position changes and usually need help being turned or repositioned. Most experts recommend changing positions at least every 2 hours.
• Avoid positions that put pressure directly on an existing pressure sore.
• Avoid positions that will allow you to slide, slip, or slump. Recliner chairs are likely to allow slipping.
• Watch for pressure from parts of wheelchairs, braces, or other equipment, or from body parts pressing and rubbing together. For example, the knees or ankles of a person who spends long periods in bed can rub together and cause sores. Work with your health provider to be sure there is either no pressure or that there is good padding between the skin and other surfaces.
• Avoid sliding. This causes friction (rubbing) on the skin that can lead to sores.

Protect and treat the sore area.