Pressure ulcers (bed sores)

Pressure ulcers develop when your skin and the tissue beneath your skin becomes damaged due to constant pressure.

They are also called bed sores, pressure injuries, pressure sores and decubitus ulcers.

Pressure ulcers can appear on any part of your body that is under pressure for a long time. They can happen very quickly if you're unwell or not able to move easily.

Pressure ulcers can range in severity from patches of discoloured skin to open wounds.

Early signs of a pressure ulcer are:

• red areas
• blistered or bruised-looking skin
• shiny areas
• warm or hard patches
• broken or cracked skin

You should check your whole body twice a day.

Pressure ulcers most often form on parts of your body that aren't covered by a large amount of body fat. Pay particular attention to bony areas such as your:

• shoulders or shoulder blades
• elbows
• back of your head
• rims of your ears
• knees, ankles, heels or toes
• spine
• buttocks (tailbone)

You may need someone to help you with this, especially if you have reduced mobility.

Pressure ulcers form when sustained pressure is placed on a particular part of your body.

This pressure interrupts the blood supply to your skin. Blood contains oxygen and nutrients that keep your tissue healthy. When your blood supply is disrupted, the tissue is damaged and will eventually die.

Once an ulcer has developed, it can easily become infected by bacteria. This is because the lack of blood supply means that your skin is also no longer getting white blood cells. White blood cells help us to fight infections.

People with normal mobility do not develop pressure ulcers.

What can increase my risk of developing pressure ulcers?

You are at greater risk of developing pressure ulcers if you have mobility problems. This may be due to illness or surgery — for example due to stroke, spinal injury or dementia .

Other risk factors for pressure ulcers are:

• poor nutrition
• older age — over 70 years
• incontinence
• a health condition that can affect your blood supply — such as diabetes
• a health condition that makes your skin vulnerable to damage
• a serious mental health condition

It's important to see a doctor if you or someone you care for has a pressure ulcer.

Ulcers are best managed early on. So, watch out for early signs of pressure ulcers. Contact your doctor if you notice any changes to your skin.

Your doctor will be able to diagnose a pressure ulcer by looking at it.

Your treatment will depend on how bad your pressure ulcer is. You may just need to change your position regularly or use a special cushion or mattress. Or you may need to use dressings to protect your skin.

Other treatment options

You may need antibiotics if your ulcer becomes infected.

Some people will need debridement. This is a procedure used to clean the wound and remove any damaged tissue.

It's important to try and prevent pressure ulcers.

To protect your skin and prevent pressure ulcers, the following will help:

• Keep active and move as much as you can.
• Eat a variety of nutritious foods, including plenty of fruits and vegetables.
• Drink plenty of fluids to make sure you are hydrated.
• Avoid smoking because this reduces blood flow to your skin.
• Avoid firm massage, especially over bony areas.

If you have difficulty moving, you may need help from your family, carer or other health team member.

Caring for your skin

There are several things that will help you care for your skin:

• Instead of soap, use a mild cleanser and dry the skin gently afterwards.
• Apply moisturisers if your skin is dry, flaky or seems to crack easily.
• Use barrier cream in skin folds.
• Use warm (not hot) water when having a bath or shower.

Changing position

It's important to move around as often as you are able. Continuous pressure on the same areas can lead to a pressure ulcer developing quickly.

Try to change position every 30 minutes. If you can, stand up and walk around.

If you can't stand, lean forward or move side to side in your chair for 2 minutes. This takes the pressure off your bottom and hips.

Try to avoid slumping or sliding forward in your chair.

Your healthcare team may use a range of special equipment to help reduce pressure, such as a special cushion.

Pressure ulcers can be painful and decrease your quality of life.

It's possible that an infection may spread from the pressure ulcer to your:

• skin (cellulitis)
• blood (septicaemia)
• muscle
• bone (osteomyelitis)

Sometimes complications from pressure ulcers can be life-threatening.

It's important to recognise pressure ulcers early and to act quickly to prevent complications.

For more information and support, try these resources:

• The Health Translations website has information on preventing pressure ulcers (Opens in new tab) in languages other than English.
• See the Carer Gateway website (Opens in new tab) for information on caring for someone with reduced mobility.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.