Pressure Ulcers (Bedsores): Symptoms, Causes, Treatment
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Pressure ulcers, also called bedsores, are skin and tissue injuries caused by sustained pressure or pressure with shear. Damage can begin beneath intact skin and needs early assessment.
What is Pressure Ulcers (Bedsores)?
Bony areas such as heels, sacrum and hips are commonly affected, and medical devices can cause injuries. They are not simply a hygiene problem; surface appearance may underestimate depth.
Related reading: Leg ulcers and their vascular causes.
Symptoms
Pain, warmth or persistent discoloration may precede a blister or open wound. Color changes can be less obvious in darker skin.
Causes
Prolonged pressure impairs blood supply. Moisture, friction, limited mobility and poor nutrition can increase tissue vulnerability, often in combination.
Risk factors
Limited mobility, reduced sensation, poor circulation or nutrition and moisture increase risk. Wheelchair users and people with medical devices also need pressure-point checks.
Diagnosis
Skilled assessment considers depth, size, tissue, circulation, infection, pressure exposure and nutrition. A photograph or color alone cannot reliably stage an injury.
Treatment
Care combines pressure relief, repositioning, suitable support surfaces, dressings and individualized tissue and nutrition management. Antibiotics are not routinely appropriate without a clinically indicated infection.
Complications
Deep injury, delayed healing, soft-tissue or bone infection and sepsis may occur. Prevention and monitoring continue after the wound closes.
Prevention
Check skin daily, follow an individualized repositioning plan and offload heels. Do not massage damaged areas or assume a special mattress replaces repositioning.
When to see a doctor
A worsening wound, spreading redness, fever or new discharge needs urgent assessment. Confusion, breathlessness or low blood pressure with infection warrants emergency care.