An Overview of Pressure Sores

A pressure sore, also known as a bed sore or pressure ulcer, is an injury to the skin that occurs when blood flow to the area is disrupted due to sitting or lying in one position for a long time. The beginning signs of a pressure sore may include discomfort and changes in skin color and temperature, and recognizing them early on—and making adjustments to prevent them from worsening—can help you avoid pain and complications.

Pressure sores can appear on any part of the skin that has prolonged contact with an object like a bed or wheelchair. They usually appear on bony areas, including the hip bone, tail bone, spine, shoulder blades, elbows, back of the head, knees, and heels.

The beginning signs of a pressure sore include:

• Skin that’s red 
• Skin that’s either abnormally warm or cool to the touch
• Blue or purple tint on the skin (if you have darker skin)
• Skin that doesn’t turn white (blanch) when pressed
• Pain, tingling, or itching on any part of the body (even if it’s minor)

Pressure sores fall into different stages from mild to severe. As a pressure sore progresses, symptoms may include:

• Blistering
• Broken skin or an open wound
• A crater-like appearance
• Significant pain
• Deep-tissue injury that can affect the muscles, tendons, and bones

Pressure sores develop in areas where your weight is pressing against a surface. If that pressure lasts for more than two or three hours and your blood can’t reach the area, the skin and underlying tissues become damaged because of the lack of oxygen and nutrients. Pressure sores can also form in areas where your skin is wet from a fluid like urine or sweat. 

Pressure sores are more likely to develop when you're elderly; as you age, your skin becomes thinner and more easily damaged. You’re also more likely to get pressure sores if you have mobility issues, are unable to switch positions, suffer from malnutrition, or have a loss of sensation in your skin. 

Your physician will be able to diagnose pressure sores by looking at them during an exam. Based on your symptoms, they can also tell you if your bed sores are at an early or a more advanced stage.

The care you need depends on how advanced your bed sore is. Always check with your doctor to make sure that you’re receiving the right treatment.

If your doctor diagnoses you with an early stage of pressure sores, they may recommend the following:

• Relieve pressure on the area: If you’re in a wheelchair, change positions every 15 minutes by leaning forward and side-to-side. If you’re in bed, make sure you’re moving to a new position every two hours. Use pillows or other supports to help keep you comfortable in different positions.
• Follow your doctor’s recommendation for cleaning your sore: For the beginning signs of a pressure sore, they may suggest you wash with mild soap and water. For a more open sore, your doctor may suggest cleaning with a saline rinse. Make sure you pat the area dry, rather than rub it, to avoid irritation.
• Cover the sore, if needed: Ask your doctor if your sore should be covered with a special dressing or bandage.
• Take care of your general health: Eat nutritious foods and get lots of sleep to help your body heal. 

More advanced sores will take a longer time to heal and will need to be treated by a healthcare provider. Your doctor may need to remove dead tissue, a process known as debridement. This is often done with a scalpel, chemical solution, whirlpool bath, or biosurgery. 

Check your skin daily if you’re at risk for pressure sores. If you're not sure how to spot the early signs, don't hesitate to call your doctor. They can help you to identify pressure sores before they cause any complications.