Pressure Ulcers

Pressure ulcers are a common risk for people who are in a wheelchair or confined to bed. When you rarely move, the pressure of your body limits the blood flow to the areas you lie or sit on. Lack of blood flow can cause areas of skin and the tissue underneath to break down and eventually die. This forms a sore called a pressure ulcer. Pressure ulcers are also called bed sores or pressure sores.


Pressure ulcers are most likely to occur in the skin over a bony part of the body that comes into direct contact with a mattress or wheelchair. These spots include the heels, hips, elbows, ankles, back, and shoulders.

The first sign of a pressure sore is often a soft, red patch of skin that stays red for 30 minutes, even after the pressure is removed. In a person with dark skin tones, the skin will turn darker or feel warm. Call a healthcare provider immediately if pressure sores are spotted.

There are 4 stages of pressure ulcers. In stage 1, there is a red, blue, or purplish area like a bruise, but no break in the skin. This is the earliest stage. In Stage 2, those areas of skin become broken and painful, like a blister. In Stage 3, the sore gets deeper, often with patches of dark skin around it. It often drains a foul-smelling fluid. In Stage 4, the sore reaches the muscle, bone, or joints. It can cause a serious bone infection or a deadly infection of the blood.


In a hospital, doctors, nurses, and health aides who help with cleansing and dressing can spot pressure sores. At home, use a mirror to look for reddish patches or sores on your body if you are restricted to bed or a wheelchair. Or, ask your caregivers, your family, or a friend to help you check.


A pressure sore can get worse quickly. It needs to be treated right away. First, relieve pressure from the area. Prop up the leg or the area near the injury with a pillow or foam cushion.

If there is an open sore, follow your healthcare provider’s instructions for how to treat it to keep it from getting infected. Often, a pressure sore is cleaned with saline or salt water to remove dead tissue. Then it is covered with a special bandage. Antibiotics can speed up healing. Severe sores may need to be treated in the hospital.

Proper healing also requires good nutrition. Make sure the person has a diet with enough calories, protein, and nutrients. Once the ulcer is healed, make sure to relieve pressure on the area on a regular basis. This can help prevent the sore from coming back.


Because pressure sores can be hard to treat and may take a long time to heal, prevention is very important.

If you are on bed rest, change your body position every 2 hours to prevent pressure sores. Don’t lie with one leg on top of the other. If you’re lying on your side, put a pillow between your legs. Use a pad or piece of foam to raise your heels slightly off the mattress when lying on your back.

If you are not mobile, or if you are caring for someone who isn’t mobile, consider buying an alternating air mattress. The mattress has alternating cells that inflate and deflate to relieve pressure and increase blood flow.

If you’re in a wheelchair, shift positions every 10 to 15 minutes. If you can’t do that, have someone shift your position at least once an hour.

Ask your healthcare provider for other ways to reduce the risk of pressure sores.

Things to Remember

  • Know which areas are most likely to develop pressure ulcers. Check the areas often.
  • Move a person at risk, or encourage the person to move, at least every 2 hours.
  • Contact your healthcare provider at the first sign of a pressure ulcer.

Pressure ulcers are a serious problem, but with attention and care, they can be treated and prevented.

What We Have Learned

  1. Pressure ulcers can get worse quickly. True or false?
    The answer is True. That is why it’s important to contact a healthcare provider at the first sign.

  2. The first stage of a pressure ulcer is an open sore like a blister. True or false?
    The answer is False. The first sign is a soft red patch of skin that stays red for 30 minutes after pressure is relieved. In a person with darker skin, the skin will look and stay darker.

  3. Pressure ulcers can be deadly. True or false?
    The answer is True. A pressure ulcer can lead to a deadly blood infection.