Bedsores (also known as pressures sores or pressure ulcers) are areas of damaged skin caused by staying in one position for too long. Constant pressure on certain areas of the body prevents sufficient blood flow to those areas. Since these areas are not supplied with essential nutrients, the tissue begins to die.

Bedsores most commonly occur where soft tissue is compressed between bone and an external surface. These bony areas include the tailbone, hips, heels, ankles, back, and elbows. Anyone who is immobilized due to illness, injury, or sedation, such as people who use wheelchairs or are paralyzed, is at risk for developing bedsores.

Bedsores can develop and get worse rapidly, and advanced sores take a long time to heal. If not treated right away, bedsores can lead to serious and life-threatening infections such as cellulitis (infection of connective tissue), bone and joint infections, and sepsis (bacterial infection of the bloodstream). Sepsis could then lead to organ failure and death.

Most bedsores can be prevented with the following strategies:

  • Change position. People who are bound to a chair or wheelchair should shift position every 15 minutes. Those who are confined to a bed should move (or be moved) to a new position every 2 hours, even during the night if not using a specialized pressure-reducing mattress. If a pressure-reducing specialized mattress is used, the person should be turned every 4 hours.
  • Keep skin clean and moisturized. Moisturize skin to keep its barrier properties in order to minimize the risk of skin breaking down.
  • However, avoid excessive moisture. Perspiration or fecal/urinary incontinence can result in excessive moisture causing maceration (softening or breaking down of skin). Use absorbent pads and incontinence briefs to aid with incontinence.
  • Protect bony areas. Use soft materials such as foam wedges to protect bony areas like the knees and ankles. Use polyurethane foam to protect the heels and sacrum (base of the spine).
  • Use pressure-reducing beds, mattresses, or cushions. Examples include those filled with foam, air, gel, or water. Talk to a doctor or nurse about what is appropriate for you.
  • Perform daily skin inspections. Any sign of redness or discoloration indicates that your position should be changed. The area should also be washed and dried thoroughly, and, for open sores, covered with a protective dressing.
  • Get help at the first sign of infection. If you notice any skin damage or sign of infection (drainage, odour, redness, warmth), tell your doctor, nurse, or caregiver immediately.
  • Maintain proper nutrition. Good nutrition will promote wound healing and prevent skin from breaking down. If you are having difficulty eating, speak to your doctor or a dietitian.
  • Prevent shearing and friction. Shearing forces (friction parallel to the skin surface) can reduce circulation causing tissue damage. Minimize shearing forces by raising the head of the bed not more than 30°. Friction of skin with another surface such as the bed can cause tearing of the tissues. Reduce friction by lifting a bedridden person rather than dragging.
  • Quit smoking. Smoking can impair wound healing by constricting blood vessels and reducing oxygen delivery to the tissue. Quit smoking to minimize the risk.