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Bedsores (Pressure Ulcers) Symptoms Causes Treatment Preventions & More All you need to know

December 29, 2021

A bedsore is a skin disorder resulting from prolonged pressure on the skin. It is also called a pressure ulcer or a decubitus ulcer. The bedsores usually occur on many parts of the skin, especially where skin covers bony structures.

Medical conditions that make patients incapable of changing positions or which require them to spend the majority of their time lying flat or seated are the leading causes of bedsores.

It may take hours or days for bedsores to appear. The majority of sores will heal with treatment, though some will never fully recover. Bedsores can be prevented and helped heal through preventative measures.

Healing of the sores may not always be possible, but they can be treated. The sores can cause potentially fatal complications if no treatment is provided.

Bedsores (Pressure Ulcers) Symptoms Causes Treatment Preventions

The United States has 3 million people who suffer from pressure sores, according to a new study from 2015.

The most common sites for decubitus ulcers are:

  • The tailbone or the buttocks
  • Blades of the shoulder and spine
  • The back of an arm or leg that rests against a chair

Bedsores can develop in the following areas:

  • A person's head, usually the back or side
  • Those on the shoulders
  • The hip, the lower back, or the tailbone
  • Knees, heels, and ankles

Signs and Symptoms

Pressure sores are characterized by the following symptoms:

  • Texture changes:

The area may feel spongy and hard.

  • The color of dark skin:

The skin color can change from blue to purple or from shiny to dull. Depending on how light the skin is, it may turn pink or red or darken. This may indicate that a sore is forming if the discoloration persists for 10–30 minutes after removing the pressure.

  • Infection:

Symptoms of infection include a change in skin color, color change around the sore, pus, black or green tissue near the sore, and fever.

  • Broken skin:

It may be accompanied by a shallow, open sore, or even pus may accumulate. There is a possibility that the wound extends deeper into the tissue.

Stages of bedsores

There are four following stages of bedsores:

  • Stage 1:

During this stage, the pain is not severe. Only your upper layers of skin are affected by these pressure sores.

Common symptoms include burning, pain, and itching. Furthermore, if the spot is firmer, softer, warmer, or cooler than the nearby skin, it can feel different.

Your skin may appear red. Those with darker skin may have a harder time identifying the discolored area. No matter how long you press on it, or even after you stop pressing, the spot doesn't become lighter. The area is receiving less blood as a result.

Any pressure sore should be treated by stopping the pressure as soon as possible. Consider lying on a foam pad, or a mattress.

At least every two hours, you should get out of bed if you spend a lot of time there. Sit for 15 minutes and then get up and move. There must be someone who can assist you.

  • Stage 2:

The sore becomes more inflamed as it breaks deeper into your skin.

If your skin is broken, bleeding, or infected with pus, you have damaged skin.

There is swelling, warmth, and redness in the area. Occasionally, clear pus may ooze from the sore. The pain is intense.

Continue with Step 1 as before. A salt-water solution or tap water should also be used to clean the wound. Your doctor may recommend that you take a painkiller for 30 to 50 minutes before you clean.

  • Stage 3:

There are sores in the fat tissue that have penetrated through the second layer of skin.

In addition to looking like a crater, the sore may smell bad as well. If the sore has died, it may present itself with red edges, pus, increased odor, or temperature. If the sore is infected, its surrounding tissue may become black.

More care is needed for sores at Stage 3. You should consult a doctor. Infections may be treated with antibiotics after dead tissue is removed. Your insurance may also guarantee you a mattress or bed with special features.

Health can take up to four months for Stage 3 pressure sores.

  • Stage 4:

This stage of sore is the most severe. Muscles and ligaments may even be affected by this stage.

It is a big, deep sore. Symptoms of infection appear on the skin, including blackening, pus, and smell. Often, you can see muscles, tendons, and bones.

You should notify your physician immediately. It is important to get immediate care for these wounds, and you may require surgery.

It can take up to 3 months or even years for a Stage 4 bedsore to heal.

What are the causes of bedsores?

The skin's blood flow is restricted by pressure against the skin, which results in bed sores. As a result of limited movement, skin becomes prone to damage and bedsores develop.

Bedsores are primarily caused by three factors:

  • Pressure.

Any type of persistent pressure on your body can cause decreased blood flow. Oxygen and nutrient-rich blood supply are vital for tissue health. The damage to the skin and surrounding tissues could lead to death without these essential nutrients.

This kind of injury occurs most often in areas that are thinly stuffed with flesh and fat, such as the vertebrae, hips, and elbows, especially for people with limited mobility.

  • Friction:

Clothing or bedding rubs against the skin, resulting in friction. In addition to making the skin more vulnerable to injury, moist skin can also make it more easily injured.

  • Strain:

Two surfaces move against each other during shear. In a raised bed, you can slip down the bed when the head is raised. It is possible that the skin over the tailbone stays in place as the tailbone moves downwards.

Risk factors of bedsores

Having trouble moving or changing positions when sitting in bed can increase your risks of bedsores. Here are a few risk factors to consider:

  • Incontinence.

When exposed to urine or stool for an extended period, the skin becomes more prone to it.

  • Stabilization.

Health issues, spinal cord injuries, and other causes may contribute to this.

  • Sensational deficits.

Among other conditions, injuries to the spinal cord and neurological disorders affect sensation. Pain or discomfort that cannot be felt can lead to an inability to recognize warning signs or the need to change positions.

  • An inadequate diet and lack of hydration.

Having adequate fluids, nutrients, protein, carbohydrates, and minerals in your food supports healthy skin and prevents tissue breakdown.

  • Circulatory problems are caused by certain medical conditions.

The risk of bedsores can be increased by health problems that can impair blood flow, such as diabetes and certain vascular diseases.


There are a number of life-threatening complications associated with pressure ulcers, including:

  • Cellulitis.

Skin and soft tissues can become infected with cellulitis. The affected area will become warm, swollen, and red. Cellulitis often does not cause pain in people with nerve damage


  • Infections of the bones and joints.

As a result of a pressure sore, an infection can incur into the bones and joints. Osteoarthritis (septic arthritis) can cause cartilage and tissue damage. The function of joints and limbs can be impacted by bone infections (osteomyelitis).

  • Cancer.

Squamous cell carcinoma can develop from long-term and nonhealing wounds.

  • Sepsis.

Sepsis rarely results from a skin ulcer.


The best treatment is prevention. Despite taking proper measures, the disease cannot be eliminated, but it can certainly be reduced. It cannot be overstated how important it is to take proper preventive measures.

It doesn't matter what the nature of the disease is, there is always a way to stop symptoms from getting worse. There are several techniques you can use to prevent the symptoms from resurfacing,

Taking direct pressure off

  • Whenever possible, move around and change positions
  • Standing up can relieve pressure
  • When you are unable to move, have your caregiver reposition you regularly
  • A minimum of twice an hour, you should change positions
  • Make sure you use special mattresses that relieve pressure
  • Avoid dragging your heels or elbows when getting up or down from your bed or chair


  • Dry your skin and keep it clean
  • Use unscented soaps to prevent drying
  • Apply a good amount of moisturizer to your skin after washing
  • The natural oils on the skin are driest when using talcum powder
  • Keep moisture stability for your skin

Tips for general use

  • When you lie in bed, you should make sure your bed sheets are smooth and wrinkle-free
  • A silk-like material such as cotton or linen should be used as sheets
  • By consuming a mixture of foods, you can balance your nutrition
  • Make sure you drink two liters of water every day
  • As soon as you notice any changes in your skin, tell your doctor or nurse

When to see a doctor?

People often delay their hospital visits in the hope that their symptoms will pass and they can just rest it off. One's health can be adversely affected by this type of thinking. In general, the longer you delay seeking medical attention, the more severe your complications will be.

Listed below are some of the signs you may want to keep an eye out for.

Bedsore may appear if you are not able to relieve the pressure. Consult your doctor if your condition doesn't improve within 24 to 48 hours.

Symptoms of infection include fever, drainage from a sore, smelling of a sore, increased redness or swelling on top of a sore, or increased warmth in its vicinity.


There is a possibility that your healthcare provider can refer you to a wound care facility that has consultants, therapists, and professionals with experience treating pressure sores.

Several factors can be taken into consideration by the team when evaluating your ulcer. Among them are:

  • Your ulcer's size and depth
  • Whether your ulcers are directly affecting skin, muscle, or bone
  • Your ulcer-affected skin color
  • In the case of an ulcer, how much tissue death occurs
  • If there are signs of infection, bleeding, or strong odor coming from your ulcers, contact your doctor

You may be asked to submit samples of the fluids and tissue surrounding your pressure ulcer. Additionally, they are likely to look for evidence of bacteria growth and cancer.


It is important to reduce pressure on an injured area of skin, care for wounds, control pain, prevent contamination, and maintain sound nourishment in order to manage pressure ulcers.

Reducing pressure

Bedsore can be treated by reducing the pressure and friction it was caused by. The following are some ideas:

  • Realignment.

Change your position frequently if you have bedsore. The number and frequency of repositions depend on your health and how well-maintained your surface is.

  • The use of support surfaces. Make sure to use mattresses, beds, and special cushions so that you can sit or lie comfortably without damaging vulnerable skin.

Wound care and dressing

Depending on the depth of the wound, pressure ulcers require different treatments. In general, wound care includes the following:

  • Cleansing. Cleanse and pat dry the affected skin if it isn't broken. Every time you change the dressing, clean the open sore with water.
  • Bandaging. By maintaining moist conditions, a bandage accelerates the healing process. Additionally, it keeps the skin around it dry and protects against infection. A bandage can be made of films, gels, or gauze. Combining dressings might be necessary.

Removing damaged tissue

Healing can only take place if wounds are free of dead and infected tissue. Damaged tissues can be removed by washing the wound with water or by cutting them out.


Pain can be reduced by nonsteroidal anti-inflammatory drugs, such as naproxen sodium (Aleve) and ibuprofen (Motrin IB). Before and after repositioning and if wounds need to be treated, these can be very helpful. A topical pain reliever may also be helpful when caring for wounds.

Eating healthy foods.

Wound healing can be facilitated by consuming a healthy diet.


Surgical intervention could be necessary for bedsores that are large and have not healed. To cushion the affected bone during surgery, a patch of muscle, dermis, or other tissue is used.

Abdur Rashid
Medically Reviewed By Abdur Rashid
MSC Public Health, MCSP, MHCPC
BSC (Hon) Physiotherapy
Consultant Neuro-spinal & Musculoskeletal Physiotherapist


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