Decubitus Ulcers/Pressure Sores/Bedsores

external image r7_bedsore09.jpg


  • Pressure sores are injuries to the skin and underlying tissue that result from prolonged pressure on the skin.
  • Develop quickly and are difficult to treat.


  • Pressure sores are caused by unrelieved pressure, friction, humidity, shearing forces, temperature, age, continence, and medication.

external image gran1.jpg

Risk Factors

  • Poor health and weakness
  • Paralysis
  • Bedrest
  • Wheelchair use
  • Recovery after surgery
  • Sedation
  • Coma
  • Smoking
  • Muscle spasms
  • Urinary incontinence
  • Weight loss

external image 205225.jpg


Decubitus ulcers can occur anywhere. Most are found:

  • Portions over the bony or cartilaginous areas
  • Sacrum
  • Knees
  • Heels
  • Ankle
  • Tailbone
  • Elbows
  • Shoulder & shoulder blade
  • Back of head
  • Hip
  • Buttocks
  • Ball of foot

external image PT05DecubitusLead.png


Pressure sores are most common in people:
  • with medical conditions that limits their ability to change positions
  • requires them to use a wheel chair
  • confined to bed for prolong period of time

There are 4 Stages of Pressure Sores

1) following characteristics: skin appears red on lighter skinned people, skin doesn't blanch when touched, on darker skinned people, skin may appear ashen, bluish, or purple

2) Ulcer is an open wound: epidermis and part of dermis is damaged or lost,ulcer may appear as a shallow, pinkish-red basin-like wound, may rupture fluid filled blister

3) Ulcer is a deep wound: fat is usually exposed, ulcer has crater-like appearance, bottom of wound may have yellowish dead tissue, damage may extend beyond primary woulnd below layers of healthy skin

4) Large scale loss of tissue: wound may expose muscles, bone, and tendons, bottom of wound likely will contain dead tissue,damage extends primary wound beyond layers of healthy skin

external image bed_sore.jpg

Removing tissue includes:

  • surgical debridement: cutting away tissue

  • mechinical debridement: using whirlpool water bath

  • autolytic debridement: process of recruiting enzymes to break down dead tissues

  • enzymatic debridement: use of chemical enzymes

external image 3347022_f496.jpg
external image alcohol-fig1b.jpg

Warning Signs of Pressure Ulcers:

-discolored or torn (swollen) skin especially over bony areas

-signs of infection- skin warmth, swelling, odor, pus

Interventions that can be used:

  • pain managment- the use of drugs such as ibuprofen

  • antibiotics

  • healthy diet- increase in calorie and fluid, high protien diet, vitamin C & Zinc

  • muscle spasm relief- use of muscle relaxants

Pressure sores can be fatal; so we suggest keeping an eye out for the start of these ulcers and annual checkups to your doctor!