Bedsores or Pressure Ulcers

Old people or people who have suffered some accidents are often medically asked to limit their ability to change positions like asked to use a wheelchair or stay confined to a bed for a long time. These people are compelled to take care of their body in this way. These people are prone to a disease called bedsores.

Bedsores are also known as pressure sores or pressure ulcers. It is like an injury to the skin or the underlying tissue of the skin and it is caused due to prolonged pressure on that particular area of the skin.

What are the Causes of Bedsores or Pressure Ulcers

Bedsores are caused when blood cannot reach the skin or the tissues due to the pressure on the area. The causes are:

  • When the skin or the tissue face sustained pressure between the bone and the external surface.
  • Friction occurred under the skin when it is dragged across a surface.
  • Shear movement i.e. movement of the skin in the opposite direction which injures tissues and blood vessels.

What are the Symptoms of Bedsores or Pressure Ulcers

The National Pressure Ulcer Advisory Panel classified the symptoms of bedsores into four stages and have given how to treat from each of the stages. The stages of bedsores symptoms are mentioned below

  1. Stage I
  2. It is the beginning stage of the disease and shows the following symptoms:

    • The skin gets red on lighter skin and discolored or darker skin and does not blanch when touched
    • The region may get tender, painful, soft or warm according to the skin
  3. Stage II
  4. At stage II of bedsores, you can see that:

    • The epidermis and the dermis gets damaged or lost
    • The wound gets pinkish or red and it looks like a blister
  5. Stage III
  6. At stage III you will get to see that the Ulcer has become a deep wound. It also will show that :

    • The wound takes the shape of a crater
    • The damage starts to extend to the healthy parts of the skin
    • The loss of skin occurred will usually expose some fats
  7. Stage IV
  8. Stage IV is the last stage and it shows the largest scale of loss of skin or tissue. The patients affected part will also show the following changes:

    • The ulcer would expose bones, muscles or tendons.
    • The damage extends further beyond the infected area.

There is a stage where it is not possible to state the stage of the pressure sore. It is when the surface of the wound is covered with yellow, brown, black or dead tissue. This stage can’t be stated exactly as in this stage, it is not possible to see the wound.

The Risk Factors of Bedsores or Pressure Ulcers

Pressure sores usually occur on those parts of the body which have suffered prolonged pressure by the bones or muscles. Prolonged pressure is caused in different parts of the body for different people.

People Using Wheelchair: for people using a wheelchair, pressure sores or bedsores occur mostly in the following regions:

  • Tailbone or buttocks
  • Back of the arms and legs which they use to rest against the chair
  • Blades of the shoulder and the spine

People who are confined to bed: for people who are compelled medically to be confined to bed, pressure sores or pressure ulcers are most likely to occur in the following sites:

  • The back part or the side part of the head
  • Blades of the shoulder or the whole shoulder itself
  • Ankles, heels and the skin behind the knees
  • The rims of the ears
  • The hip, lower back or the tailbone or the buttocks

Thus we can see that bedsores take place and originate in those sites of the body which usually need to support the whole of the body and take pressure in the process of doing so.


If the person doesn’t notice any improvements within 24 to 48 hours, of a suspect symptom of bed sores, then it is best to consult a doctor at the earliest and seek immediate treatment and medical care if he sees any signs of infections like fever or foul odor from the diseased area.

The initial stage of treatment is by reducing the pressure on the pressure areas by either repositioning or by using support surfaces.

If the wound occurs in the later stages, then it must be kept clean and applied dressings properly and regularly.

During the end stages, treatment of Bedsores can be done by removing it in various methods such as – Surgical, Mechanical, Autolytic and Enzymatic Debridement process.

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