Bedsores
(Bed Ulcers · Decubitus Ulcers · Pressure Sores)
In this condition factsheet:
The Facts on Bedsores
Bedsores are also known as pressure sores or decubitus ulcers. They form when your bone squeezes your skin and tissue against an outside surface, usually on weight-bearing parts of your body where the bones are near the skin. Bedsores usually develop below your waist if you are bedridden, although they can occur almost anywhere on your body. Common sites are the hips, shoulder blades, elbows, base of the spine, knees, ankles, heels, and even between fingers and toes.
Bedsores can develop in some people with just a few hours of constant pressure and range from mild reddening to severe craters that extend into the muscle and bone. They're quite a nuisance and often painful. Anyone who must remain in a bed, chair, or wheelchair for extended periods can develop these sores.
Most pressure sores affect patients over 70 years old who are bedridden in hospitals and long-term care facilities. In Canada, about 25% of people in acute-care settings (e.g., hospitals) develop pressure sores. In non-acute care settings (e.g., nursing homes), the prevalence of pressure sores is even higher (about 30%).
Causes of Bedsores
Bedsores are injuries caused by constant and unrelieved pressure that damages the skin and underlying tissue due to lack of mobility and blood circulation (i.e., being bedridden). If you must sit or lie for prolonged periods, the surface of your seat or bed puts excessive pressure on the bony prominences or pressure points in your body. Common pressure points on the body include the tail bone (sacrum), hip bone areas, and the ankle and heel. Less common sites include the elbows, spine, ribs, and back of the head.
Pressure sores may also result from friction caused by your skin rubbing against another surface, or when two layers of skin slide on each other, moving in opposite directions and causing damage to the underlying tissue. This may happen if you are transferred from a bed to a stretcher, or if you slide down in a chair.
Excessive moisture that softens your skin and reduces its resistance can also cause pressure sores. This can occur with excessive perspiration and with urinary or fecal incontinence.
All the factors listed below place you at higher risk for pressure sores:
- age over 65 years
- immobility
- inactivity
- fecal or urinary incontinence
- poor nutrition
- decreased level of consciousness
- excessively low or high body weight
- smoking
- corticosteroid use
- dry skin
- impaired sensation
Medical conditions such as the following also put you at risk:
- anemia
- infections
- edema
- diabetes mellitus
- stroke
- dementia
- alcoholism
- fractures
- cancer malignancies
- peripheral arterial disease
- venous insufficiency
Symptoms and Complications of Bedsores
A pressure sore usually begins as a reddened, sensitive patch of skin and then goes on to develop into a sore or ulcer that can extend deep into the muscle and even bone. If left untreated, a pressure sore may lead to cellulitis or a chronic infection.
