Table of ContentsView AllTable of ContentsTreatment Based on StageCleaningDressingSurgical TreatmentComplementary Remedies
Table of ContentsView All
View All
Table of Contents
Treatment Based on Stage
Cleaning
Dressing
Surgical Treatment
Complementary Remedies
Bedsores, also known as pressure ulcers ordecubitusulcers, occur when too much pressure is applied to an area of your skin for a long time. The pressure prevents blood from reaching the affected area, so the skin dies.
Treatment for bedsoresdepends on the severity of the sore. Staging uses a universal system based on the level of tissue loss. Therapies can involve repositioning, dressings, and other treatments of the affected areas. Surgery may be needed to repair the bedsores in the most advanced stage.
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Bedsore Treatment Based on Injury Stage
Stage 1
Symptoms include:
Treatment includes:
Consult your healthcare provider if the sore recurs or does not heal within a few days.
Stage 2
Contact your healthcare provider for instructions on how to heal bedsores, which may include the following procedures:
Or, apply a saline-dampened gauze, which is changed twice daily and kept damp between dressing changes.
Stage 3
One or more of the following signs of infection may be present:
Stage 4
Unstageable
Symptoms (which prevents staging from being determined) include:
Treatment:
Deep-Tissue Pressure Injury
Treatment depends on the staging of the bedsore, which can be challenging because the ulcer can appear as stages 1 or 2 on the surface, but it could be as deep as stages 3 or 4 under the surface.
Where Bedsores Appear on the BodyBedsores most often occur where there is constant exertion of pressure on your skin, typically in areas where bone is close to your skin and there is little padding from fat. While bedsores can develop anywhere on your body, some of the most common locations of bedsores are:Coccyx(tailbone at the base of your spine)Ischium(bony area above the back side of your thigh and beneath your buttocks)Sacrum(the bone in the center of your lower back just above your buttocks)Trochanter (the bony area on the side of your hip)Shoulder bladesBacks and sides of the kneesBack of your headHeels of your feetSides of your hips
Where Bedsores Appear on the Body
Bedsores most often occur where there is constant exertion of pressure on your skin, typically in areas where bone is close to your skin and there is little padding from fat. While bedsores can develop anywhere on your body, some of the most common locations of bedsores are:Coccyx(tailbone at the base of your spine)Ischium(bony area above the back side of your thigh and beneath your buttocks)Sacrum(the bone in the center of your lower back just above your buttocks)Trochanter (the bony area on the side of your hip)Shoulder bladesBacks and sides of the kneesBack of your headHeels of your feetSides of your hips
Bedsores most often occur where there is constant exertion of pressure on your skin, typically in areas where bone is close to your skin and there is little padding from fat. While bedsores can develop anywhere on your body, some of the most common locations of bedsores are:
Cleaning Bedsores During Treatment
Your healthcare provider will recommend the most appropriate technique for cleaning your bedsores during treatment. To reduce your risk of infection, clean a bedsore every with each dressing change. Common guidelines for cleaning bedsores during treatment include:
When bedsores require treatment from a healthcare provider, debridement (removal of dead tissue) may be used to convert a chronic wound into an acute wound so it can start to heal. Your healthcare provider may use one of the following debridement techniques to clean dead tissue from a bedsore:
How to Prevent Bed Sores
Dressing Bedsores as Treatment
Dressing bedsores as treatment helps to prevent infection and promote healing. The specific dressing used varies based on the staging of the bedsores being treated.
Generally, the goal is to keep the bedsore covered with a dressing to protect it against infection. If using gauze, it should be kept moist between dressing changes to promote healing.
Dressings are usually occlusive, meaning they are placed on the skin after a thin layer of treatment is applied to protect the skin and create a barrier to moisture loss. They are used in the following ways:
Certain dressings are used to protect and accelerate the healing process of the bedsores. These dressings include:
Surgical Treatment for Complicated Bedsores
Surgical treatment for complicated bedsores can be necessary when the sores become too deep or large to treat. Surgery is a two-step process that includes cleaning and reconstructing the affected area.
Surgical treatment starts with debriding the wound. This is done to remove dead or infected tissue. It may also require removing infected bone. While the procedure creates a larger wound, the remaining healthy tissue is more likely to heal than the damaged tissue that was removed.
After the affected area is cleaned, a surgeon covers and closes the area with healthy, thicker tissue with a good blood supply. This can be accomplished in one of two ways, as follows:
Skin Flap
Askin flapprocedure involves detaching a flap of healthy skin and tissue close to the wound so that it can be pulled over the wound to cover it. Since part of the flap remains attached to blood vessels connected to healthy skin and tissue, the flap has a source of healthy nourishment as it heals. Covering the wound with skin and muscle is used to repair bedsores over large bony areas (usually at the base of the spine, hips, and the upper end of the thighbones).
Skin Graft
Askin graftinvolves removing, or harvesting, a flap of healthy skin and tissue from another area, such as your back, buttocks, or thigh, and moving it to cover the wound. Skin grafts can be effective for treating large, shallow pressure sores.
Surgery can improve the quality of life for some people. However, it is not always successful. Frail older adults and those with other disorders, such as undernourishment, may experience complications that prevent full wound repair if the underlying conditions are not addressed.
Evidence-Based Remedies to Complement Bedsore Treatment
Bedsore treatment can be extensive, often involving an individualized comprehensive care plan. Its aims are to:
While treatment varies based on the severity of the bedsore and guidance from your healthcare provider, the following evidence-based therapies may be used to complement your bedsore treatment:
Change Positions Regularly
Changing positions with the following methods relieves pressure over bony areas since continuing to put pressure on an ulcer can delay healing:
Maintain Moisture
Protect the skin against moisture-associated damage, includingdermatitisassociated withincontinence,with products that create a protective layer that maintains hydration while blockin external sources of moisture and irritants, such as:
Relieve Pain
The following can help ease pain from bedsores:
Maintain Nutrition and Hydration
Continue to eat well and stay hydrated, as follows:
Address the Psychological Effects
Incorporate psychological support into care to address the following:
Summary
Bedsores are common problems that occur when an area of skin remains in the same place under pressure for long periods. They often affect older people and those who have limited mobility.
Treatment depends on the stage, or severity of a bedsore. Prompt treatment can help prevent severe problems and the progression to severe stages. The most extreme bedsores can increase your risk of life-threatening infections,
Contact your healthcare provider if you notice symptoms of bedsores. Bedsores are easiest to treat at their early stages when the risk of infection is lowest.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Merck Manual Consumer Version.Pressure sores.American Academy of Family Physicians.Pressure sores.Model Systems Knowledge Translation Center (MSKTC).Surgical and reconstructive treatment of pressure injuries.MedlinePlus.How to care for pressure sores.Bhattacharya S, Mishra RK. Pressure ulcers:Current understanding and newer modalities of treatment.Indian J Plast Surg. 2015 Jan-Apr;48(1):4-16. doi:10.4103/0970-0358.155260Merck Manual Professional Version.Pressure injuries.Gould L, Stuntz M, Giovannelli M, et al.Wound healing society 2015 update on guidelines for pressure ulcers.Wound Repair Regeneration. 2016;24(1):145-162. doi:10.1111/wrr.12396Woo KY, Beeckman D, Chakravarthy D.Management of moisture-associated skin damage: a scoping review.Adv Skin Wound Care. 2017 Nov;30(11):494-501. doi:10.1097/01.ASW.0000525627.54569.daDiscala SL, Basri D, Vartan CM, Silverman MA.Use of topical morphine to relieve painful pressure ulcers.Consult Pharm. 2018 Apr 1;33(4):215-221. doi:10.4140/TCP.n.2018.215Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z.Pressure ulcer and nutrition.Indian J Crit Care Med. 2018 Apr;22(4):283-289. doi:10.4103/ijccm.IJCCM_277_17Qian L, Yan S, Ting ST, Han ZM, Qi T.Complications and psychological impact of pressure ulcers on patients and caregivers.Int Wound J. 2024 Apr;21(4):e14836. doi:10.1111/iwj.14836
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Merck Manual Consumer Version.Pressure sores.American Academy of Family Physicians.Pressure sores.Model Systems Knowledge Translation Center (MSKTC).Surgical and reconstructive treatment of pressure injuries.MedlinePlus.How to care for pressure sores.Bhattacharya S, Mishra RK. Pressure ulcers:Current understanding and newer modalities of treatment.Indian J Plast Surg. 2015 Jan-Apr;48(1):4-16. doi:10.4103/0970-0358.155260Merck Manual Professional Version.Pressure injuries.Gould L, Stuntz M, Giovannelli M, et al.Wound healing society 2015 update on guidelines for pressure ulcers.Wound Repair Regeneration. 2016;24(1):145-162. doi:10.1111/wrr.12396Woo KY, Beeckman D, Chakravarthy D.Management of moisture-associated skin damage: a scoping review.Adv Skin Wound Care. 2017 Nov;30(11):494-501. doi:10.1097/01.ASW.0000525627.54569.daDiscala SL, Basri D, Vartan CM, Silverman MA.Use of topical morphine to relieve painful pressure ulcers.Consult Pharm. 2018 Apr 1;33(4):215-221. doi:10.4140/TCP.n.2018.215Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z.Pressure ulcer and nutrition.Indian J Crit Care Med. 2018 Apr;22(4):283-289. doi:10.4103/ijccm.IJCCM_277_17Qian L, Yan S, Ting ST, Han ZM, Qi T.Complications and psychological impact of pressure ulcers on patients and caregivers.Int Wound J. 2024 Apr;21(4):e14836. doi:10.1111/iwj.14836
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Merck Manual Consumer Version.Pressure sores.American Academy of Family Physicians.Pressure sores.Model Systems Knowledge Translation Center (MSKTC).Surgical and reconstructive treatment of pressure injuries.MedlinePlus.How to care for pressure sores.Bhattacharya S, Mishra RK. Pressure ulcers:Current understanding and newer modalities of treatment.Indian J Plast Surg. 2015 Jan-Apr;48(1):4-16. doi:10.4103/0970-0358.155260Merck Manual Professional Version.Pressure injuries.Gould L, Stuntz M, Giovannelli M, et al.Wound healing society 2015 update on guidelines for pressure ulcers.Wound Repair Regeneration. 2016;24(1):145-162. doi:10.1111/wrr.12396Woo KY, Beeckman D, Chakravarthy D.Management of moisture-associated skin damage: a scoping review.Adv Skin Wound Care. 2017 Nov;30(11):494-501. doi:10.1097/01.ASW.0000525627.54569.daDiscala SL, Basri D, Vartan CM, Silverman MA.Use of topical morphine to relieve painful pressure ulcers.Consult Pharm. 2018 Apr 1;33(4):215-221. doi:10.4140/TCP.n.2018.215Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z.Pressure ulcer and nutrition.Indian J Crit Care Med. 2018 Apr;22(4):283-289. doi:10.4103/ijccm.IJCCM_277_17Qian L, Yan S, Ting ST, Han ZM, Qi T.Complications and psychological impact of pressure ulcers on patients and caregivers.Int Wound J. 2024 Apr;21(4):e14836. doi:10.1111/iwj.14836
Merck Manual Consumer Version.Pressure sores.
American Academy of Family Physicians.Pressure sores.
Model Systems Knowledge Translation Center (MSKTC).Surgical and reconstructive treatment of pressure injuries.
MedlinePlus.How to care for pressure sores.
Bhattacharya S, Mishra RK. Pressure ulcers:Current understanding and newer modalities of treatment.Indian J Plast Surg. 2015 Jan-Apr;48(1):4-16. doi:10.4103/0970-0358.155260
Merck Manual Professional Version.Pressure injuries.
Gould L, Stuntz M, Giovannelli M, et al.Wound healing society 2015 update on guidelines for pressure ulcers.Wound Repair Regeneration. 2016;24(1):145-162. doi:10.1111/wrr.12396
Woo KY, Beeckman D, Chakravarthy D.Management of moisture-associated skin damage: a scoping review.Adv Skin Wound Care. 2017 Nov;30(11):494-501. doi:10.1097/01.ASW.0000525627.54569.da
Discala SL, Basri D, Vartan CM, Silverman MA.Use of topical morphine to relieve painful pressure ulcers.Consult Pharm. 2018 Apr 1;33(4):215-221. doi:10.4140/TCP.n.2018.215
Saghaleini SH, Dehghan K, Shadvar K, Sanaie S, Mahmoodpoor A, Ostadi Z.Pressure ulcer and nutrition.Indian J Crit Care Med. 2018 Apr;22(4):283-289. doi:10.4103/ijccm.IJCCM_277_17
Qian L, Yan S, Ting ST, Han ZM, Qi T.Complications and psychological impact of pressure ulcers on patients and caregivers.Int Wound J. 2024 Apr;21(4):e14836. doi:10.1111/iwj.14836
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