All You Need To Know About Pressure Ulcers

Guidelines for Wound Photography

What is Pressure Ulcer?

Also known as Bedsore, Pressure Sore, or Decubitus Ulcer, a Pressure Ulcer is an area of damaged skin & underlying tissue caused by prolonged pressure on the skin that cuts-off blood flow to the parts of the body and results in injuries to the skin and tissues. A Pressure Ulcer is an open wound on the skin that often occurs on the skin covering bony areas but the most common places for a Pressure Ulcer are: hips, back, ankles, and buttocks. 

In simple language, Pressure Ulcers can happen to anyone but the people who spend a long time in one position or those confined to a bed or sit in a chair or wheelchair for long periods due to several reasons such as paralysis, illness, old age, or frailty, etc are usually prone to this. In other words, people who are not in a condition to make small movements are at risk of Pressure Ulcers.

The condition can be treated but chronic deep ulcers are difficult to treat. It depends on several factors such as underlying medical conditions and the stage of the ulcer. 


Prolonged pressure at a particular area of the body is the main cause of a pressure ulcer including other factors such as moisture, poor circulation, and nutrition contributing. When a person stays in one place for a long time or cannot change its position without help, it may cause the skin to break down and make people more vulnerable to pressure sores. They can develop and progress at a fast rate but the excessive moisture and skin irritants such as urine and feces can also contribute to ulcer formation.

There are three primary contributing factors for pressure ulcers. They are:

  • Pressure - If there is any constant pressure on any side of the body, it can lessen the blood flow to tissues. Due to inadequate blood supply, tissues do not get essential nutrients such as oxygen and other nutrients due to which they get damaged and might eventually die.

  • Friction - It occurs when the skin rubs against clothing or bedding especially the thin patients, frail skin, and poor circulation as turning and moving can damage the skin and increases the risk of bedsores.

  • Shear - It occurs when two surfaces move in the opposite direction.


The patients who are unable to move due to different conditions or use wheelchairs have a higher risk of developing pressure ulcers:

  1. Buttocks and tailbone

  2. Spine

  3. Shoulder blades

  4. Back of arms and legs

but each stage of bedsore has different symptoms. Depending on the stage, the symptoms are the following:

  1. Skin discoloration 

  2. Infection

  3. Open skin

  4. Swelling

  5. Pus-like draining

  6. Tender areas

  7. Skin that softer or firmer than the surrounding skin

Stages Of Pressure Ulcer

This ulcer occurs in four stages:

  1. Stage I - There is no broken skin but it will look discolored and red. The discoloration may vary from blue to purple. You will feel warm to the touch and may be itchy.

  2. Stage II - There is a painful breakage in the skin with discolored skin around it.

  3. Stage III - Due to the tissue damage below the skin surface, the ulcer is much deeper within the skin

  4. Stage IV - Severe damage to the skin and tissue may lead to infection including your muscles and bones.

Who is Affected?

People are more prone to pressure ulcers who:

  1. Have poor eating habits or not getting enough nutrients.

  2. Obesity

  3. Being confined to bed with illness or after surgery

  4. Medical conditions like diabetes etc

  5. Inability to move some or all the parts of the body


 The treatment for the pressure ulcer depends on the stage and condition of your ulcer. It includes:

  1. Try to move and regularly change your position to remove the pressure from the sore. You can use foam pads or pillows or dynamic mattresses and cushions to provide a constant flow of the air.

  2. Make some lifestyle changes such as repositioning frequently and healthy eating preferences.

  3. Apply dressing to protect the wound and improve healing.

  4. Clean the wound properly with a saline solution after every dressing.

  5. Remove dead tissue as a wound does not heal if there is any dead or infected tissue is present.

  6. Take oral antibiotics or antibiotic cream to treat the infection.

  7. Surgery 

  8. Negative pressure wound therapy

The healing process depends on the stage of your ulcer. The sooner it is diagnosed, the sooner treatment can be started and recovery can also be quick. Wound Care Surgeons may suggest you make some small lifestyle changes in your diet while later stages require more aggressive treatment.