Illustrations

Areas where bedsores occur

Progression of a decubitis ulcer

Alternative names Bedsore; Decubitus ulcer

Definition A pressure ulcer is an area of skin and tissue that becomes injured or broken down. Generally, pressure ulcers occur when a person is in a sitting or lying position for too long without shifting his or her weight. The constant pressure against the skin causes a decreased blood supply to that area. Without a blood supply, the area cannot survive and the affected tissue dies.

The most common places for pressure ulcers are over bones close to the skin, such as the elbow, heels, hips, ankles, shoulders, back, and the back of the head.

Considerations While it is more common for people to get pressure ulcers if they spend most of their time in bed or use a wheelchair, people who can walk can also get pressure ulcers when they are bedridden as a result of an acute illness or injury.

Causes Factors which increase risk for pressure ulcers include:

• Age - elderly people are at higher risk
• Inability to move certain parts of the body without assistance, such as with spinal or brain injury patients, and patients with neuromuscular diseases
• Malnourishment
• Being bedridden or in a wheelchair
• Having a chronic condition, such as diabetes or artery disease, that prevents areas of the body from receiving proper blood flow and nutrition
• Urinary incontinence or bowel incontinence (moisture next to the skin for long periods of time can cause skin irritation that may lead to skin breakdown)
• Fragile skin
• Mental disability from conditions, such as Alzheimer's (some patients may not be capable of taking the proper steps toward prevention and may not seek treatment when an ulcer has formed)