Pressure ulcers are also called bedsores, or pressure sores. They can form when your skin and soft tissue press against a harder surface, such as a chair or bed, for a prolonged time. This pressure reduces blood supply to that area. Lack of blood supply can cause the skin tissue in this area to become damaged or die. When this happens, a pressure ulcer may form. Show
You have a risk of developing a pressure ulcer if you:
You will need to take steps to prevent these problems. Self-careYou, or your caregiver, need to check your body every day from head to toe. Pay special attention to the areas where pressure ulcers often form. These areas are the:
Call your health care provider if you see early signs of pressure ulcers. These signs are:
Treat your skin gently to help prevent pressure ulcers.
Eat enough calories and protein to stay healthy. Drink plenty of water every day. Make sure your clothes are not increasing your risk of developing pressure ulcers:
After urinating or having a bowel movement:
If You Use a WheelchairMake sure your wheelchair is the right size for you.
Sit on a foam or gel seat cushion that fits your wheelchair. Natural sheepskin pads are also helpful to reduce pressure on the skin. Do not sit on a donut-shaped cushions. You or your caregiver should shift your weight in your wheelchair every 15 to 20 minutes. This will take pressure off certain areas and maintain blood flow:
If you transfer yourself (move to or from your wheelchair), lift your body up with your arms. Do not drag yourself. If you are having trouble transferring into your wheelchair, ask a physical therapist to teach you the proper technique. If your caregiver transfers you, make sure they know the proper way to move you. When You Are in BedUse a foam mattress or one that is filled with gel or air. Place pads under your bottom to absorb wetness to help keep your skin dry. Use a soft pillow or a piece of soft foam between parts of your body that press against each other or against your mattress. When you are lying on your side, put a pillow or foam between your knees and ankles. When you are lying on your back, put a pillow or foam:
Other tips are:
When to Call the DoctorCall your provider right away if:
Talk to your provider if you have questions about pressure ulcers and how to prevent them. Alternative NamesDecubitus ulcer prevention; Bedsore prevention; Pressure sores prevention Images
ReferencesJames WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Dermatoses resulting from physical factors. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM eds. Andrews' Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 3. Qaseem A, Humphrey LL, Forciea MA, Starkey M, Denberg TD. Clinical Guidelines Committee of the American College of Physicians. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2015;162(5):370-379. PMID: 25732279 pubmed.ncbi.nlm.nih.gov/25732279/. Woelfel SL, Armstrong DG, Shin L. Wound care. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 118. Read More
Patient Instructions
Review Date 5/31/2022Updated by: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What areas are prone to skin breakdown and pressure injuries?The most common sites are the back of the head and ears, the shoulders, the elbows, the lower back and buttocks, the hips, the inner knees, and the heels. Pressure injuries may also form in places where the skin folds over itself. And they can occur where medical equipment puts pressure on the skin.
What is the most frequent site of skin breakdown?The most common areas for skin breakdown (pressure points) in adults are the sacrum/coccyx (tailbone), heels, elbows, lateral maleollus (outside of the ankle), greater trocater (hip bone) or the bottom of the femur (outside and inside of the knee) and the ischial tuberosities (the bones we sit on).
What body part is at a higher risk of skin breakdown?The back or sides of the head. The shoulder blades. The hip, lower back or tailbone. The heels, ankles and skin behind the knees.
Which areas are common sites for pressure injuries?Common sites include the sacrum (tailbone), back, buttocks, heels, back of the head, and elbows.
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