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How to Prevent Bedsores

If a person becomes immobile, bedridden, unconscious, or for whatever reason, unable to sense pain, they may experience pressure ulcers on their skin. These are called bedsores, and about 2.5 million1 Americans develop these sores every year. 

Bedsores can be uncomfortable to downright dangerous, but luckily there are things you can do to prevent and treat them before they progress to the level of infection. 

In this article, we’ll discuss everything you need to know about bedsores, including prevention, symptoms, and treatment, so that you or your loved one won’t have to worry about this uncomfortable condition. If you think you or somebody you know might have bedsores, be sure to contact your doctor so they can get you started on a treatment plan. 

What are Bedsores?

Bedsores2, also know as pressure ulcers, occur on areas of the skin that are consistently under pressure. This happens most commonly when people are bound to a bed or a wheelchair, or if they are wearing a cast for a long period. The bedsores are the result of the constant friction or pressure against their skin.2

You might have also heard them referred to as pressure sores, pressure ulcers, pressure injuries, or decubitus ulcers.2 

Symptoms of Bedsores

The symptoms of bedsores vary depending on how advanced they are. According to Johns Hopkins Medicine, bedsores can be divided into four stages, from least to most severe.2

Stage One: The area will likely feel warm to the touch and look either red, blueish, or purple-toned, depending on your skin’s color. At this point, it may feel like it burns, itches, or hurts.2

Stage Two: At this point, the area may have an open sore or look like a scrape or blister. The skin around the wound may appear discolored, and the person will likely be in a significant amount of pain.2 

Stage Three: Bedsores that have progressed to this level will feel very painful and might have a “crater-like” appearance because there will now be damage below the skin’s surface.2 

Stage Four: People with bedsores this far advanced will be in a lot of pain. There will be a large wound present, and the area around it will look significantly damaged and discolored. At this stage, the muscles, bones, tendons, and joints may be involved, and infection is likely.2 


Causes of Pressure Sores

As mentioned, pressure sores usually develop when somebody must remain still for a very long time and the surface of whatever they are lying or sitting on puts pressure on their skin. The reason a sore develops is that the constant pressure ends up cutting off blood flow to the skin.1 The outermost layer of skin quickly begins to die. In fact, according to the Cleveland Clinic, this can start happening in as little as two hours.1 As the dead cells break down, a bedsore or pressure sore begins to form.1 

Bedsores are even more likely to form when there is a combination of pressure, moisture (sweat, for example), and traction (a stretching of the skin).1

These sores occur most often on the tailbone, hips, buttocks, heels of the feet, shoulder blades, back of the head, or the backs and sides of the knees.2 

Bedsore Risk Factors

If bedsores can develop after just two hours, why isn’t everyone developing them after something like a long day at work? The reason for this is that it takes a certain combination of factors for bedsores to develop, and some people are more at risk. 

The following groups of people are at higher risk of developing pressure sores:

  • Those who are bedridden or unconscious2
  • Those in a coma or vegetative state1
  • People who are unable to sense pain2
  • Those with thinner skin, like the elderly1
  • People currently wearing casts, splints, or other prosthetic devices1
  • People with diabetes2
  • Those with cancer1
  • People with cerebral palsy1 
  • Dementia patients1
  • Those who’ve experienced heart failure1 
  • Or kidney failure1
  • People with peripheral artery disease1
  • Spinal cord injury or spina bifida patients1
  • Those with chronic venous insufficiency1 
  • Patients with circulation problems2
  • People with poor nutrition2

These risks are increased if the person is not turned, positioned correctly, provided with proper nutrition, or cleaned regularly, as moisture can also contribute to bedsores.2 This may be why pressure sores are more common in hospital wards that tend to be more busy, like the orthopedic surgery ward3


Prevention Tips for Bedsores

Luckily, bedsores can be prevented. Johns Hopkins Medicine recommends the following tips2

  • Turning and repositioning every two hours
  • Sitting up straight in a wheelchair to prevent pulling on the skin
  • Changing positions in your wheelchair every 15 minutes
  • Use soft padding between yourself and the wheelchair or bed to reduce pressure
  • Keeping the skin clean and dry
  • Eating adequate calories, vitamins, minerals, fluids, and proteins

How to Treat Bedsores

If you already have bedsores, they are treatable, and the level of treatment depends on the severity of your bedsores. The first step would be to remove pressure from the affected area. If you already have a wound, you’ll need to keep it clean and protected with gauze. You’ll also want to make sure that you’re consuming a healthy diet with plenty of vitamins, minerals, and protein.1 

If the bedsores have already progressed beyond Stage One or Two, you may need to have the damaged, infected, or dead tissue removed, or even receive a skin transplant to the area. If the bedsore has become infected, your doctor will likely put you on antibiotics.1

Bedsores left untreated are more likely to turn into an infection, which can cause fever, chills, or even mental confusion, heart issues, and weakness.1 Therefore, it is always a good idea to consult your doctor if you have a bedsore to get treatment right away. 

If you’re looking for a sustainable sleep solution while you manage bedsores, explore our medically reviewed roundup of our Best Mattresses for Bedsores and Pressure Ulcers


Frequently Asked Questions

Are bedsores dangerous?

When bedsores first appear, they tend to be uncomfortable and painful, but not necessarily dangerous. However, if they are left untreated, they are more likely to become infected, which can be dangerous. 

Are bedsores contagious?

No, bedsores are not contagious. Rather, they are injuries due to ongoing pressure on the skin. 

What cream can I use to prevent bedsores?

Some doctors recommend using a barrier cream4 to help prevent bedsores. Barrier creams are applied directly to the skin and act as a safeguard between the skin and irritants – like moisture from sweat or urine, for example.4 

Studies show5 that barrier creams can be useful in preventing bedsores in at-risk populations. Specifically, the barrier creams made from a hyperoxygenated fatty acid compound or silicone/antiseptic cream are the most effective, as well as those that contain hexyl nicotinate, zinc stearate, isopropyl myristate, dimethicone 350, cetrimide, and glycerol preparation.5

Natalie G.

Natalie G.

Writer

About Author

Natalie is a content writer for Sleep Advisor with a deep passion for all things health and a fascination with the mysterious activity that is sleep. Outside of writing about sleep, she is a bestselling author, improviser, and creative writing teacher based out of Austin.

Combination Sleeper

    Resources

  • 1. “Bedsores (Pressure Injuries)”. Cleveland Clinic. Last modified February 24, 2024.
  • 2. “Bedsores”. Johns Hopkins Medicine. Webpage accessed October 20, 2024.
  • 3. Borojeny, Lotfolah Afzali., et al. “The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis”. National Library of Medicine. 2020.
  • 4. Nicol, Matthew. “Barrier cream”. DermNet. 2017.
  • 5. “The Prevention and Management of Pressure Ulcers in Primary and Secondary Care: Barrier creams”. National Library of Medicine. 2014.