Ask the nurse: How to prevent and treat pressure sores

Pressure sores (or bedsores) are areas of damage to the skin and underlying tissue ultimately resulting in lesion and ulceration. They are commonly formed over the bony areas on the back, hips, heels, sacral area, or ankles and they’re much easier to prevent than to treat.

The main causes of pressure sores include:

  • Unrelieved pressure: skin and tissue directly compressed between the bone and a hard surface such as a chair.
  • Friction: occurring when skin rubs against a surface, for example heels rubbing against the sheets of a bed.
  • Shear: occurring when skin and tissue are pulled in opposing directions, for example when a person slips down or is dragged along a bed.

What can I do to help prevent pressure sores?

Position changes are key to preventing pressure sores. These changes need to be frequent, avoid stress on the skin and minimise pressure on vulnerable areas.

Your health team can help develop a good strategy, whether it's at-home assistance or in a hospital. Here’s our basic guide to the prevention or pressure sores.

1. Skin care

  • Clean the affected skin. Use moisturising, unscented soaps like and warm (not hot) water to clean your skin. Be gentle. Don’t use excessive force as this causes friction. Pad dry. Never use soaps and other products that contain alcohol, because they can dry out your skin.
  • Protect your skin. Make sure your skin is dry. Use talcum powder sparingly. Apply lotion or cream to dry skin. Change soiled bedding and clothing as required.
  • Inspect your skin daily. Check for red or broken skin regularly. Use a mirror for hard to see areas.
  • Keep your skin dry. If you have urinary or bowel incontinence, take steps to prevent exposing the skin to moisture and bacteria. Your care may include frequently scheduled help with urinating, changing of pads or soiled clothing or using protective lotions on healthy skin.
  • Change soiled bedding and clothes: Change sheets, pads, and bedclothes if soiled.

2. Nutrition

  • Maintain a healthy diet. Foods that are high in protein may help prevent skin breakdown. Examples are meat, beans, and milk. Nutritional shakes and dietary supplements may also provide you extra calories, vitamins and protein if deficient in your diet. Ask your caregiver or a health professional for more information about the right foods for you.
  • Drink enough to keep the skin hydrated. Good hydration is important for maintaining healthy skin. Drink at least eight glasses of fluids each day, unless your medical professional tells you not to. Healthy liquids include water, skimmed milk, and juice.

3. Lifestyle

  • Change your position often: Change your position every 2 hours if you are in a bed all day or as required. Change your position every 15-30 minutes if you are in a wheelchair all day. Have a regular turning schedule. If you are helping a person move in bed, lift them. Do not slide them. An alternative is to use lifting equipment or an overhead trapeze. This may help prevent damage to the skin from sliding down in bed.
  • Stay active. Limited mobility is a key factor in causing pressure sores. Daily exercise matched to your abilities can help maintain healthy skin. A physiotherapist can recommend an appropriate exercise program that improves blood flow, maintains vital muscle tissue, stimulates appetite and strengthens the body.
  • Quit smoking. If you smoke, quit. It reduces the amount of oxygen in the blood. Smokers tend to develop more-severe wounds, and their wounds heal more slowly. Talk to your doctor if you need help.

4. Products & Equipment

  • To protect skin over bony areas: Use pillows or foam wedges to keep bony areas from touching one another. Put a foam pad or a pillow under your legs to keep your heels from touching the bed. Remove extra sheets or bedding from underneath you.
  • Use special equipment and pads: A slide and turn sheet under you may help others move around in bed. An overhead trapeze can help you change positions in bed. Special mattresses and overlays may relieve pressure. Examples include a foam mattress pad, or special air or water mattresses.
  • Select a cushion that relieves pressure. Use cushions to relieve pressure and help ensure your body is well positioned in the chair. Various cushions are available, such as foam, gel, water filled and air filled. An occupational therapist or physiotherapist can advise you on how to place them and their role in regular repositioning. Protect bony areas with appropriate positioning and cushioning. Lie at an angle with cushions supporting the back or front. You can also use cushions to relieve pressure between the knees and ankles.

How to treat pressure sores

Treating pressure sores can be difficult. Infected sores heal slowly and the infection can spread to other parts of the body. The priority is to find the cause, treat the problem: Relieve the pressure and seek medical advice early.

When should I contact my doctor?

Contact your doctor if:

  • You are experiencing constant pain
  • You see red or purple skin over a bony area that does not go away
  • You see a blister or open sore over a bony area
  • You have an open sore over a bony area that looks like a deep crater
  • You have green or yellow drainage or a bad smell coming from a sore on a bony area
  • You have questions or concerns about pressure ulcer prevention or care.

Signs the infection may have spread:

  • Fever or chills
  • General overall feeling of weakness
  • Mental confusion or difficulty concentrating
  • Rapid heartbeat
  • Constant pain around bony prominence

Independence Australia offers over 2000 wound care products including dressings, skin care, tapes and compression.

For more product advice contact our Customer Service Team on 1300 788 855. Alternatively, click here to locate your nearest wound clinic through the Australian Wound Management Association (AWMA).