A Guide to Pressure Injuries

A pressure injury (previously called a bedsore, pressure ulcer, or decubitus ulcer) is a wound that happens when there is too much pressure on an area of skin for too long. Constant pressure reduces blood flow to the skin. Without enough blood and oxygen, the skin and underlying tissue can break down and become damaged. The good news is that most pressure injuries can be prevented.

You may be more at risk if you:

• Have limited feeling in parts of your body
• Spend a lot of time in bed or in a wheelchair
• Have trouble moving or changing positions
• Do not feel pain or pressure very well
• Wear braces or orthotics
• Have trouble eating or drinking
• Cannot feel or control bowel and bladder relief (causes moisture on the skin)
• Have stiff or tight muscles (spasticity or contractures)
• Have difficulty telling others when you are in pain or are uncomfortable

Pressure injuries most often develop over bony parts of the body, including the tailbone, buttocks, hips, heels, feet, ankles, knees, elbows, shoulder blades, and under braces.

Check your skin every day, all over your body.

Changing positions, moving often, and keeping skin clean and dry can help keep your skin healthy. If you cannot see certain areas, use a mirror or ask someone to help.

• Red, purple, or darker skin than normal
• Skin that does not go back to its normal color
• Swelling
• Warm, hard, or tender areas
• Blisters
• Open sores

Change Positions Often

Even small movements help. 

In bed:

• Change position at least every 2 hours
• Use pillows to cushion bony areas
• Keep the head of the bed at 30 degrees or lower unless told otherwise

In a wheelchair:

• Shift your weight every 15–30 minutes
• Lean side to side or push up if you are able
• Use tilt feature if available

Use Proper Equipment

• Use a pressure-relieving seat cushion in your wheelchair
• Make sure your wheelchair fits correctly (pressure mapping may be used to check for problem areas, if recommended by a provider)
• Check that braces fit well and do not rub or cause pressure
• Use a supportive mattress if recommended

Tell your provider if anything feels uncomfortable or does not fit well.

Take Care of Your Skin

Healthy skin is better able to resist injury.

• Keep your skin clean and dry
• Lift, don’t drag, when moving or transferring
• Do not rub or massage bony areas

Eat and Drink Well

Good nutrition helps your skin stay strong and healthy.

• Eat regular meals each day
• Include protein in your diet
• Ask to see a dietitian if you have questions

Getting help early can prevent a minor skin problem from becoming a serious wound.

Call if you notice:

• A red or dark spot that does not go away
• A blister or open area
• Fluid, drainage, or bad smell
• Fever
• A sore that is getting larger
• Braces, equipment, or a wheelchair that feels uncomfortable or does not fit right

• Check your skin every day
• Change positions often
• Use the proper cushion and equipment
• Tell someone if something doesn’t look or feel right

Taking care of your skin helps you stay healthy, comfortable, and active.