Bedsores (pressure ulcers)

Diagnosis

Your healthcare professional likely will look closely at your skin to decide if you have a pressure ulcer. If a pressure ulcer is found, your healthcare professional will assign a stage to the wound. Staging helps determine what treatment is best for you. You might need blood tests to learn about your general health.

Questions from the doctor

Your healthcare professional might ask questions such as:

• When did the bedsores first appear?
• How painful are the bedsores?
• Have you had bedsores before?
• How were they treated, and what was the outcome of treatment?
• What kind of care assistance is available to you?
• What is your routine for changing positions?
• What medical conditions have you been diagnosed with, and what is your current treatment?
• What do you usually eat and drink?

Treatment

Treating pressure ulcers involves lowering pressure on the affected skin, caring for wounds, controlling pain, preventing infection and eating well.

Treatment team

Members of your care team might include:

• A primary care professional who oversees the treatment plan.
• A healthcare professional specializing in wound care.
• Nurses or medical assistants who provide care and education to manage wounds.
• A social worker who helps you or your family access resources and focus on emotional concerns related to long-term recovery.
• A physical therapist who helps you move better.
• An occupational therapist who helps make sure seating surfaces are right.
• A dietitian who tracks what you need to eat and recommends a good diet.
• A healthcare professional who specializes in skin conditions, also known as a dermatologist.
• A neurosurgeon, vascular surgeon, orthopedic surgeon or plastic surgeon.

Reducing pressure

The first step in treating a bedsore is to lower the pressure and friction that caused it. Try to:

• Change position. If you have a bedsore, turn and change your position often. How often you change your position depends on your condition and the quality of the surface you are on.
• Use support surfaces. Use a mattress, bed and special cushions that help you sit or lie in a way that protects vulnerable skin.

Cleaning and dressing wounds

Care for pressure ulcers depends on how deep the wound is. Generally, tending to a wound includes these steps:

• Clean. If the affected skin isn't broken, wash it with a gentle cleanser and pat dry. Clean open sores with water or saline each time a dressing is changed. Saline is a saltwater solution.
• Put on a bandage. A bandage speeds healing by keeping the wound moist. It also creates a barrier against infection and keeps the skin around it dry. Bandage choices include films, gauzes, gels, foams and treated coverings. You might need a combination of bandages.

Removing damaged tissue

To heal properly, wounds need to be free of damaged, dead or infected tissue. The healthcare professional may remove damaged tissue, also known as debriding, by gently flushing the wound with water or cutting out damaged tissue.

Other interventions

Other interventions include:

• Medicines to control pain. Nonsteroidal anti-inflammatory drugs, also known as NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), might reduce pain. These can be very helpful before or after changing position and with wound care. Pain medicines applied to the skin also can help during wound care.
• A healthy diet. Good nutrition promotes wound healing.

Surgery

A large bedsore that fails to heal might require surgery. One method of surgical repair is to use padding from your muscle, skin or other tissue to cover the wound and cushion the affected bone. This is called flap surgery.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Coping and support

People with bedsores may have discomfort. They also can be socially isolated or depressed. Talk with your healthcare team about your needs for support and comfort. A social worker can help find community groups that provide services, education and support for people dealing with long-term caregiving or terminal illness.

Parents or caregivers of children with bedsores can talk with a child life specialist for help in coping with stressful health situations. Family and friends of people living in assisted living facilities can support residents and work with nursing staff to make sure they receive the proper preventive care.