Bedsores, also known as pressure sores, are injuries of the skin and tissue that are a result of pressure from staying in one position for too long. They usually occur in people who are in wheelchairs or are bedbound due to an illness. Being in one position creates pressure on these areas, causing less blood flow. Without proper blood flow, these areas do not get enough oxygen and nutrients and can eventually die. There are 4 stages of bedsores. In stage I, the skin is not broken, but it appears red in people with lighter skin or discolored in individuals with darker skin. Stage II is when the outer layer of skin is damaged, and the wound looks like a fluid-filled blister. Stage III is when the loss of skin causes fat to be exposed and the ulcer looks like a crater. In stage IV, the wound may show muscle, bone, or tendons and the bottom of the wound will contain dead yellow tissue.
In addition to pressure, bedsores typically have other factors that play a role in their development, including friction (dragging of skin across another object, such as a bed or wheelchair) and sheer (movement of two tissues in opposite directions). Some risk factors for bedsores usually include difficulty moving, older age, loss of sensation (spinal cord injury), or excessive moisture or dryness in an area of the body. A doctor can typically diagnose bedsores by examining the affected area. Once a bedsore is suspected, blood tests may be ordered to check for general health as well as tissue cultures to look for infections or cancer. Treatment for all bedsores focuses on repositioning the person to decrease the pressure in the affected area. Treatment for stage I and stage II bedsores usually includes care of the wound as well as ongoing general care. Treatment for stage III and stage IV is more difficult and involves cleaning the wound and removing damaged tissue. In severe cases, surgery may be needed.