Bed sores (pressure sores) develop when blood to a particular area is cut off as a result of extended periods of time spent either sitting or lying down in one position. Bed sores injure the skin and the tissue beneath it, and worsen rapidly once they develop. Bony areas such as the heels, ankles, hips and tailbone are typically affected. People who are paralyzed or bedridden, use wheelchairs, or cannot adjust their positions on their own are susceptible to developing bed sores.
Bed sores are classified by stages, with stage I being the mildest and stage IV being the most severe. In stage I, the skin is red and does not briefly get lighter when touched, and may be more painful, tender, firm, soft, cool or warm than skin in surrounding areas; in stage II, a shallow open wound is visible and surrounding tissue may appear red or purple; in stage III, damage has spread to tissue below the skin and the wound has gotten deeper; and in stage IV, there is tissue loss severe enough to expose muscle, bone and tendons.
Although beds sores are easily identified by a physical examination, in some cases blood tests to check the general health of the patient may be ordered. In cases in which bed sores do not respond to treatment, tissue cultures may be performed to check for bacterial or fungal infections.
Conservative treatment methods, such as changing position at least every two hours, keeping the sore clean and protected, and maintaining a healthy diet, are usually effective treatments for a bed sore. In severe cases, surgical reconstruction of the affected area may be required. Lifestyle changes, such as quitting smoking and becoming physically active, help to decrease the risk of developing bed sores.