Pressure Sores Decubitus ulcers, Bed Sores Normal Abnormal These are ulcers (sores) caused by prolonged pressure on the skin.  The most susceptible places are areas with prominent bones or cartilage.  Usually, when a patient is on prolonged bed rest due to illness or paralysis, he is likely to exert pressure over a bony site.  Here, friction develops when the patient moves around, causing moisture to build up on the skin. The elderly, who tend to have thin skin, poor circulation, and suffer from incontinence, Dementia, low body weight, and Malnutrition, are especially at risk. The ulcers are divided into 4 stages, depending on the depth and size (stage I is the most superficial, stage IV the deepest). Change to high protein diet rich in vitamins and minerals (e.g., Zinc, vitamin C, and iron) Whirlpool may be used to help remove dead tissue and stimulate circulation. Prolonged pressure on the ulcer will make it worse, so frequent turning (every 2 hours) may be done by the patient, nurses, or special beds. Irrigation of the wound with saline solution Topical antibiotic ointments Gel-foam bandages Hydrocolloid dressings such as Duo-Derm (clean ulcers only) Surgical cleaning and debridement (removal of dead tissue) may be needed Antibiotics are given orally or intravenously for deeper infections Analgesics are needed if there is pain. Good nutrition Good hygiene Linens should be kept clean and dry Frequent turning of immobilized (bed bound) individuals Special mattress may help Shingles Skin cancer Pyoderma gangrenosum Ecthyma gangrenosum Common Areas of Involvement Tail bone area Hips Back Elbows Heels Ankles