Key takeaways
- Change position at least every two hours and use an air mattress.
- Check the lower back, hips, heels, shoulder blades and back of the head every day.
- Redness that does not fade within 30 minutes is a Stage 1 warning sign.
- Open, deep or smelly sores need professional wound care quickly.
What causes bed sores?
When someone lies or sits in one position for a long time, pressure cuts off blood flow to the skin over bony areas. Without blood, skin and the tissue beneath it start to die. Friction from dragging the patient across sheets and moisture from sweat or urine make the damage faster.
People most at risk are bedridden or wheelchair-bound patients, the elderly, stroke and paralysis patients, people with diabetes, and anyone who is poorly nourished or dehydrated.
The four stages of bed sores
- Stage 1 — skin is intact but red (or darker on brown skin) and does not fade when pressed. It may feel warm, firm or painful.
- Stage 2 — the top layer of skin breaks, forming a shallow open wound or blister.
- Stage 3 — a deeper wound reaching the fat layer under the skin; it may look like a crater.
- Stage 4 — very deep damage exposing muscle, tendon or bone, with a high risk of serious infection.
Some sores are covered by dead tissue so the depth cannot be seen. These need assessment by a nurse or doctor.
Where to check every day
Look carefully at the tailbone and lower back, hips, heels and ankles, elbows, shoulder blades, and the back of the head. In patients who sit for long periods, check the buttocks. Use good light and gently turn the patient to see every area.
How to prevent bed sores at home
- Turn the patient every two hours: back, left side, right side, using pillows for support.
- Use an alternating-pressure air mattress for anyone in bed most of the day.
- Lift rather than drag the patient when repositioning — use a draw sheet.
- Keep skin clean and dry; change diapers promptly and use a barrier cream where advised.
- Float the heels on a pillow placed under the calves.
- Give enough protein and fluids; poor nutrition slows healing.
Treating a bed sore at home
Stage 1 sores often heal if pressure is completely removed from the area and the skin is kept clean and dry. Stage 2 and deeper sores need proper wound cleaning and dressing, chosen by a nurse or doctor based on the wound. Never apply home remedies, powders or tight bandages to an open sore.
Deep, infected or non-healing wounds may need advanced dressings such as VAC (negative pressure) therapy, prescribed by a surgeon.
When to call a nurse or doctor
Get help if a sore is open, getting larger, has pus or a bad smell, the surrounding skin is hot and swollen, or the patient develops fever. These can be signs of infection that needs prompt treatment.
Frequently asked questions
How fast can a bed sore develop?
In a high-risk patient, early skin damage can begin within a few hours of unrelieved pressure. That is why two-hourly turning is so important.
Does an air mattress prevent bed sores?
An alternating-pressure air mattress greatly reduces pressure on the skin, but it does not replace regular turning, skin care and good nutrition.
How long does a bed sore take to heal?
Stage 1 sores can settle in a few days once pressure is removed. Deeper sores can take weeks to months and need regular professional dressings.
This guide is general information for families, not medical advice. Always follow your treating doctor’s instructions. In an emergency call 108 / 112.