Pressure Ulcers

Jenna Wishnew, MD, FACS

General Surgeon located in Richardson, TX

Pressure ulcer also known as bed sore or pressure sore is an injury to the skin or underlying tissues primarily caused by prolonged pressure exerted over specific areas of the body. It develops on skin that covers bony areas, such as the heels, ankles, hips, and tailbone. It can happen over hours or days to anyone but mostly to those who are confined to bed or sit in a chair or wheelchair for long periods with limited ability to change positions.


- Constant pressure on skin for prolonged period

- Exposure to skin irritants mainly moisture from sweat, urine or stool

- Pulling or stretching of skin from sliding in an inclined bed or wheelchair



- Age > 65 due to reduced subcutaneous fat and capillary blood flow

- Immobilization i.e. Bedbound, wheelchair bound, paralysis, in coma or vegetative state

- Decreased mobility i.e. Prolonged hospital stay, undergoing lengthy or complicated surgeries, weakness or cognitive impairment

- Wearing casts, splints or prosthetic devices

- Impaired capacity for wound healing secondary to malnutrition, diabetes, impaired tissue perfusion due to peripheral arterial disease or venous insufficiency

- Chronic comorbidities i.e. Cancer, cerebral palsy, dementia, heart failure, kidney failure, spinal cord injury or spina bifida




- Pressure offloading with turning, cushions, wedges, air loss mattress, etc.

- Increase protein in diet and optimized nutrition for wound healing (Hyperlinked)

- Irrigation or cleaning the wound

- Wound dressings

- Surgical debridement (Hyperlinked)

- Chemical debridement (Hyperlinked)

- Skin substitute graft (Hyperlinked)