Pressure ulcers, also referred to as bedsores, are areas of damage to skin and tissues on the body. The ulcers occur on portions of the body that experience sustained pressure, friction and sheering conditions. Paralyzed and bed-bound individuals have an increased risk of developing pressure ulcers. Bedsores fall into four categories depending on the severity of the condition.
Arms, Back and Shoulders
Individuals confined to a wheelchair frequently experience pressure ulcers on the body where the chair causes constant pressure. These locations include the elbows and along the backs of the arms. These areas rub on the wheelchair armrest. The spine and shoulder blades may rub along the back of the chair and cause pressure ulcers due to the friction of the chair and pressing on it while rolling the wheelchair.
Hips and Buttocks
The buttocks and the tailbone are at risk for pressure ulcers in wheelchair-bound individuals, according to the Mayo Clinic. Because of loss in sensation below the waist, paralyzed people or people with decreased sensation in the lower body do not feel the pain associated with the need to change positions. Wheelchair bound individuals may also lack the ability to shift positions to relieve the pressure on the buttocks and sacrum.
Shifting positions every 15 minutes helps decrease the risk of developing these sores, according to the American Academy of Family Physicians. Bed-bound patients may experience pressure ulcers on the sides of the hips as well as the tailbone.
Head and Ears
People confined to bed may develop pressure ulcers on the head. Common locations for these sores include the back of the head and the side of the head. The rims of the ears can also develop pressure sores, according to the Mayo Clinic.
Legs Ankle and Heel
Wheelchair-bound individuals may develop pressure ulcers where the legs rest on the lower portion of the wheelchair. Not moving the legs for extended periods while in the wheelchair increases the risk of developing the sores on the legs. Individuals who are bed-bound may also develop bedsores on the lower extremities.
Areas at increased risk for developing the sores in individuals confined to bed include the sides of the knees, heels and the ankles because of the bony protrusions on the bed. For people with decreased mobility or individuals who are in a coma, the knees, ankles and heels also experience friction and sheer from sliding in the bed to change positions.
