How do Bed Sores Form?

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  • Written By: J. Beam
  • Edited By: Niki Foster
  • Last Modified Date: 14 October 2019
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Bed sores, also called pressure sores or pressure ulcers, form on the body as a result of decreased blood flow, causing tissue to become damaged, form sores and eventually die. Typically, bed sores afflict those who are bedridden or consistently use a wheelchair, either from illness, injury or paralysis, and cannot change position in a bed without help. When a person spends too much time in one position, the sustained pressure applied to an area can result in damage to skin tissue.

Bed sores can pose a risk to people who are confined to bed with an acute illness or injury, but the greatest risk is posed to people with spinal cord injuries and those permanently bed ridden, such as the elderly. The elderly population accounts for the majority of cases. Their skin is typically thinner, and they are often underweight, a combination that optimizes conditions for the formation of sores. Other conditions that increase the risk of sores include a decrease in pain awareness, incontinence and malnutrition.

The National Pressure Ulcer Advisory Panel is a professional organization that has categorized bed sores by stages of severity. Stage I pressure sores are superficial wounds that appear as a persistent area of red skin that may cause mild itching or burning to the patient or feel warm and spongy to the touch. Theseusually go away as soon as the consistent pressure is relieved by changing position or becoming mobile again.


Stage II bed sores are open wounds with skin loss that appear as either a blister or abrasion. Though these sores require treatment, they generally heal quickly if treated appropriately. Stage III and Stage IV are the advanced stages.

Stage III indicates that the damage has extended beyond the layers of skin to affect the muscle. Stage IV indicates the most severe stage, with considerable skin loss and damage to muscle, bone, joints and possibly other supporting structures. Stage IV sores are extremely difficult to heal and are often complicated by infection, which can be lethal.

Prevention of bed sores is a daunting task for care givers, but is easier than treatment and healing. Prevention is best achieved by regularly repositioning the patient. The frequency of repositioning depends on whether any signs of tissue damage. If a patient has Stage I bed sores already, he or she should be repositioned at least every two hours. These sores can also be prevented by providing support, such as cushions or pads. It is also important to keep the patient’s skin clean and dry.

If you have a loved one confined to a hospital or nursing home, periodically check that precautions are being taken against the formation of bed sores. If you are caring for someone confined to a bed and/or wheelchair at home, remember to help protect him or her. If you see an open wound or broken skin accompanied by signs of infection, such as fever or drainage, seek medical attention.


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