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What is a decubitus ulcer?

Your decubitus ulcer questions, answered.

Understanding Decubitus Ulcers

Decubitus ulcers are localized injuries to the skin and underlying tissue, primarily caused by prolonged pressure on specific areas of the body. Common sites where these ulcers develop include the back, hips, heels, and elbows. When pressure restricts blood flow to these areas, the skin and tissue become deprived of oxygen and essential nutrients, leading to tissue damage and ulcer formation.

The Stages of Decubitus Ulcers

Decubitus ulcers are classified into different stages based on their severity. It is crucial to identify the stage of the ulcer accurately, as treatment plans and interventions will vary accordingly.

Stage 1

At this stage, the skin appears reddened and may be warmer or cooler to the touch than the surrounding areas. The affected area may also be itchy, painful, or more sensitive than usual.

Stage 2

During stage 2, the ulcer progresses to a shallow open wound. There may be a loss of skin layers, and the area may appear as a blister, abrasion, or shallow crater.

Stage 3

In stage 3, the ulcer deepens and extends into the underlying tissue layers. The wound may appear as a crater, with visible fat deposits. Signs of infection may also be present.

Stage 4

Stage 4 ulcers are the most severe. The wound extends deep into the muscle, bone, or supporting structures. Infection is likely, and there may be significant tissue loss and damage.

Causes of Decubitus Ulcers

Decubitus ulcers typically develop due to sustained pressure on specific areas of the body. However, several contributing factors increase the risk of developing these ulcers:


Long periods of immobility, such as bed rest or sitting in a wheelchair, increase the risk of developing pressure ulcers.

Friction and Shear

Friction occurs when the skin rubs against a surface, while shear occurs when layers of tissue slide against each other. These forces can damage the skin, making it more susceptible to ulcers.


Prolonged exposure to moisture, whether from sweat, urine, or other bodily fluids, can soften the skin and increase the risk of developing ulcers.

Prevention Strategies

Prevention of decubitus ulcers is crucial, particularly for individuals at a higher risk. Here are some effective strategies to minimize the risk of developing these ulcers:

  • Frequent Position Changes: Encourage regular repositioning to reduce prolonged pressure on any single area of the body. This is especially important for individuals who are bedridden or have limited mobility.
  • Optimal Support Surfaces: Utilize specialized support surfaces, such as pressure-relieving mattresses or cushions, to distribute pressure evenly and reduce the risk of developing ulcers.
  • Maintaining Skin Hygiene: Keep the skin clean and dry, using gentle cleansing techniques. Moisturize the skin regularly to prevent dryness and cracking, which can make it more susceptible to ulcers.
  • Proper Nutrition: Ensure a well-balanced diet rich in protein, vitamins, and minerals to support healthy skin and tissue repair.


Decubitus ulcers are a serious health concern that can significantly impact an individual’s well-being and quality of life. By understanding the causes, prevention strategies, and available treatment options, we can work together to reduce the incidence and severity of decubitus ulcers.

Remember, early intervention and proactive care are key in protecting our skin health and preventing the development of these painful and potentially life-threatening sores.

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