Treatment - Pressure ulcers (sores)

Treatments for pressure ulcers (pressures sores or bedsores) include:

• changing your position regularly
• using special mattresses to reduce or relieve pressure
• dressing the ulcer to help it heal
• surgery to seal the wound and reduce the risk of infection

Changing position

Moving and changing your position helps to relieve the pressure on ulcers that have already developed.

Your care team will draw up a repositioning timetable. This shows how often you need to move, or be moved if you're not able to move yourself.

For some people, repositioning may need to be every 15 minutes. For others it may be every 2 to 4 hours.

You may also be given advice about:

• correct sitting and lying positions and how to adjust them
• how to support your feet to relieve pressure on your heels
• any special equipment you need and how to use it

Changing position can also help prevent pressure ulcers forming.

Mattresses and cushions

Your care team can recommend a specially designed static foam or dynamic mattress if you have a pressure ulcer or are at risk of an ulcer.

If you have a more serious ulcer, you'll need a more advanced mattress or bed system. For example, a mattress connected to a pump that delivers a constant flow of air into the mattress.

There is also a range of foam or pressure-relief cushions available. Ask about the types most suitable for you.

Dressings

Specially designed dressings can protect pressure ulcers and speed up healing.

Alginate dressings

Alginate dressings are made from seaweed and contain sodium and calcium. They can help with healing.

Hydrocolloid dressings

Hydrocolloid dressings contain a gel that encourages growth of new skin cells in the ulcer, while keeping surrounding healthy skin dry.

Other dressing types

Foams, films, hydrofibres or gelling fibres, gels and antimicrobial dressings may be used.

Gauze dressings are not usually used to prevent or treat pressure ulcers.

Creams and ointments

Antiseptic or antibiotic creams or ointments are not usually used to treat pressure ulcers. You may need barrier creams to protect skin that's damaged or irritated by incontinence.

Antibiotics

Your care team may prescribe antibiotics to treat an infected ulcer or a serious infection, such as:

• blood poisoning (sepsis)
• bacterial infection of tissues under the skin (cellulitis)
• infection of the bone (osteomyelitis)

Diet and nutrition

A healthy, balanced diet can help speed up healing. Make sure to include protein and a good variety of vitamins and minerals.

You may need help from a dietitian to help you improve your diet. They may give you a diet plan.

Try to drink plenty of fluids. Being dehydrated can slow down healing.

How to eat well

Removing damaged tissue

It may be necessary to remove dead tissue from the pressure ulcer to help it heal. This is known as debridement.

If there's a small amount of dead tissue, it may be removed using specially designed dressings.

You may need to have larger amounts of dead tissue removed. This is done in hospital.

The tissue may be removed using:

• high-pressure water jets
• ultrasound
• surgical instruments, such as scalpels and forceps

You will usually get a local anaesthetic to numb the area before debridement. You should not feel any pain during the procedure.

Surgery

Severe pressure ulcers might not heal on their own. You may need surgery to seal the wound and reduce your risk of infection.

Ask your surgeon about the benefits and risks of surgery if it's recommended for you.