Decubitus Ulcer (Pressure Ulcer)

A decubitus ulcer develops when the skin and underlying tissues are damaged due to prolonged pressure in individuals who remain in the same position for extended periods. In individuals receiving at-home care, recognizing and monitoring these wounds is important because as tissue damage progresses, the risk of infection may increase and the healing process may become longer.

This content is not intended for diagnosis or treatment purposes; it has been prepared solely to support early awareness and safe care approaches for patients and their relatives.

Who Is More Likely to Develop Pressure Ulcers?

The risk of pressure ulcers may be higher especially in:

✔ Individuals who remain bedridden for long periods

✔ Wheelchair users

✔ Individuals who have experienced paralysis

✔ Those who remain immobile after fractures

✔ Individuals with malnutrition

✔ Older adults

This condition is associated with factors such as immobility, skin integrity, circulation, and nutritional status.

In Which Areas Do Pressure Ulcers Most Commonly Develop?

Areas with bony prominences that are exposed to constant pressure are at greater risk:

• Heels

• Hip area (sacrum)

• Sitting bones

• Elbows

• Back of the shoulders

• Behind the ears (especially when using oxygen masks or CPAP devices)

• Back area

• Ankles

For individuals receiving at-home care, regular observation of these areas is very important.

How Can Early Signs Be Recognized?

The beginning of a pressure ulcer does not always appear as an open wound. The following changes may be early warning signs:

• Redness of the skin

• Discoloration that does not fade

• Tenderness or pain

• Hardening or increased warmth

• Excessive moisture or dryness of the skin

If these changes are noticed, protective skin care approaches and professional evaluation are important.

Safe Approaches to Reduce Risk at Home

These practices are not treatments; they are only informational approaches intended to help reduce risk.

1. Repositioning

Depending on the patient’s condition and the recommendations of healthcare professionals:

• Repositioning in bed every 2 hours

• Shifting weight while using a wheelchair

• Using positioning supports and cushions

The goal is to prevent pressure from remaining on a single area for a prolonged period.

2. Skin Monitoring

Daily observation is important for identifying early changes such as:

• Redness

• Swelling

• Increased warmth

• Moisture

• Breakdown of skin integrity

During observation, the skin should not be rubbed, pressed, or scrubbed, as this may make the skin more sensitive.

3. Supportive Mattresses and Cushions

Support products may help distribute pressure more evenly, such as:

• Anti-decubitus mattresses

• Air cushions

• Heel protectors

• Positioning pillows

Product selection should be individualized, and guidance from a healthcare professional may be beneficial.

4. Nutrition and Hydration

For healthy tissue maintenance, the following are important:

• Adequate protein intake

• Balanced vitamin and mineral intake

• Sufficient fluid consumption

When these are insufficient, tissue repair may become more difficult. Nutritional changes should be planned under the guidance of a physician or dietitian.

5. Moisture Management

Skin may become more vulnerable to damage when it remains wet or moist for prolonged periods.

This may occur in situations such as:

• Sweating

• Urinary or fecal incontinence

• Wound drainage

For this reason, maintaining skin cleanliness and dryness is important; however, harsh or aggressive cleansing products should be avoided.

When Is Professional Support Necessary?

A healthcare professional should be consulted without delay in the following situations:

• Appearance of an open wound

• Redness that does not disappear

• Foul odor

• Presence of discharge or pus

• Increasing pain

• Fever

• Rapid spreading of the wound

Attempting to manage the wound at home without professional guidance may increase risks; therefore, wound care should be planned through professional evaluation.

Important Note About Pressure Ulcer Treatment

Treatment of pressure ulcers must be individualized. Factors such as the patient’s:

• Age

• Skin condition

• Underlying diseases

• Level of mobility

• Nutritional status

• Stage of the wound

all influence the treatment approach. For this reason, general prescriptions or internet-based solutions are not appropriate.

Our Approach as Bir Adım Sağlık

At Bir Adım Sağlık, we approach the pressure ulcer process with the following perspective:

• Preventive care education

• Skin and risk assessment

• Positioning planning

• Guidance on appropriate support products

• Professional wound care and follow-up

• Family education and support

Our goal is to ensure that the patient experiences a safe care process, to prevent wound formation whenever possible, and to manage existing wounds professionally and effectively.