Full Definition

A pressure ulcer — also called a pressure injury, decubitus ulcer, or bedsore — is an area of skin and underlying tissue damage caused by sustained pressure, often in combination with shear or friction. They develop most commonly over bony prominences such as the sacrum (tailbone), heels, hips, and shoulder blades in seniors who spend extended periods in bed or a wheelchair without repositioning.

Pressure ulcers are staged from I (non-blanchable redness) to IV (full-thickness tissue loss exposing muscle or bone). Stage III and IV wounds can become life-threatening due to infection, sepsis, and systemic complications. Healing deep pressure ulcers in older adults is often a lengthy, difficult process.

In nursing facilities, pressure ulcer rates are a closely monitored quality metric reported publicly through Medicare’s Care Compare. High rates may indicate inadequate nursing assessment, insufficient turning schedules, poor nutritional status management, or understaffing. Families should ask facilities about their pressure ulcer prevention protocol during the evaluation process.

Pressure ulcers are largely preventable with appropriate care: regular repositioning, pressure-redistributing mattresses and cushions, adequate nutrition and hydration, moisture management, and daily skin inspection. The development of a pressure ulcer in a care facility is frequently a reportable event in Texas.