How to Care for Bed Sores? | Start With Pressure Relief

Bed sores — pressure ulcers, in medical terms — form when skin stays under pressure long enough that blood flow to the area drops and the tissue starts breaking down. They usually appear over bony spots like the heels, ankles, hips, and tailbone. The right care routine flips the situation around, and most of it happens at home. Left alone, bed sores deepen quickly and can turn infected — early, consistent care prevents most of that.

Knowing how to care for bed sores comes down to four jobs: take pressure off the sore, clean and cover the wound, protect the skin around it, and recognize when a sore needs a doctor. The steps below follow current guidance from the Mayo Clinic, MedlinePlus, and NICE.

Bed Sore Care: Why Pressure Relief Comes First

Pressure relief is the most important step in bed sore care — a wound can’t heal while body weight keeps pressing on it. Get the person off the affected area right away, and keep the pressure off long enough for tissue to recover.

In bed, that means turning or repositioning about every 2 hours around the clock. In a chair or wheelchair, shift position frequently — every 15 to 30 minutes when the person can manage it — and add a pressure-relieving cushion.

• Support surfaces: pressure-redistributing mattresses, bed overlays, cushions, and pads take weight off vulnerable spots. Match the surface to the person’s needs for pressure redistribution, shear reduction, and moisture control.
• Skip ring cushions: doughnut-shaped cushions reduce blood flow and concentrate pressure on the tissue around the sore. The Mayo Clinic specifically advises against them.
• Keep the head of the bed low — commonly no more than 30 degrees when elevation is needed — so the body doesn’t slide and create shear.

Build daily skin checks into the routine. Look for red or purple patches over bony spots and act before skin breaks open. If someone is found lying on a sore, reposition them off it immediately and record the position they were in so caregivers can see what caused it. Pay extra attention after long stretches in bed or a wheelchair — that’s when pressure has had time to do the most damage.

Cleaning and Dressing an Open Sore

Keep the wound clean, covered, and moist, and protect the skin around it. Intact skin gets a gentle cleanser; open wounds get cleaned with water or saline at every dressing change.

• Closed skin: wash with a mild cleanser and pat dry — never rub.
• Open sores: rinse with water or saline each time the dressing is changed.
• Dressings: keep the sore covered with a dressing that holds moisture against the wound.
• Surrounding skin: barrier creams help when urine or stool exposure is an ongoing problem.
• Skip the harsh stuff: don’t use hydrogen peroxide or iodine cleansers unless a clinician specifically instructs it, and don’t massage the skin over or near the ulcer.

Pain is part of the picture too. NICE’s guidance says to assess and manage pain at every visit, including pain during cleansing and dressing changes, so plan dressing changes around pain control rather than rushing.

Dressing choice matters — foam, hydrocolloid, and film dressings suit different wounds. Compare the best dressings for bed sores in our tested roundup before restocking the cabinet.

When Should You Call a Doctor About a Bed Sore?

Call promptly if the sore worsens, becomes more painful, smells bad, or drains pus — and if the person develops fever, warmth, or swelling around the area. The same goes for a sore that won’t improve or a new sore that appears.

Mayo Clinic’s bed sore treatment guidance is clear that open sores and deeper tissue damage need professional evaluation. Sores that reach deep tissue may need more aggressive treatment, and for severe ulcers that won’t heal with wound care, surgical closure can be required.

Support the body’s repair work too: good nutrition and hydration are standard parts of bed sore care. MedlinePlus provides the same instructions for home, hospital, and long-term care settings, and NICE’s clinical guidance covers children, young people, and adults alike.

Here’s the whole routine as a quick-reference table: