What Areas of the Body are Prone to Develop Bed Sores?

By Nursing Home Law Center

Bedsores develop where constant pressure to a body part cuts off the blood flow. Those body parts that come in contact with the mattress when we lie down, or with the chair when we sit, are usually the ones where bedsores develop. In addition to this, the amount of fat can influence the development of bedsores. Fat acts as a cushion for the body and relieves pressure. If a body part has little fat insulation, it will be at higher risk for developing bedsores.

The most common areas where pressure sores occur include:

• Back of the head. This part can be in constant contact with the pillow or mattress for patients in a coma or who are paralyzed or too weak to move. It also has little fat underneath the skin, making it a prime candidate for developing bedsores.
• Ankles. Patients who lie on their sides, or whose legs roll to one side when they lie on their backs, are prone to developing bedsores on their ankles. Not only do the ankles come in contact with the mattress, but they tend to have less fat than other parts of the body.
• Heels. Most intubated patients and comatose patients lie on their backs, which means their heels are pressed against the mattress. Those patients confined to wheelchairs can also be at risk for bedsores in the heels. The heels have a little more cushion than the ankles but are still at risk for bedsores.
• Hips. The hips are at risk whether the patient lies in bed on his back, on his side, or remains confined to a wheelchair. There tends to be a little more fat here, but bony protuberances can take the brunt of pressure from a bed or chair.
• Lower back. The back is another risk for both bedridden and wheelchair-bound patients. The shape of the back and the firmness of the mattress will make a big difference, but lower backs are often the place where bedsores develop.
• Knees. Knees do not have much fat to cushion them. Depending on how the patient is lying, they could be at risk for pressure sores.
• Spine. The spine has bony protuberances that can easily develop bedsores. This can be especially true for patients with spines that stick out further due to other ailments.

What is a Bedsore?

A bedsore is a wound on a body that develops because continuous pressure on a part of the body cut off the blood flow. With the blood cut off, the tissue and skin in the area began to die. Eventually, the skin and the tissue underneath can wear away. It is not usually an issue with normal, healthy individuals who are moving around and can shift position in bed. When patients become confined to a bed or wheelchair, however, their risk increases. Bedsores are also referred to as pressure sores or decubitus ulcers.

Who is at Risk?

The most at risk population are those who lack the ability or the energy to move themselves, and those whose capacity to heal has been compromised. The conditions that increase the risk of bedsores include:

• Paralysis. Quadriplegics are unable to move their bodies, and paraplegics may have difficulty keeping pressure points from developing on their legs.
• Coma. Whether induced or natural, a coma prevents a patient from moving at all, they cannot even roll over naturally, as a sleeping person would.
• Weakness. Elderly and sick patients may lack the energy they need to move, or to move often enough.
• Smoking. Smoking inhibits the body's healing response, so once a bedsore develops it is likely to progress faster.
• Diabetes. Diabetes patients also exhibit reduced capacity to heal. In addition, they may have neuropathy and be unable to feel their extremities. This means they may not feel the need to move body parts that are necrotizing under constant pressure.
• Atheroma. Plaque buildup inhibits blood flow and makes it easier to get bedsores and harder for them to heal.
• Dehydration. Dehydration is a leading factor in developing bedsores.
• Incontinence. Just as babies should not be left in dirty diapers, patients should not be left in their own urine and feces.

Medical professionals caring for patients with the above conditions should check the at-risk parts of the body with special care.

Related Information

• Common areas for bedsores to develop
• Bedsores: The Affliction of the Afflicted
• The Dirty Secret About Pressure Sores: An Infographic

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