Bedsore (Pressure Ulcer) Dressing: Management & Step-by-Step Guide
Bedsores (pressure ulcers) develop due to prolonged pressure on the skin, often in immobile patients. Proper wound assessment, staging, and dressing selection are crucial for healing.
1. Bedsore Staging & Characteristics
| Stage | Description | Appearance |
| Stage I | Non-blanchable erythema | Red, intact skin |
| Stage II | Partial-thickness skin loss | Blister, shallow ulcer |
| Stage III | Full-thickness skin loss | Deep crater, fat visible |
| Stage IV | Full-thickness + tissue necrosis | Bone/tendon exposed |
| Unstageable | Covered by slough/eschar | Depth unknown |
2. Dressing Selection Based on Wound Type
| Wound Condition | Recommended Dressing | Purpose |
| Dry/Necrotic | Hydrogel or Alginate | Moisture retention, debridement |
| Moderate Exudate | Foam or Hydrocolloid | Absorb fluid, protect |
| Heavy Exudate | Alginate or Silver Dressing | Control infection, absorb drainage |
| Infected | Antimicrobial (Silver/Honey) | Fight bacteria |
| Granulating | Transparent Film or Hydrocolloid | Promote healing |
3. Step-by-Step Bedsore Dressing Change
Supplies Needed:
✔ Sterile gloves
✔ Saline or wound cleanser
✔ Appropriate dressing (e.g., foam, alginate)
✔ Skin barrier film (if needed)
✔ Adhesive tape/securement
Procedure:
- Hand hygiene & don gloves.
- Gently clean wound (saline, no harsh antiseptics).
- Debride if needed (slough/necrotic tissue).
- Apply skin protectant (around wound edges).
- Place dressing (ensure full coverage).
- Secure with tape/film (avoid pressure on wound).
- Document wound size, exudate, and dressing type.
4. Key Principles in Bedsore Care
✅ Relieve pressure (reposition every 2 hrs, use foam mattresses).
✅ Keep wound moist (not too wet/dry).
✅ Monitor for infection (pus, odor, increased pain).
✅ Nutrition support (high-protein diet for healing).
5. When to Consult a Specialist?
- Stage III/IV ulcers (may need surgical debridement).
- Suspected osteomyelitis (bone infection).
- Non-healing wounds (despite proper care).