Pressure sores, commonly known as bed sores, begin as a reddened area of the skin.  If you were to put your head down on your arm for about 5 minutes, you will notice a reddened area on your forehead and on your arm once you remove the pressure.  This reddened area is an area that received too much pressure.  During this time, the pressure displaced the little bit of fat stores that you have in your forehead and diverted blood flow away from that area.  Circulation was cut off, therefore depriving that area of blood and nutrients.  If this was too continue, you would develop a pressure sore.

There are several factors that contribute to the formation of pressure sores. 

1) Prolonged pressure to a bony area such as the hips, ankles, shoulder blades, elbows, tailbones, and heels. 

a) It is very important to remove the pressure to these areas about every two hours.  By changing the body's postion, you allow blood to flow back to the area to provide oxygen and nutrients to keep the skin healthy.  Generally, the body will tell you when to move, that is why we do not wake up with bed sores in the morning.  Your body tells you when to reposition, but the elderly cannot always do this without assistance.  Setting up a "body rotation" schedule is crucial in preventing pressure sores.

2) Poor nutrition and inadequate hydration cause malnutrition and dehydration. 

a) The body cannot heal itself when it is starved and dehydrated.  A diet rich in protein and water, along with the other components to a healthy diet, will help heal damaged skin and muscle tissue.

3) Loss of body fat/body weight.

a) Body fat is very important in the elderly.  As most adults try to lose body fat/body weight, body fat and weight loss in the elderly can cause some serious problems.  Body fat helps protect the bony areas from breaking down causing open wounds.  Too much body fat/body weight can also cause added pressure.  Keeping the body fat/body weight within acceptable limits is ideal.

4) Incontinence (inability to control the bowel and bladder) will cause the skin to breakdown very easily. 

a) It is important to keep the skin clean and dry to prevent the acids from the bowel and bladder from deteriorating the skin.  Prolonged exposure to urine and stool can also cause worsening of the sore by promoting bacterial growth.

Pressure sores, once formed, can be successfully healed.  By removing pressure, providing adequate nutrition/hydration, proper body rotation, and keeping the skin clean and dry, along with proper medical treatment has had great success.  If you suspect that skin breakdown is occurring, follow the above guidelines and seek medical attention as soon as possible.