Caring for Bedridden Patients: Preventing Heel & Sacral Ulcers
Why Pressure Ulcers Are a Real Threat for Bedridden Patients
For patients who are bedridden—whether temporarily or long term—pressure ulcers are one of the most common and preventable complications. These wounds develop when prolonged pressure cuts off blood flow to areas of the skin, typically over bony prominences like the heels and sacrum (the base of the spine). If not addressed early, they can become painful, infected, and slow to heal.
Key Stats:
- Over 70% of pressure injuries occur in people over 70 years old.
- The heel and sacrum are the two most common sites of injury.
- Healing can take weeks or months, especially if ulcers reach deeper tissue layers (source).
What Causes These Ulcers?
- Prolonged pressure on one area, cutting off circulation
- Shear and friction from slight movements or repositioning
- Excess moisture from sweat or incontinence
- Thin or fragile skin, common in elderly or malnourished patients
Patients who are unable to reposition themselves or are incontinent are at particularly high risk—especially if they lie in the same position for extended periods.
Early Warning Signs to Watch For
Caregivers should check high-risk areas daily for signs like:
- Redness or discoloration that doesn’t fade
- Swelling, tenderness, or warmth to the touch
- Blisters, open wounds, or skin tears
- Skin that feels firmer or softer than surrounding areas
Even a small area of skin breakdown can escalate quickly without attention.
Top 5 Strategies for Preventing Heel & Sacral Ulcers
1. Regular Repositioning
Repositioning helps relieve constant pressure on any one area. Aim to:
- Turn patients every 2 hours
- Use a turning schedule
- Elevate heels off the bed with pillows or supports
2. Use Pressure-Relieving Surfaces
- Alternating pressure mattresses or foam overlays help redistribute weight
- Cushion chairs with supportive pads or foam wedges
3. Apply Protective Dressings Proactively
One of the most effective ways to reduce ulcer formation is using silicone foam dressings on the heels and sacrum.
These dressings:
- Redistribute pressure over a wider area
- Reduce friction and shear
- Absorb moisture to protect skin integrity
- Are gentle to remove, minimizing trauma
Studies show that applying these dressings before any signs of damage appear can significantly reduce the incidence of pressure injuries in high-risk patients (source).
4. Keep Skin Clean and Dry
- Perform regular incontinence care
- Use mild, pH-balanced cleansers
- Apply moisturizer to keep skin supple, but avoid overly wet conditions
5. Monitor Nutrition and Hydration
Poor nutrition impairs skin repair. Ensure:
- Adequate protein intake
- Sufficient hydration
- Supplement with vitamins/minerals if recommended by a healthcare provider
The Role of Silicone Foam Dressings
These dressings are a powerful tool in pressure ulcer prevention, especially for the heel and sacral regions. They are:
- Conformable: Designed to mold around bony contours
- Breathable and waterproof: Protect from external moisture but allow skin to breathe
- Low-trauma: Silicone adhesive is gentle during dressing changes
- Clinically proven: Research supports their use for prevention and treatment in both hospital and home care settings
Final Tips for Caregivers
- Don’t wait for a wound to form—be proactive.
- Keep a daily care checklist.
- Educate family members or secondary caregivers about turning schedules, skin checks, and dressing use.
- If in doubt, consult a wound care nurse or physician for tailored care.
Key Takeaway
Preventing pressure ulcers in bedridden patients requires daily attention, smart tools, and simple routines. Silicone foam dressings, when used proactively on the heels and sacrum, offer an effective and gentle way to protect fragile skin from pressure-related damage.
