Contributing Clinical Educator

Andrew Marxen, BAN, RN, CWCN, CWHS, MBA

Pressure ulcers, also referred to as decubitus ulcers, are more than just surface wounds; they’re a serious complication that can significantly impact patient outcomes and healthcare costs. As wound care professionals, understanding their development, prevention, and wound care treatments for pressure ulcers is essential to delivering effective care. With new clinical standards released in 2025, staying informed on the latest evidence-based guidelines is more important than ever.

At Wound Care Professionals, we partner with clinicians eager to stay at the forefront of wound care, offering real-world education, expert consulting, and a supportive community. In this guide, we’ll explore what pressure ulcers are, how they develop, and most importantly, how to prevent pressure ulcers on bedridden patients and manage them effectively through targeted wound care treatments.

What Are Pressure Ulcers?

Pressure ulcers are localized injuries to the skin and/or underlying tissue, usually over a bony prominence, resulting from prolonged pressure or pressure combined with shear. Areas such as the sacrum, heels, elbows, and hips are especially vulnerable.

They are staged from 1 to 4 based on severity:

• Stage 1: Non-blanchable redness on intact skin.

• Stage 2: Partial-thickness skin loss with exposed dermis.

• Stage 3: Full-thickness loss, possibly exposing fat.

• Stage 4: Full-thickness tissue loss with exposed muscle or bone.

To support clinicians in identifying, treating, and preventing pressure ulcers at every stage, Wound Care Professionals has developed a collection of Essential Guides. These practical, evidence-based resources cover everything from wound assessment and documentation to advanced treatment protocols—helping healthcare providers stay aligned with the latest standards and deliver the best possible outcomes for their patients.

Immediate recognition and accurate staging are crucial for guiding pressurized ulcer treatment strategies and improving healing outcomes.

How Do Pressure Ulcers Develop?

Pressure injuries occur when prolonged pressure reduces blood flow to the skin, depriving tissues of oxygen and nutrients. Immobility, friction, moisture, and poor nutrition are common contributing factors to this condition. Bedridden patients or those with limited mobility are at the highest risk. Pressure injuries occur when prolonged pressure and shear forces reduce blood flow to the skin. Understanding these triggers is key to building an effective prevention plan.

How to Prevent Pressure Ulcers on a Bedridden Patient: Proven Strategies

1. Risk Assessment

Utilize evidence-based tools, such as the Braden Scale, to identify high-risk individuals early. This allows for interventions before any tissue breakdown occurs.

2. Routine Repositioning

Repositioning the patient at least every two hours is one of the most essential techniques. For patients who use wheelchairs, shifting weight every 15 minutes is recommended.

3. Pressure-Relieving Devices

Use specialized support surfaces such as low-air-loss mattresses or heel protectors. These reduce direct pressure on vulnerable areas.

4. Skin Care and Moisture Management

Keep the skin clean, moisturized, and dry. Incontinence management is crucial—moist environments increase the risk for breakdown.

5. Nutrition and Hydration

Ensure diets are rich in protein, vitamins, and minerals, especially zinc and vitamin C, which support tissue repair and regeneration.

Latest Approaches to Pressure Ulcer Treatment

Despite our best efforts, pressure ulcers still occur. When they do, timely and comprehensive wound care treatments for pressure ulcers are critical. Here’s what works:

1. Debridement

Removing necrotic tissue using mechanical, enzymatic, autolytic, or surgical methods accelerates healing and reduces the risk of infection.

2. Advanced Dressings

Hydrocolloids, alginates, foam dressings, and antimicrobial options create a moist wound environment, which is essential for healing. The correct dressing depends on the wound’s stage and exudate levels.

3. Negative Pressure Wound Therapy (NPWT)

NPWT has shown excellent results in complex wounds by promoting granulation tissue growth and removing excess fluid.

4. Infection Control

Topical antimicrobials and systemic antibiotics may be necessary if signs of infection are present. Cultures and sensitivity tests help guide treatment.

5. Interdisciplinary Coordination

Optimal care involves a multidisciplinary team comprising nurses, physicians, dietitians, and wound care specialists, working together to address all aspects of healing.

As our founder, Nancy Morgan, teaches in our Wound Care Certification Courses, effective pressure ulcer treatment requires a combination of clinical expertise, practical technique, and caregiver education. It’s that real-world impact that Wound Care Professionals was built on.

A Final Word

Pressure ulcers represent a vital area of concern for healthcare professionals. Knowing how to prevent pressure ulcers on a bedridden patient and implementing evidence-backed wound care treatments for pressure ulcers can substantially enhance outcomes. Whether you’re in acute care, long-term care, or home health, proactive care makes the difference.

Ready to go deeper?

Contact Wound Care Professionals today to learn how we can help you provide top-tier wound care.

References

• National Pressure Injury Advisory Panel (NPIAP). (2025). Prevention and Treatment of Pressure Ulcers/Injuries: International Guideline. https://npiap.com/page/InternationalGuidelines

• Agency for Healthcare Research and Quality (AHRQ). (2023). Preventing Pressure Ulcers in Hospitals: A Toolkit for Improving Quality of Care.
  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/index.html

• National Institute for Health and Care Excellence (NICE). (2014, updated 2023). Pressure Ulcers: Prevention and Management.
  https://www.nice.org.uk/guidance/cg179