Fiducia TogetherPressure ulcers
Also called Pressure sores, Bedsores, Decubitus ulcers
Skin and tissue damaged by unrelieved pressure. Mostly preventable, and a reliable indicator of how good the care is.
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.
What it is
Pressure ulcers are the plainest measure of care quality there is. Around 1,300 new ones are reported in England every month, and the overwhelming majority of them were preventable.
Unrelieved pressure cuts off blood supply to the skin and the tissue beneath. Damage can start within a couple of hours in a vulnerable person, and deep tissue can be destroyed before anything is visible on the surface.
The bony points are where they form: sacrum, heels, hips, elbows, shoulder blades, ears, and under medical devices such as oxygen tubing and catheters.
Signs you might notice
Category 1 is a patch of redness that does not blanch when you press it. On darker skin it may look purplish or feel warmer, firmer or boggier than the surrounding skin, and blanching is not a reliable test. That difference matters and is the reason pressure damage is under-detected in people with darker skin.
Category 2: a shallow open sore or a blister.
Category 3: full thickness loss, with visible fat.
Category 4: down to muscle, tendon or bone.
Deep tissue injury: a purple or maroon area of intact skin, which can deteriorate rapidly.
How it can affect day-to-day life
The harm is not cosmetic. Pressure ulcers cause severe pain, take months to heal, and cause sepsis and death.
The people most at risk are the least able to say so: dementia, spinal cord injury, sedation, malnutrition, incontinence and immobility.
And they are a safeguarding matter. A category 3 or 4 ulcer acquired in care usually warrants a safeguarding referral, because it means the basics were not done.
Supporting someone well
Reposition on a schedule and record it. Every two to four hours depending on risk, and record it because unrecorded repositioning is indistinguishable from repositioning that did not happen.
Use the SSKIN model: Surface, Skin inspection, Keep moving, Incontinence and moisture, Nutrition.
Check the skin daily at every bony point, and check under and around every device.
Do not rub reddened skin. It causes further damage.
Get the right surface: an appropriate cushion and mattress, and check the settings are correct rather than assuming.
Keep skin clean and dry. Moisture from incontinence or sweat multiplies the risk, so treat incontinence as skin protection.
Feed people properly. Protein and fluid are what heals tissue.
Fiducia Together holds skin integrity, repositioning and weights in one clinical record, so the checks are evidenced and a deteriorating area is escalated rather than noticed at the next handover.
Where to get help
A district nurse or tissue viability nurse assesses and dresses ulcers. Ask for tissue viability by name for anything beyond category 1.
Report new pressure damage acquired in a care setting through the provider's incident process, and raise safeguarding where appropriate.
Signs of infection, spreading redness, smell, fever, need same-day medical assessment.
Tools we make that might help
These are our own products. We have put them here because they do something specific for this condition, not because every page needs a list.
Fiducia Together
Skin integrity, repositioning and weights in one record, so the checks are evidenced rather than assumed.
Last reviewed 2026-08-28 by Fiducia Together · Next review due 2027-08-28
Important: This page is general information, not medical advice, and it is not a diagnosis. If you are worried about your health or someone else's, speak to a GP, pharmacist, or call 111. In an emergency, call 999.