Bedsore Prevention

What is a Bedsore: Pressure Sore: Pressure Ulcer: Pressure Injury?

It's a good thing that we toss and turn in bed or move often in a chair. Such movement redistributes the pressure on your body from the mattress or cushion. If illness or injury prevents this movement, pressure builds up on pressure points and blood circulation is reduced. Reduced blood flow can cause skin and underlying tissues to die, creating a bedsore / pressure sore.

A few simple steps, can help prevent these painful, dangerous, and costly sores; reports the November 2006 issue of the "Harvard Health Letter." In 2006, Medicare in the US, logged nearly 323 000 cases of pressure sores as secondary diagnoses. The average cost of treating pressure sores was $40,381.00

Medical Sheepskin and Merino Lambswool can prevent and treat pressure sores.

Pressure sores are painful, debilitating and unnecessary. Use this guide to learn about bed sores and their prevention. Bed sores can develop very quickly and may progress into a Stage 4 pressure ulcer; like the one shown below. Preventing this from happening should be of primary concern for all caregivers. The same products are ideal for improving the comfort level of patients who have had a hip or knee replacement.

Bed sores are often first seen in the tailbone or ankle areas. 

Bedsore Stage 4Preventing bedsores is the logical and most humane method you have of caring for those confined to a bed or wheelchair. Bedsores are unnecessary and, 95% of the time, can be prevented. - American Family Physician, October 1996: v54, n5, p1519 (14)

Bedsore prevention is really common sense if you understand the 3 major factors that cause them. Bedsores can be prevented by maintaining skin integrity. Prevent bed sores by:
  • reducing pressure on pressure points
  • keeping the skin dry
  • reducing shear or friction that causes fragile skin to tear.

Bed Sore Prevention Guidelines:

1. Take care of the skin:
Inspect the skin daily. Pay special attention to red areas and pressure points. Minimize moisture contact with the skin. Australian Medical sheepskins reduce pressure and will wick moisture away from the skin, keeping it dry.

2. Protect the skin from injury:
Avoid massaging skin over bony areas. Change body position at least every 2 hours- more frequently in a chair. Reduce friction ( rubbing) by lifting rather than dragging. Do not use donut shape cushions. These can increase the risk of getting pressure ulcers by reducing blood flow in the areas of contact with the cushion.

If the patient is confined to a bed, reduce pressure points with Australian Medical Sheepskins. The head of the bed should be raised as little as possible. When the head of the bed is raised above 30 degrees, the body may slide over the bed surface, damaging skin and small blood vessels. Pillows or wedges should be used to keep knees and ankles from touching each other. Patients should avoid lying directly on the hip bone when lying on their side. Pillows and Medical Sheepskin will help. If the patient is completely immobile, pillows should be put under their legs from mid-calf to ankle to keep heels off the bed. Never place pillows under the knees- this reduces blood circulation. 

3. Eat well:
Eat a balance diet. Proteins and calories are very important for healthy skin. Healthy skin is less liable to be damaged.

4. Improve the patients ability to move:
A rehabilitation program can help some people gain movement and independence. The patient can help to prevent most pressure sores.

Bed Sores, decubitus ulcers and pressure sores develop through 4 stages. Notify your medical practitioner and nursing staff if you notice any of the following:

Bedsore Stage1-1Bedsore Stage1-2Stage 1.

You will notice redness of the intact skin. The skin is unbroken, but inflamed and may be painful and warm to the touch. You might also notice the skin's texture may be spongy or firm.



Bedsore Stage2-1Bedsore Stage2-2

Stage 2.

Here you will see the first sign of skin breakdown and partial skin loss. It will look like an abrasion, blister or shallow crater. The outer layer of the skin is broken, red and painful. Surrounding tissue may be pale, red or swollen.

Bedsore Stage 4



Stages 3 & 4 result in ulcer production.

The skin has broken down and there is extensive destruction or damage to the underlying muscle, bone or supporting structures. Ulcers are extremely difficult to heal and may take many months for complete repair. Preventing the development of an ulcer should be considered seriously.

 Bed sores, decubitus ulcers and pressure sores are unnecessary and can be prevented. Prevention is possible when you provide an environment for the patient that does not foster the formation of bedsores. This environment can be produced by Australian HiTemp UR Medical Sheepskins. These sheepskins are approved FDA Medical Devices.

Pressure Ulcer Stages Revised by NPUAP:

February 2007 - The National Pressure Ulcer Advisory Panel (NPUAP) redefined the definition of a pressure ulcer and the stages of pressure ulcers, including the original 4 above stages and adding 2 stages on deep tissue injury and unstageable pressure ulcers. 

Pressure Ulcer Definition- A pressure ulcer is a localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. 

Pressure Ulcer Stages

Suspected Deep Tissue Injury:
Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by painful, firm, mushy, boggy, warmer or cooler areas as compared to adjacent tissue.

Deep tissue injury may be difficult to detect in individuals with dark skin tones. Evolution may include a thin blister over a dark wound bed. The wound may further evolve and become covered by thin eschar. Evolution may be rapid exposing additional layers of tissue even with optimal treatment.

Stage I:
Bedsore Stage1-1 thumbnailIntact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area.

The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. Stage 1 may be difficult to detect in individuals with dark skin tones. May indicate "at risk" persons (a heralding sign of risk)

Stage 2:
Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.

Presents as a shiny or dry shallow ulcer without slough or bruising.* This stage should not be used to describe skin tears, tape burns, perineal dermatitis, maceration or excoriation.
*Bruising indicates suspected deep tissue injury

Stage 3:
Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.

The depth of a stage 3 pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have subcutaneous tissue and stage 3 ulcers can be shallow. In contrast, areas of significant adiposity can develop extremely deep stage 3 pressure ulcers. Bone/tendon is not visible or directly palpable.

Stage 4:
Stage 4Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.

The depth of a stage 4 pressure ulcer varies by anatomical location. The bridge of the nose, ear, occiput and malleolus do not have subcutaneous tissue and these ulcers can be shallow. Stage 4 ulcers can extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteomyelitis possible. Exposed bone/tendon is visible or directly palpable.

Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed.

Until enough slough and/or eschar is removed to expose the base of the wound, the true depth, and therefore stage, cannot be determined. Stable (dry, adherent, intact without erythema or fluctuance) eschar on the heels serves as "the body's natural (biological) cover" and should not be removed.

If a bed sore has developed already, the best thing that you can do is to try and reduce the factors causing the bed sore. Pressure often a major cause of bedsores. Pressure against small blood vessels in the skin will cause them to collapse with a resulting decrease in blood flow. Low oxygen and nutrient levels results in skin death. The death of the skin is the beginning of what is recognised as a bed sore. To prevent this from happening, you must reduce the pressure on the skin. This can be achieved by lying/sitting on a Australian Medical Sheepskin. Australian Medical Sheepskins also wick moisture away from the skin; keeping it dry and firm. Moist skin is more likely to tear when a person moves. Australian Medical Sheepskins also reduce friction. If a person lies directly on a Australian Medical Sheepskin, skin abrasion and tears are less likely to happen.

Premium grade Australian Medical Sheepskins (AS4480-1 1998) add comfort and an improved feeling of well-being to those confined to a bed or wheelchair. The 2004 clinical trial at the Royal Melbourne Hospital found that people placed on these Australian Medical Sheepskins had 58% fewer bed sores than those placed on regular bed linen. For clinical trial details, click:Research Effective caregivers use HiTemp UR Medical Sheepskins to prevent or manage bed sores.

You might also consider the following products:



Australian Medical Sheepskin






Size About 30" x 42"

Natural shape

Available in:

18" x 20"

18" x 36"

30"X 60"

18" x 36 "
Wool Type Low temperature wash, Merino Medical Sheepskin. Merino wool knitted into a backing material with a waterproof, breathable backing. Low temperature wash Merino Sheepskin Bed Pad, with elastic straps to keep it in place.
Wool-Pile Height 30mm 30mm 30mm
Colour Champagne White Gold
Wool-Pile Density About 1400 GSM 1200 GSM Below M101, but very good.
Washability Machine Wash in Woolskin in cold water. Air dry. Machine wash with Woolskin. Dry in dryer. Machine Wash in Woolskin in cold water. Air dry.
Affordability Excellent value..will last many years with good care.

Cheapest  Easiest to care for.

Really nice feel.


Great value- very soft, fine wool.


 Order from The Pressure Sore Prevention Store, with its secure payment gateway. Or, if you are not sure about the best product for your situation, call us at: 1- 800- 463- 1985

Pressure Smart XD1900 is a new range of wool products, specially developed for the Prevention of Pressure Sores and Decubitus Ulcers. Pressure Smart XD1900is made from Merino Superwash Wool and has a pile density of 1900 grams/metre2. Because it is a manufactured product, all product items are the same..unlike sheepskins which differ from one to another.

Pressure Smart XD products are: machine washable and can be dried in the dryer..making them eminently suitable for institutional use. These products are recommended for incontinent clients; because of their ease of care and pressure sore prevention properties.

Consider these new Pressure Smart XD 1900 products:

  • M102XD- Overlay- 26" x 40"- for shoulders to below the buttocks protection.
  • M103XD- Pressure Care Assist for heel protection
  • M105XD- Cushion-It for wheelchairs
  • SC104XD - Superior Pressure Smart XD Overlay- 30" x 60"- for total body protection.