Pressure sores in the sacral area—the base of the spine or “tailbone”—are some of the most common and dangerous skin injuries for those with limited mobility. Because this area has little padding and bears significant weight while sitting or lying down, it is a high-risk zone for skin breakdown.
What Causes Sacral Pressure Sores?
These injuries, also known as bedsores or decubitus ulcers, develop when constant pressure cuts off blood flow to the skin. Without blood to deliver oxygen and nutrients, the tissue begins to die.
Key risk factors for the sacral area include:
- Prolonged Pressure: Staying in one position for too long, especially lying on your back or sitting in a wheelchair.
- Shearing Forces: When the skin stays in place but the bone underneath moves, often caused by sliding down in a bed or being dragged during a transfer.
- Incontinence: Constant moisture from urine or stool weakens the skin and makes it more prone to infection.
- Poor Nutrition: A lack of protein, vitamins, and minerals makes it harder for skin to stay healthy and heal itself.
Recognizing the Stages
Understanding the severity of a sacral wound is vital for proper treatment:
- Stage 1: Intact skin with redness that doesn’t turn white when pressed (non-blanchable). The area may feel warmer, cooler, firmer, or softer than surrounding skin.
- Stage 2: The top layer of skin is broken, often looking like a shallow open sore, abrasion, or clear fluid-filled blister.
- Stage 3: A deeper wound that reaches the fatty tissue layer, resembling a small crater.
- Stage 4: The most severe stage, involving deep tissue loss that may expose muscle, tendons, or even bone.
Effective Prevention & Care
Ninety-five percent of pressure sores are preventable with a dedicated care routine.
- Frequent Repositioning: Change positions every 2 hours while in bed and every 15 to 30 minutes while in a wheelchair. If possible, do “wheelchair pushups” to lift yourself off the seat briefly.
- Use Supportive Surfaces: Specially designed pressure-relieving equipment can significantly reduce risk:
- Specialty Mattresses: Air or gel-filled mattresses help redistribute body weight.
- Cushions: Products like the Jay Fusion cushion or ROHO cushion can help offload pressure from the sacrum.
- Warning: Never use “donut” or ring-shaped cushions, as they actually restrict blood flow to the center area.
- Skin Hygiene: Wash the area gently with mild soap and warm water. Use a moisture barrier cream to protect against irritation from incontinence.
- Specialized Dressings: For Stage 2 or higher, specialized dressings like McKesson Sacral Silicone Foam or MedVance Bordered Silicone
can protect the wound and maintain a moist healing environment. - Nutrition & Hydration: Prioritize a diet high in protein and vitamins A and C to support tissue repair.
When to Call a Professional: If you notice a sore that does not improve within 2–3 days, or if you see signs of infection like pus, foul odor, or fever, contact a healthcare provider immediately.
Would you like more information on specialized cushions or tips for caregiver-assisted repositioning? Call our office and ask to speak to an ATP 661-393-4877.