Pressure Sores: What Caregivers Need to Know in the First Week Home

By Kelvin Koay, Registered Pharmacist

Medically reviewed by Kelvin Koay, RPh · Published: 21 Jul 2026 · Last reviewed: 21 Jul 2026

Key Takeaways

Pressure sores can begin to develop within two to four hours of unrelieved pressure — repositioning every two hours is the single most effective prevention.
Stage 1 pressure sores (persistent redness that does not fade) can reverse completely with prompt action; Stage 3 and 4 wounds require professional wound assessment.
Nutrition matters as much as wound care — low protein intake significantly slows skin repair in bedridden patients.
If a wound is increasing in size, producing pus, or accompanied by fever, contact your pharmacist or wound care nurse the same day.

Why are the first days at home critical for pressure sore prevention?
What is a pressure sore and how does it develop?
Where do pressure sores most commonly form?
What can caregivers do to prevent pressure sores?
How are pressure sores managed at home?
When does a pressure sore need medical attention?
Frequently asked questions

Why are the first days at home critical for pressure sore prevention?

Your family member has just been discharged from hospital. They are tired, their mobility is limited, and they will be spending most of the next several days in bed or in a chair. This is exactly the window when pressure sores are most likely to develop — and the window when the right care can prevent them entirely.

Pressure sores (also called pressure ulcers or bedsores) are one of the most common and preventable complications of post-discharge recovery. They cause significant pain, slow overall recovery, and — if infected — can lead to readmission. As a caregiver, knowing what to look for and what to do in the first week is one of the most important things you can do at home.

What is a pressure sore and how does it develop?

A pressure sore forms when sustained pressure on a part of the body cuts off blood supply to the skin and the tissue beneath it. Without blood flow, the tissue begins to break down — sometimes within two to four hours of unrelieved pressure.

Medical professionals use a four-stage system to describe how pressure sores progress:

Stage 1 — The skin is intact but there is a reddened area that does not turn white when pressed. The skin may feel warmer, firmer, or softer than the surrounding area. This stage is reversible with prompt action.

Stage 2 — A shallow open wound or blister appears. The wound bed looks pink or red and the outer layer of skin has been lost. This stage requires proper wound cleaning and dressing.

Stage 3 — The wound has gone through the full thickness of skin and fatty tissue is visible beneath. There may be slough (soft yellow or grey tissue) in the wound bed. This stage requires professional wound assessment.

Stage 4 — The deepest stage. Bone, tendon, or muscle may be visible. This requires urgent medical attention.

The goal of home care is to catch any developing sore at Stage 1 — before it progresses.

Where do pressure sores most commonly form?

Pressure sores form over bony prominences — areas where bone sits close to the skin surface and pressure concentrates. For a patient who is mostly lying down, the highest-risk areas are:

Sacrum (the base of the spine, above the buttocks) — the most common site
Heels — especially in patients lying flat with legs extended
Hips (greater trochanter) — for patients lying on their side
Back of the head — in patients with limited neck movement
Shoulder blades and elbows — in patients propped up in bed

For patients spending significant time in a wheelchair or chair, the coccyx and sitting bones are at highest risk.

Check all of these areas during each repositioning. It takes less than two minutes and gives you early warning before any wound develops.

What can caregivers do to prevent pressure sores?

Reposition every two hours

Repositioning is the single most effective pressure sore prevention measure available. For a bedbound patient, turn them from their back to one side, then to the other side, every two hours during waking hours. At night, every four hours is generally acceptable unless the care team has specified otherwise.

Use pillows to support the patient in a side-lying position at a 30-degree angle — not flat on their side, which concentrates pressure directly on the hip bone. Place a pillow between the knees and another under the lower leg to keep the heels raised off the mattress.

Inspect and care for the skin at each turn

At each repositioning, check the high-risk areas listed above. Clean the skin gently with mild soap and water — do not scrub. Dry thoroughly, especially in skin folds. Apply a simple moisturiser to dry or fragile areas to maintain the skin’s protective barrier.

If the patient is incontinent, use a barrier cream on the buttocks and perineal area at every change. Moisture from urine or stool is one of the strongest accelerants of skin breakdown, and consistent protection at each change is non-negotiable.

Support nutrition

A patient who is not eating well will not heal well. Protein is the primary building block for skin repair — a patient on a low-calorie or low-protein diet after discharge is at significantly higher risk of both developing and worsening pressure sores.

If the patient is eating poorly, speak with your pharmacist about appropriate nutritional supplements. Small, frequent meals with protein-rich foods — eggs, fish, tofu, legumes — are more practical than trying to increase single meal sizes in a fatigued patient.

Consider a pressure-relieving mattress or cushion

Standard mattresses do not distribute weight evenly. A foam pressure-relieving mattress overlay or a specialist alternating-air mattress significantly reduces interface pressure for high-risk patients. Your pharmacist or discharge team can advise on appropriate equipment based on the patient’s mobility and risk level.

How are pressure sores managed at home?

Stage 1 — Act on redness immediately

If you notice persistent redness that does not fade within 30 minutes of removing pressure from the area, this is a Stage 1 sore. Relieve pressure from that area completely and increase repositioning frequency. Do not massage the reddened area — this can cause further tissue damage beneath the skin.

Stage 2 — Clean and dress the wound

A blister or shallow open wound requires gentle cleaning with saline or clean water. Do not burst intact blisters — the skin over a blister provides natural protection. Cover with a non-adherent dressing and change when soiled or as directed.

Do not use iodine, hydrogen peroxide, or coloured antiseptics on open wounds unless specifically directed by a healthcare professional. These can damage fragile healing tissue and slow recovery.

Stage 3 and Stage 4 — Seek professional wound assessment

Wounds at these stages should not be managed at home without guidance from a wound care nurse or doctor. Contact your pharmacist or discharge team to arrange a wound care review before proceeding.

Contact your pharmacist or wound care nurse the same day if:
The wound is increasing in size despite correct repositioning; there is pus, a bad smell, or increasing warmth around the wound; the patient has a fever; or you notice black or hardened tissue covering the wound.

When does a pressure sore need medical attention?

Most Stage 1 and straightforward Stage 2 wounds can be managed at home with correct technique and appropriate dressings. The following situations require same-day contact with your pharmacist or wound care team:

A wound that is getting larger despite repositioning every two hours
Signs of infection: increasing redness spreading outward, pus, foul smell, warmth around the wound
Fever in a patient with an open wound
Black or leathery tissue covering the wound
A wound that has not improved after seven days of correct home care
You are not confident about wound assessment or dressing technique

When in doubt, contact your pharmacist first. We can help you assess whether a wound needs escalation to a clinic or hospital, and advise on appropriate wound care products for the stage you are dealing with.

Frequently asked questions

How quickly can a pressure sore develop?

A pressure sore can begin to develop within two to four hours of unrelieved pressure on vulnerable skin. In patients with poor circulation, diabetes, or very thin skin — such as the elderly — the process can be faster. This is why repositioning every two hours is a clinical standard, not just a suggestion.

Can a pressure sore heal on its own at home?

Stage 1 pressure sores can resolve completely with prompt repositioning and skin care. Stage 2 wounds can heal well at home with correct wound cleaning and dressing. Stage 3 and Stage 4 wounds require professional wound management and will not resolve without appropriate clinical support.

What type of dressing should I use for a pressure sore?

The right dressing depends on the wound stage and how much fluid the wound produces. Your pharmacist can help you select an appropriate option — foam dressings, hydrocolloid dressings, and non-adherent wound pads each suit different situations. Do not place regular gauze directly on an open wound as it can stick to healing tissue and cause damage on removal.

How do I know if a pressure sore is infected?

Signs of infection include: redness spreading beyond the wound edges, pus or cloudy discharge, a foul smell, the wound area feeling warmer than surrounding skin, and fever in the patient. If you notice any of these signs, contact your pharmacist or wound care nurse the same day rather than waiting for a scheduled appointment.

When should I speak to a pharmacist about a pressure sore?

Speak to a pharmacist as soon as you notice a Stage 1 sore that does not improve within 24 hours of pressure relief, before you begin treating any Stage 2 wound if you are unsure of the correct approach, or if the wound appears to be getting worse at any stage. Early input prevents small wounds from becoming complex ones.

Summary

A pressure sore at Stage 1 takes hours to develop and can be reversed in days with the right response. A Stage 4 wound can take months to heal and carries serious infection risk. The difference between those two outcomes is almost always consistent repositioning, daily skin inspection, and acting on early warning signs without delay.

This article is for general educational guidance only. It does not replace a consultation with your pharmacist, wound care nurse, or doctor. If you have questions about wound management, medical equipment, or your family member’s recovery plan, speak with a qualified healthcare professional before making any changes.

About National Pharmacy Malaysia

National Pharmacy Malaysia is a registered pharmacy in Kuala Lumpur, specializing in post-discharge recovery support, wound care, and medication management.

PPUM branch: Lobby, KKWK, Pusat Perubatan Universiti Malaya, 59100 Kuala Lumpur · 011-1122 6830
Mont Kiara branch: Lot LG2-06, Sunway 163 Park, Jalan Kiara, 50480 Kuala Lumpur · 03-6419 6239

Questions about wound care products, pressure-relieving equipment, or your discharge plan? WhatsApp us at 011-1122 6830.