Common Pressure Ulcer Sites: Bony Prominences at Highest Risk

Pressure ulcers (bedsores) develop over bony prominences where tissue is compressed between bone and external surface. Highest-risk sites by patient position:

Supine (Lying on Back)

• Sacrum / coccyx (most common overall)
• Heels
• Occiput
• Scapulae
• Elbows

Lateral (Side-Lying)

• Trochanter (greater trochanter of femur)
• Malleolus (lateral ankle)
• Ear (helix)
• Acromion (shoulder)
• Ribs

Prone (Face Down)

• Forehead, cheeks, chin
• Acromion, iliac crest
• Knees, toes

Sitting (Wheelchair/Chair)

• Ischial tuberosities (most common sitting site)
• Sacrum/coccyx
• Greater trochanters
• Heels (footrests)
• Scapulae (chair back)

Prevention Priorities

• Repositioning q2h (bed), q1h (chair) + offloading devices
• Skin assessment each shift
• Moisture management, nutrition (protein, zinc, vitamins C/A)
• Support surfaces (foam, air, gel overlays/mattresses)