Pressure Sores in Grand Rapids, MI: Prevention, Care, and Local Resources

Pressure sores (also called pressure injuries, bed sores, pressure ulcers, or decubitus ulcers) are areas of damage to the skin and the underlying tissue caused by constant pressure, shear, or friction. They are common in people with reduced mobility, such as those who are:

• Bedridden at home or in a hospital
• Using a wheelchair
• Recovering from surgery or serious illness

In Grand Rapids, Michigan, pressure sores are a frequent concern in hospitals, nursing homes, rehabilitation centers, and home-care settings, especially during long winter months when people tend to be less active.

What Are Pressure Sores?

Pressure sores develop when constant pressure reduces blood flow to the skin and underlying tissues. Without enough blood flow, the tissue can become damaged and eventually die.

Areas most at risk include skin over bony parts of the body, such as:

• Heels and ankles
• Elbows
• Hips and hipbones
• Tailbone (coccyx) and lower back
• Shoulder blades and spine
• Back or sides of the head
• Rims of the ears

People in Grand Rapids who spend long periods in bed (for example, after surgery at Spectrum Health or Trinity Health Grand Rapids) or who use a wheelchair are at especially high risk.

Why Pressure Sores Are Serious

If not treated early, pressure sores can:

• Become deep wounds involving muscle, tendon, or bone
• Become infected (cellulitis, bone and joint infections, abscesses)
• Lead to sepsis (a life-threatening bloodstream infection)
• Rarely, lead to certain skin cancers (such as squamous cell carcinoma)

Because pressure sores can be difficult and slow to heal, especially in older adults and people with chronic conditions (like diabetes, vascular disease, or poor nutrition), prevention is critical.

Stages (Grades) of Pressure Sores

Healthcare providers in Grand Rapids hospitals and clinics typically classify pressure sores into stages (grades):

• Grade I – Skin discoloration (red, blue, purple, or black), but skin is not broken. The area may feel warm, firm, or painful.
• Grade II – Partial-thickness skin loss. The top layers of skin are damaged or open, often looking like a blister or shallow open sore.
• Grade III – Full-thickness skin loss. Damage extends through the skin layers and may expose fat tissue.
• Grade IV – Deep tissue damage. Necrosis (death) of skin and underlying structures such as muscle, tendon, joint, or bone.

Early stages (Grade I and II) are much easier to treat than advanced stages.

Who Is at Higher Risk in Grand Rapids?

Anyone with limited mobility is at risk, but certain factors increase the likelihood of pressure sores:

Immobility and Paralysis

• Stroke survivors
• People with spinal cord injuries or severe head injuries
• People recovering from major surgery or serious illness in local facilities (e.g., Spectrum Health, Metro Health, Mercy Health, Trinity Health Grand Rapids)

Age and Skin Changes

• Older adults often have thinner, more fragile skin
• Long hospital stays or time in bed increase the risk

Medical Conditions

• Diabetes (nerve damage can reduce sensation and pain awareness)
• Circulation disorders (poor blood flow to the skin)
• Malnutrition or unintentional weight loss
• Obesity (extra pressure on skin and capillaries, especially when combined with immobility)
• Urinary or fecal incontinence (moisture and irritation from urine or stool)

Lifestyle Factors

• Smoking:
  • Reduces blood flow to the skin
  • Slows wound healing
  • Increases the risk of developing pressure sores and makes recovery more difficult

Common Locations for Pressure Sores

If You Use a Wheelchair

Pressure sores often occur where your body rests against the chair:

• Tailbone and buttocks
• Shoulder blades
• Spine
• Backs of arms and legs

If You Are Bedridden

Pressure sores may develop on:

• Heels, ankles, and toes
• Hips and hipbones
• Lower back and tailbone
• Back or sides of the head
• Rims of the ears
• Backs or sides of the knees
• Shoulders or shoulder blades

These risk areas are routinely checked by nurses and wound care specialists in Grand Rapids hospitals and nursing facilities.

Early Warning Signs to Watch For

Check your skin (or your loved one’s skin) at least once a day, especially over bony areas. Look for:

• Red, purple, or blue areas that do not fade after pressure is relieved
• Swelling, warmth, or tenderness
• Torn, cracked, or wrinkled skin
• Blisters or open areas
• Signs of infection: increased warmth, redness, pus, bad odor, fever, or worsening pain

Early detection is especially important during Michigan’s cold, dry winters, when skin can become drier and more fragile.

Preventing Pressure Sores in Grand Rapids

If you are confined to a bed or chair for any period of time, prevention is essential. A pressure sore prevention plan should be developed with your healthcare team, including your primary care provider, home health nurse, or wound care specialist.

1. Position Changes and Pressure Relief

If You Use a Wheelchair

• Shift your weight or change position every 15 minutes if possible.
• Use pressure-redistributing wheelchair cushions to spread pressure more evenly.
• Ask a physical or occupational therapist (for example, at Spectrum Health Rehabilitation or Mary Free Bed in Grand Rapids) to recommend cushions and proper sitting posture.

If You Are in Bed

• Change position at least every 2 hours, even during the night.
• Avoid lying directly on your hipbones.
• Use pillows or foam wedges as soft buffers between your skin and the bed, especially between:
  • Knees
  • Ankles
  • Under calves (to lift heels off the bed)

Head-of-Bed Elevation

• Keep the head of the bed at or below 30 degrees whenever medically safe.
• If your medical condition requires a higher angle, your care team will choose the lowest safe elevation to reduce sliding and shear.

Side-Lying Position

• When lying on your side, aim for about a 30-degree tilt, not directly on your hipbone.
• Use pillows to support your back and between your knees.

2. Support Surfaces and Technology

Pressure-relieving equipment can help prevent and manage pressure sores:

• Pressure offloading mattresses (special foam, alternating pressure, or low-air-loss mattresses)
• Wheelchair cushions designed for pressure relief
• Pressure-sensing mats or monitoring devices that measure:
  • Skin pressure
  • Moisture
  • Body motion

These technologies may be used in Grand Rapids hospitals, long-term care facilities, and some home-care settings.

3. Protecting Skin from Medical Devices

Pressure can also come from medical devices, such as:

• Oxygen tubing
• Catheters
• Cervical collars
• Casts and splints
• Restraints

To reduce risk:

• Check the skin under and around devices regularly.
• Ask your nurse or doctor to adjust, pad, or reposition devices if you notice redness or discomfort.
• Request regular skin assessments if you are in a hospital or rehabilitation facility.

4. Daily Skin Care

Proper skin care is especially important in a climate like West Michigan’s, where winter air is cold and dry and indoor heating can dry skin further.

Key steps include:

• Daily skin checks for redness, discoloration, or breakdown, especially over bony areas.
• Keep skin clean and dry, especially if you have incontinence.
• Maintain balanced moisture:
  • Use gentle moisturizers to keep skin supple, not overly dry.
  • Avoid letting skin stay wet from sweat, urine, or stool.
• Never massage bony areas (such as heels, hips, or tailbone) because the skin and tissues there are too delicate and can be damaged.
• Use mild, fragrance-free cleansers and gently pat skin dry.

5. Nutrition, Hydration, and Lifestyle

Healthy nutrition is vital for preventing and healing pressure sores.

Diet and Hydration

• Eat a balanced, nutrient-dense diet, including:
  • Lean proteins (fish, poultry, beans, eggs, dairy)
  • Whole grains
  • Fruits and vegetables
  • Healthy fats
• Drink enough fluids/water (as allowed by your medical condition).
• Maintain a healthy body weight:
  • Low body weight can lead to thin, fragile skin.
  • Excess weight can increase pressure on skin and blood vessels.
• If you are malnourished or at risk of malnutrition, your healthcare team may recommend:
  • Increased protein, calories, and fluids
  • Oral nutritional supplements
  • Vitamin or mineral supplements, if needed

Dietitians and nutritionists at Grand Rapids hospitals and clinics can help design a personalized nutrition plan.

Activity Levels

• Maintain safe activity levels, as recommended by your doctor or physical therapist.
• Even small movements—such as seated exercises, leg lifts, or arm movements—can improve circulation and reduce risk.

Quit Smoking

• Smoking slows skin healing and reduces blood flow.
• Quitting smoking can significantly improve your skin health and your body’s ability to heal existing pressure sores.
• For help, you can contact local smoking cessation programs through:
  • Kent County Health Department
  • Grand Rapids Public Health resources
  • Your primary care provider or local hospital system

Good Hygiene Practices

• Practice regular bathing or cleansing routines, adapted to your mobility level.
• Promptly clean skin after episodes of incontinence.
• Use barrier creams if recommended by your nurse or doctor.

Treatment Options for Pressure Sores in Grand Rapids

Treatment depends on the stage (grade) and severity of the pressure sore. Your care may involve a team including doctors, nurses, wound care specialists, dietitians, and physical or occupational therapists.

General Treatment Principles

• Relieve pressure:
  • Frequent position changes
  • Special mattresses, cushions, or beds
• Keep the sore moist and the surrounding skin dry:
  • Dressings are chosen to maintain a moist wound environment and protect nearby skin.
  • There is no single “best” dressing type; options include foam, hydrocolloid, alginate, or saline gauze when others are unavailable.
• Clean the wound regularly:
  • Use appropriate wound-cleansing solutions as recommended by your healthcare provider.
• Manage infection:
  • Topical antiseptics (like iodine-based products) or antibiotics may be used if infection is present.
  • No one antiseptic or antibiotic is proven superior; choice depends on the wound and patient.
• Debridement (removal of dead tissue):
  • For deeper or necrotic wounds, surgery may be needed to remove dead tissue and sometimes underlying or exposed bone.
  • The space may be filled with appropriate materials to support healing.
• Surgical closure:
  • In some cases, surgery and skin grafts or flaps are used to close large or deep wounds.

Supportive Care

• Continue healthy, nutritious eating as advised by your nutrition team.
• Maintain good hydration, unless restricted for medical reasons.
• Follow all positioning and pressure-relief instructions from your care team.

When to Seek Medical Help in Grand Rapids

Contact a healthcare professional promptly if you notice:

• New areas of redness or discoloration that do not improve after relieving pressure
• Blisters, open sores, or skin breakdown
• Signs of infection: fever, worsening redness, warmth, swelling, pus, or foul odor
• Increasing pain or discomfort in pressure areas

Local Care Options

If you are in the Grand Rapids, MI area, support is available through:

• Your Primary Care Provider (GP) – for initial assessment and ongoing management
• Hospital Wound Care Clinics at:
  • Spectrum Health
  • Trinity Health Grand Rapids
  • Metro Health
  • Mercy Health
• Home Health and Domiciliary Care Staff – for in-home assessments, dressing changes, and education
• Kent County Health Department & Grand Rapids Public Health – for community health resources, chronic disease support, and smoking cessation programs

If your clinic or health system offers a nurse advice line, you can call for 24/7 guidance on managing skin concerns and deciding when to seek urgent care.

Key Points About Pressure Sores

• Pressure sores are areas of skin and tissue damage caused by constant pressure, friction, or shear.
• Skin over bony areas such as heels, elbows, the back of the head, hips, and tailbone is at highest risk.
• Reduced blood flow from constant pressure can cause tissue death if not relieved.
• Major risk factors include immobility, paralysis, older age, diabetes, circulation problems, incontinence, malnutrition, obesity, and smoking.
• Prevention focuses on regular position changes, pressure-relieving surfaces, daily skin care, good nutrition, and lifestyle changes (including quitting smoking).
• Early detection and treatment can prevent serious complications such as infection, sepsis, and deep tissue damage.

If you or a loved one in Grand Rapids is at risk for pressure sores, talk with your healthcare provider about a personalized prevention and care plan tailored to your home, mobility level, and medical needs.