How often should I turn someone who is bed-bound?

A common guide is about every 2 hours in bed, and more frequently when sitting. Your care team may tailor this – some people need turning more often. A written schedule helps everyone keep to it.

There’s a red mark that won’t fade – is it serious?

A patch of redness (or colour/temperature/firmness change on darker skin) that does not turn white when pressed is an early pressure injury. Keep all pressure off that area and check whether it improves; if it doesn’t settle, or the skin breaks, contact a doctor or nurse.

Should I massage or rub a reddened area to improve circulation?

No. Massaging skin over a bony area can worsen the tissue damage and is not recommended.

Does a special mattress mean I no longer need to turn my relative?

No. Pressure-relieving mattresses and cushions reduce risk but do not remove it – regular repositioning is still essential.

When is a bedsore an emergency?

Get prompt medical help if you see spreading redness, pus, a foul smell, increasing pain, or if the person has a fever or seems unwell – these suggest infection that needs treatment.

Pressure Injuries / Bedsores Singapore

Written & reviewed by the BestDoctors.sg editorial team · Last updated 24 Aug 2026 · General information, not medical advice

Quick answer. A pressure injury (also called a pressure sore, bedsore or pressure ulcer) is damage to the skin and tissue underneath, caused by sustained pressure on one area – usually over a bony part of the body – in someone who can’t move or reposition themselves. For families caring for a bed- or chair-bound relative, they are largely preventable: regular repositioning, pressure-relieving surfaces, daily skin checks and good nutrition are the cornerstones of protection.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

The one early sign to learn: a patch of skin that is red (or, on darker skin, a change in colour, warmth or firmness) that does not turn white (blanch) when gently pressed. Caught at this stage, the skin often recovers simply by keeping pressure off it.

What a pressure injury is – and why it happens

Body weight resting on one spot squeezes the small blood vessels in the skin and tissue; when blood flow is cut off long enough, the tissue is starved of oxygen and begins to die. Two forces make it worse: shear (when someone slides down a bed and the skin is dragged one way while deeper tissue moves the other) and friction (skin rubbing on sheets). Moisture from sweat, urine or faeces softens and weakens skin so it breaks down more easily – which is why pressure, shear, friction and moisture are tackled together.

Who is at risk

Anyone who can’t shift their own weight: people who are immobile, bed- or chair-bound, older or frail, plus those with poor nutrition or dehydration, incontinence or moist skin, reduced sensation (after stroke, or with diabetes/neuropathy), and poor circulation. Someone recovering from surgery or a hip fracture is also more vulnerable.

Common sites and the stages

Pressure injuries form over bony areas: the tailbone (sacrum), buttocks, heels, hips, elbows, back of the head, shoulder blades and ankles. In plain English, the stages run from (1) intact skin with non-blanching redness or colour change; to (2) a blister or shallow open sore; to (3–4) deeper wounds involving fat, muscle or bone. Sometimes the surface looks minor while deeper tissue is already damaged – so early action matters.

Prevention – the most important part for caregivers

Reposition regularly. In bed, aim to change position roughly every 2 hours (international guidance ranges from about 2 to 6 hours depending on risk and support surface); when sitting in a chair, reposition more often. Use a turning schedule;
Use pressure-relieving equipment – special mattresses and cushions (these reduce but do not replace repositioning);
Keep skin clean and dry – manage incontinence promptly, pat dry, consider a barrier cream on at-risk skin;
Protect the heels – a pillow under the calves can “float” them off the bed;
Keep bedding smooth, and avoid dragging the person during transfers (lift or use a slide sheet to reduce friction and shear);
Support good nutrition and hydration;
Do daily skin checks over all bony areas – and never massage reddened areas over a bony point, which can worsen the damage.

Treatment and complications

The first and most important step is to take all pressure off the affected area. Beyond that: appropriate wound dressings, keeping the wound clean, treating any infection, optimising nutrition, and pain relief. Deeper or non-healing wounds need a doctor or wound-care nurse; severe wounds sometimes need specialist or surgical treatment. Pressure injuries can become infected and heal slowly, so early care matters.

A simple daily prevention routine for caregivers

Prevention is easier when it becomes a predictable daily rhythm rather than an afterthought. A workable routine for someone who spends most of the day in bed or a chair includes: a full skin check at least once a day – ideally during washing or changing – looking and gently pressing over every bony area for redness that doesn’t blanch or any change in colour, warmth or firmness; a repositioning schedule written up where everyone can see it, so the person is turned or shifted regularly through the day and night; keeping the skin clean and dry, changing promptly after any incontinence and applying a barrier product to at-risk skin; checking that sheets are smooth and free of crumbs or hard objects; floating the heels off the mattress with a pillow under the calves; and offering drinks and nourishing food at each contact, since hydration and protein support skin health. During transfers, use a slide sheet or proper technique to lift rather than drag, to avoid friction and shear. Keep a simple log of position changes and any skin changes noticed – it helps the care team and flags problems early. If anything looks like it is starting to break down, take the pressure off that area immediately and contact a nurse or doctor rather than waiting to see if it settles.

When to see a doctor or nurse

See a doctor or nurse for any open sore, or any non-blanching redness that doesn’t settle after pressure is relieved. Seek prompt care for signs of infection: spreading redness, warmth, swelling, pus, a foul smell, increasing pain, or fever. A geriatric or wound-care team can advise.

Sources

NHS — Pressure ulcers: definition, sites, non-blanching redness, risk factors, prevention, infection red flags.
HealthHub Singapore — pressure-injury prevention toolkit (repositioning ~every 2 hours, caregiver steps).
Singapore General Hospital — geriatric-medicine resources for pressure injuries; Singapore Medical Journal — care of the bedridden patient.
Mayo Clinic / Cleveland Clinic — stages, shear/friction mechanism and complications.

General information only. This guide is general information about the health of older adults and is not a diagnosis or personalised medical advice. See a doctor — a GP or a geriatrician — for assessment and treatment, and don’t dismiss new problems as “just old age.” Seek prompt medical care for any sudden confusion or change in alertness in an older person, and call 995 or go to A&E for a fall with severe hip or groin pain and inability to stand, or for sudden face drooping, arm weakness or speech difficulty (act F.A.S.T. — possible stroke).

Pressure Injuries (Bedsores) in Singapore: A Caregiver’s Guide