Decubitus ulcers (also known as pressure ulcers, pressure ulcers) are caused by prolonged pressure on local tissues, which results in tissue ulceration and necrosis due to persistent ischemia, hypoxia, and malnutrition. Skin bedsores are a common problem in rehabilitation and nursing care. According to the literature, about 60,000 people die of bedsore complications every year. Zhangqiu City People’s Hospital burns Ge Peng common causes 1, pressure factors (1) vertical pressure: the most important cause of bedsores is the local tissues suffered persistent vertical pressure, especially in the body bone thick rumble protruding place. Such as long-term bedridden or wheelchair, improper placement of liner in the splint, uneven or crumbs in the plaster, etc., the local long time to withstand more than the normal capillary compression, can cause bedsores. (Generally speaking, the pressure that the blood vessels under the skin layer can withstand is about 32mmHg, and if the pressure exceeds the above, the local blood vessels may be twisted and deformed, which affects the passage of blood flow and ischemic phenomenon.) (2) Friction: Friction acts on the skin and easily damages the cuticle of the skin. When the patient moves in bed or sits in a wheelchair, the skin can be rubbed by the retrograde resistance of the bed sheet and the surface of the wheelchair cushion. If the skin is rubbed and then impregnated by sweat, urine, stool, etc., bedsores are prone to occur. (3) shear force: the so-called shear force is a force applied to the object leads to produce a parallel anti-directional plane sliding, is made of friction and vertical pressure added. It has a close relationship with the position, for example: when the body slides down when the head of the bed is raised in a horizontal position, the skin and the bed appear to have parallel friction, plus the gravity of the skin in the vertical direction, which leads to the generation of shear force, causing local skin blood circulation disorders and the occurrence of decubitus ulcers. 2.Nutritional status:The whole body lacks nutrition, muscle atrophy, and the pressure place lacks protection. Such as long-term fever and malignant disease. Systemic nutritional disorders, nutritional intake is insufficient, there is a reduction in protein synthesis, negative nitrogen balance, subcutaneous fat reduction, muscle atrophy, once the pressure, the skin at the bony prominence to withstand the external pressure and bony prominence on the skin of the extrusion pressure, the lack of muscle and adipose tissue protection at the pressure, causing blood circulation disorders and the emergence of pressure ulcers. 3.Decreased skin resistance:The skin is often subjected to physical stimuli such as moisture and friction (e.g. improper use of plaster bandages and splints, incontinence, uneven folds of bed sheets, and debris on the bed), which reduces the skin’s resistance. 4.Prone people:Older people have loose and dry skin, lack of elasticity, subcutaneous fat atrophy, thinning, skin vulnerability increases. The most vulnerable parts of the body are those without muscle wrapping or with thin muscle layer, lacking fat tissue protection and often pressurized by the bone protrusion. Decubitus ulcer symptoms and its care, supine position occurs in: occipital bone, scapula, elbow, vertebral body protrusion, sacrococcygeal, heel. Side-lying position is good for: ear, shoulder peak, elbow, ribs, hip, knee joints, inner and outer and inner and outer ankles. Prone position is preferred in: ears, cheeks, shoulders, female breasts, male genitals, iliac crest, knees, toes. Clinical staging is divided into three phases according to the formation process, which is divided into erythema, blisters and ulcers. The prevention of decubitus ulcers is extremely important and is mainly based on careful nursing care. Symptoms of different stages: Decubitus ulcer I degree (erythema stage): the pressure area of the whole body shows localized ecchymosis, and the skin shows erythema. If the pressure is removed in this stage, the change disappears within 48 hours. Decubitus ulcer II degree (blister stage): blisters of varying sizes appear on the pressure area, the skin is red and congested, and does not subside when pressed with a finger. Decubitus ulcer III degree (shallow ulcer): the ulcer does not exceed the whole layer of the skin, due to the lack of blood supply at the base of the ulcer, it is pale, granulomatous oedema, and the water is running. Decubitus ulcers of degree IV (deep ulcers): deep fascia and muscles are involved, and the affected tissues are black with necrosis due to ischemia. Due to cellular infection, the lesions often invade the bone, forming osteitis or osteomyelitis. According to its pathological process, it is divided into 4 grades, grade 1 – the skin is intact and there is a red mark that does not turn white when pressed, grade 2 – the epidermis or dermis is damaged, but it has not yet penetrated the dermis; grade 3 – the epidermis or dermis is damaged in its entirety, and penetrates into the subcutaneous tissues, but has not yet penetrated the fascia and the muscular layer; grade 4 – the entire dermis is damaged; it involves the muscle and the bone. According to the color of the wound is divided into: ① red wounds: the base of the wound is healthy red granulation tissue, clean or healing wounds belong to this category ② yellow wounds: the base of the wound for the shedding of cells and dead bacteria, generally yellow wounds also refers to the infected wounds; ③ black wounds: wounds with black necrotic tissues and black scabs, such as dry gangrene of the diabetic foot, the surface of the depth of decubitus ulcers with necrotic scabs ④ pink wounds: there are Pink wounds: covered with newborn epithelial tissue. Clinical manifestations of decubitus ulcers can be seen as a series of activities in the skin, with a range of color depth changes from red to white, no tissue loss, and deep destruction extending to the muscles, joint capsules, and bones. Early changes in the skin, white erythema is characterized by intense erythema changes from pink to bright red. It turns white when pressed with a finger and quickly reproduces the erythema when the finger is released. The reddened areas are often accompanied by slight edema of the skin, which may be painful in patients with normal perception. The skin returns to normal without sequelae within 24 hours after the pressure is released. Pigmentation reflects the severity of the change in vascular status; the more severe the color, the more drastic the change in the skin, which may change from black-red to blue-purple. There is no color change when pressure is applied with a finger, there is a decrease in skin temperature, and the lesion may feel soft or hardened.