What is a pressure ulcer?

This medical term is derived from the Latin word “decumbere,” which can be translated as “to lie down.” A pressure ulcer describes damage to the skin and underlying structures that can result from compression. In ALS, severe paralysis (and the resulting sitting and lying positions) leads to an increased risk of developing pressure ulcers.

Common sites for pressure ulcers include the skin areas over the sacrum and ischial tuberosities (due to prolonged sitting), as well as the shoulder region and the extensor surfaces of the elbows (due to prolonged lying down). A pressure ulcer can also develop on the nose or face if a breathing mask must be worn for much of the day to provide respiratory support and exerts increased pressure on the underlying skin.

Pressure ulcers are a key focus of prevention in nursing care—the development of pressure lesions should be prevented by optimizing patient positioning and the associated pressure relief. In addition to nursing interventions (skin care, repositioning regimens), various assistive devices are used to prevent pressure ulcers. These include special nursing beds with anti-pressure ulcer mattresses, as well as therapy tables and wheelchairs with a standing function that allow patients to stand despite severe leg paralysis (with corresponding pressure relief for the buttocks and back).