Pressure Ulcers

What is a pressure ulcer?

A pressure ulcer is when the skin and tissue under the skin is injured. Pressure ulcers can happen anywhere. They are most common on the heels, elbows, and hips.

Stages of pressure ulcers

Apples are used to represent pressure ulcers.
Stage 1

When the skin is pressed, the red color of the apple will not go away and the color won't change.

Stage 2

The outer skin of the apple is partly removed.

Stage 3

There is a bite in the apple.

Stage 4

The bite is far into the core.

Suspected deep tissue injury

A bruised apple has a dark spot. It is unknown how "bad the apple is under the spot.


A caramel covered apple has a thick caramel completely covering the apple. No one can see and know what is happening under it.

What are possible causes?
  • Constant pressure on the skin for a long time
What are some symptoms?
  • Redness and warmth
  • Strange smell
  • Pain
What to do?
  • Stay hydrated
  • Eat more protein to help with healing
  • Eat more calories to help with healing
  • May need a multivitamin supplement
  • Consult a doctor or dietitian before making big changes
  1. DeMarco S. Wound and Pressure Ulcer Management. Johns Hopkins Medicine, based in Baltimore, Maryland. Published June 14, 2017. Accessed January 19, 2021.
  2. Wake WT. Pressure ulcers: what clinicians need to know. The Permanente journal. Published 2010. Accessed January 19, 2021.
  3. Overview pressure ulcer (pressure sores) . NHS Choices. Updated April 15, 2020. Accessed January 24, 2021.
  4. Academy of Nutrition and Dietetics. Nutrition Care Manual. Accessed December 12, 2020.