Bed Sore over Hip/Side Bone (Trochanter)

About Bed Sore over Hip/Side Bone (Trochanter)

The greater trochanter is a bony prominence on the side of the hip that takes the patient's weight in side-lying postures. Bedsores here are typical in paralysis, prolonged ICU care, fractures, severe debilitation and old age. Hip bedsore treatment at Kayakriti starts with detailed inspection of both hips, the sacrum and the heels, since trochanteric ulcers often coexist with sores at other pressure points.

The wound is graded as Category I to IV based on depth. Early redness without skin loss is Category I, while open shallow wounds form Category II. Category III ulcers extend into fat, and Category IV reach muscle, tendon or bone. Trochanter ulcer care depends heavily on this stage, but every grade benefits from early plastic surgery review to slow progression and preserve reconstructive options.

Pressure sore hip treatment for Category I and II wounds usually does not need admission when comorbidities are stable. We provide specialised dressings, oral antibiotics if needed and structured education on positioning. Patients are reviewed weekly at first, then once or twice monthly for three months after healing. Side-lying must be alternated with prone or back positioning to relieve pressure on the hip.

Category III and IV trochanteric ulcers require admission and a multidisciplinary review. We assess nutrition, diabetes, anaemia, cardiac fitness and renal function, and obtain pre-anaesthetic clearance. Imaging may be requested when bone involvement is suspected. Wound management bedsore protocols at this stage focus on aggressive debridement, controlling infection and planning a stable reconstruction.

Reconstructive options include fasciocutaneous flaps, tensor fasciae latae flaps and other rotation or advancement flaps that bring well-vascularised tissue over the trochanter. Surgery is performed under general or regional anaesthesia. A suction drain prevents fluid collection beneath the flap. In selected cases, staged surgery is used so that infection clears fully before definitive cover is performed.

Aftercare is structured: pain control, antibiotics, drain monitoring and strict positioning protect the flap during early healing. Patients and families are taught air mattress use, two-hourly turning, skin care and nutrition strategies. Reviews are scheduled at one week and then once or twice monthly for three months as part of our reconstructive wound surgery follow-up, with photographs supporting clear progress tracking.

What to expect

• Detailed staging of the trochanteric ulcer and review of other pressure points
• Assessment of nutrition, diabetes and anaemia
• Dressing and antibiotic plan for early-stage hip ulcers
• Surgical debridement with flap cover for deep wounds
• Suction drain placement and structured post-operative monitoring
• Family training on positioning, mattress and skin care

Recovery

• Avoid pressure over the operated hip with alternating positions
• Drain care and wound checks during the first one to two weeks
• Suture removal around two weeks and gradual return to mobilisation
• Continued nutrition, hydration and glycaemic optimisation
• Scheduled reviews to detect early recurrence and adjust care