Most common pressure sore site ischium or sacrum
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most common pressure sore site sacrum vs ischium prevalence
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The textbooks confirm the answer clearly. Here is a summary:
Most Common Pressure Sore Site: Sacrum
The sacrum is the most common overall site for pressure ulcer development. The ischium (ischial tuberosity) is second or third, depending on the patient population.
Common sites in order (general population):
- Sacrum/coccyx - most common overall
- Heels - second most common overall
- Ischial tuberosities
- Greater trochanters
- Lateral malleoli/fibular head
"Pressure sores most frequently occur over bony prominences below the waist, including the sacrum, greater trochanter, malleolus, heel, ischial tuberosity, and fibular head."
- Textbook of Family Medicine, 9e
"The most common bony prominences involved are the sacrum, ischial tuberosities, greater trochanters, heels, and lateral malleoli."
- Dermatology 2-Volume Set, 5e
Important Context - Population Matters
| Patient Group | Most Common Site |
|---|---|
| Bedridden / hospital / nursing home patients | Sacrum |
| Wheelchair users / paraplegics (sitting all day) | Ischial tuberosity |
| ICU / supine patients | Sacrum/coccyx and heels |
The International Pressure Ulcer Prevalence (IPUP) Survey confirmed that the sacrum/coccyx had the highest overall prevalence across acute care settings.
Bottom line for exams: Sacrum = most common site overall. Ischium = most common in wheelchair-bound/paraplegic patients.
According to bailey and love
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According to Bailey and Love's Short Practice of Surgery (28th Edition), the answer is clear:
Common Sites for Pressure Injuries - Bailey & Love (Summary Box 3.8)
The sites are listed in this order:
- Ischium ← listed FIRST
- Greater trochanter
- Sacrum
- Heel
- Malleolus
- Occiput
So according to Bailey & Love specifically, ischium is the most common site - it is listed first in their summary box on common sites for pressure injuries and ulcers.
This is a classic exam distinction:
- Bailey & Love → Ischium first
- General/epidemiological data → Sacrum most common overall
Bailey & Love also notes that 80% of paraplegics will develop a pressure sore - and since paraplegics spend prolonged time sitting, the ischial tuberosity bears the greatest sustained pressure, explaining why ischium is listed first in a surgical textbook.
Bailey and Love's Short Practice of Surgery, 28th Ed., Summary Box 3.8
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