Understanding Pressure Injuries: What You Need to Know

What is a Pressure Injury?

A pressure injury is localized damage to the skin and underlying tissue, typically resulting from prolonged pressure, shear, or friction. These injuries commonly develop over bony areas of the body—such as the heels, hips, tailbone, elbows, and shoulder blades—where the cushioning between skin and bone is minimal.

While often associated with individuals who are bedridden or use wheelchairs, pressure injuries can occur in anyone who remains in one position for an extended period. Consider how uncomfortable you might feel after sitting too long at a desk—now imagine being unable to shift your weight at all.

Why Do Pressure Injuries Happen?

Our bodies are designed to move. When a specific area is subjected to continuous pressure, blood flow is restricted, depriving tissues of oxygen and nutrients. Over time, this can lead to skin and tissue breakdown.

Other risk factors that increase the likelihood of developing pressure injuries include:

• Moisture (from sweat or incontinence)
• Poor nutrition or hydration
• Medical conditions such as diabetes or vascular disease
• Immobility due to injury, illness, or surgery

When these factors combine, the risk of tissue damage increases significantly.

The 4 Stages of Pressure Injuries

Pressure injuries are classified into four stages, depending on their severity:

• Stage 1: Red, intact skin that may feel warm or firm. It’s an early warning sign—intervention at this point can prevent further damage.
• Stage 2: The skin breaks open, forming a shallow ulcer or blister. Pain and inflammation are common.
• Stage 3: The ulcer deepens, exposing fat tissue and appearing crater-like. There is significant damage to underlying structures.
• Stage 4: The most severe stage, where muscle, tendons, and even bone may be exposed. Infection and long-term complications are serious risks.

Early detection and treatment are key to preventing progression from one stage to the next.

Preventing Pressure Injuries: The Best Strategy

When it comes to pressure injuries, prevention is far more effective—and less costly—than treatment. Whether in a hospital, nursing home, or home care setting, the following strategies are essential:

• Reposition frequently (at least every two hours for bedbound patients)
• Use pressure-relieving devices, such as alternating pressure mattresses, foam cushions, or heel protectors
• Keep skin clean and dry
• Ensure adequate nutrition and hydration
• Conduct regular skin inspections, especially on high-risk areas

For caregivers, understanding and implementing these steps can make a life-changing difference in patient comfort and health outcomes. Pressure injuries are not just a medical concern—they’re a quality-of-life issue. By raising awareness and promoting preventive care, we can reduce the incidence of pressure injuries across healthcare and home settings alike. If you're caring for someone at risk, speak to a healthcare provider about the best pressure prevention equipment and care practices to help protect their skin and overall well-being.