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What is a Pressure Injury?

A pressure injury is localized damage to the skin and underlying soft tissue usually over a bony prominence like the spine, tailbone, shoulder blades and heels.  The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. Other factors that contribute to these injuries include microclimate (heat and humidity), nutrition and comorbidities (multiple chronic illnesses present).

Pressure Injury Stages

  • Stage 1: Intact skin with a localized area of non-blanchable erythema (does not turn white when pressed).  The area may be painful, firm/soft or warmer/cooler than the adjacent skin.
  • Stage 2: Includes partial thickness loss of skin with exposed dermis (top layer of skin). Usually involves a red or pink wound bed and a blister (intact or ruptured).
  • Stage 3: Includes total thickness tissue loss, possible exposure of skin fat layer and a sunken hole called a crater.
  • Stage 4 Includes total thickness tissue loss with exposure to bone, tendon or muscle.
  • Unstageable: Includes total thickness tissue loss that may be covered by a scab or dead tissue that makes the wound unmeasurable.
  • Deep Tissue Injury: Includes an intact, discolored, localized or blood-filled blister that indicates damage to underlying deep tissue.

Why do Pressure Injuries Form?

Pressure injuries form due to prolonged and/or intense pressure on the skin. These injuries most often develop on patients with limited mobility and one or more contributing factors such as poor nutrition, incontinence, or compromised circulatory status.

Other extrinsic contributing factors include:

  • Friction:When the fragile skin rubs against clothing or bedding, it becomes more vulnerable to injury, especially when moist.
  • Shear:When the skin is pulled in the opposite direction of the mattress or wheelchair, pressure is placed on the body and pressure injuries can ensue.
  • Moisture: When the skin is wet or moist due to sweating or incontinence.

Understanding and managing the risk factors for pressure injuries is key in determining the most effective ways for preventing and treating pressure injuries.

Additional Information for Preventing and Managing Pressure Injuries:

  • How Pressure Mapping can be used as a tool
  • Tips to Prevent Pressure Injuries 

Learn more about Drive DeVilbiss Pressure Prevention products