Pressure Injury Prevention
You are at risk if
- Old age: Skin gets thinner and less elastic with age, increasing the risk of breakdown.
- Malnutrition or Obesity: Being underweight reduces muscle and fat protecting the skin. Being overweight puts excess pressure on the skin.
- Reduced Mobility: Difficulty in movement can increase risk of continuous stress at the pressure-prone areas of the body. Avoid positioning.
- Incontinence: Constantly wet skin (from urine or feces) is more prone to skin breakdown.
- Disease: Conditions that cause poor blood circulation (e.g. heart disease/ Diabetes Mellitus), sensation problems (e.g. nerve/ blood vessel disease), or difficulties moving (e.g. stroke), can increase the risk of skin breakdown.
What are the pressure injuries?
- Also known as pressure ulcer, pressure sore, or bedsore.
- It happens when you lie or sit down in the same position for a period of time.
- When your skin is pressed against bone the blood supply is cut off and damage to the skin and tissue occurs.
Pressure injury prevention
- Surface: Seek and ask for suitable pressure relieving products, such as an air mattress, pillow, and foam dressing for an existing pressure injury.
- Skin Inspection: Inspect skin once a day and more frequently for bed and chair-bound patients, especially for the presence of redness.
- Just Move: Keep moving, promote gentle exercise, reposition every 2 hours for bed-bound patients. When elevating head of bed, it must not be more than 30° unless contraindicated. Avoid repositioning directly on the ulcer/injury. A physiotherapist is recommended.
- Personal Care: Good personal hygiene, keep skin clean and dry. If with diarrhea, change diaper immediately and use a barrier cream/spray.
- Eat Healthy: Eat protein-rich food every meal and drink 6–8 glasses of fluid a day, unless instructed otherwise. For nasogastric tube feeding, monitor weight weekly.
- Seek Help: If you suspect a pressure injury, inform a healthcare professional immediately.
What am I looking for? What are the signs of a pressure injury?
- Often, it first shows up as a red, warm, or tender spot that does not go away.
- The skin may look like a blister filled with blood or clear fluid, or an open wound which may reach the fat, muscle, or even bone.
- Look for signs of rubbing, skin changes, or unusual pain.
- Check areas where pressure injuries can form or where you’ve had an ulcer before.
What are the stages of pressure injuries?
- Stage 1: Skin is unbroken but red and inflamed.
- Stage 2: Skin is broken on the top layer only.
- Stage 3: The injury extends down to the tissue under the skin.
- Stage 4: The injury extends further, forming a large crater. The deeper tissues, tendons, and bone may be visible.
- Unstageable Pressure Injury: Skin is covered with yellow, grey, green, brown, or black dead tissue or pus. Depth of injury cannot be determined.
- Deep Tissue Pressure Injury: Skin is unbroken but the tissue under the skin is damaged. It may look purple or dark red.
Where do pressure injuries occur?
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