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Pressure Injuries: The Complete Guide to Causes Symptoms Treatment and Prevention

Pressure Injuries: Important Information on Causes,



Treatment, and

PreventionImagine being confined to a bed or wheelchair for an extended period of time. Now, picture the discomfort and pain that can arise from the constant pressure on your skin.

Unfortunately, this can lead to pressure injuries, commonly known as bedsores or pressure sores. In this article, we will explore the causes, risk factors, symptoms, stages, diagnosis, treatment, and prevention of pressure injuries.

Our aim is to provide valuable knowledge that will help you understand this condition and take the necessary steps to prevent and manage it effectively.

Definition and Causes

Pressure injuries, also called bedsores or pressure sores, are injuries to the skin and underlying tissues caused by prolonged pressure and lack of blood flow to specific areas of the body. They most commonly occur on bony prominences such as the heels, hips, tailbone, and elbows.

The constant pressure on these areas leads to the breakdown of skin and the underlying tissues, resulting in painful and often hard-to-heal wounds.

Risk Factors

Certain individuals are more susceptible to developing pressure injuries. Wheelchair users and bedridden individuals are at high risk, as they often experience prolonged pressure on specific areas.

Older adults, especially those in nursing homes, are also more prone to these injuries due to their fragile skin and decreased mobility. Chronic illnesses such as diabetes can further increase the risk, as the body’s ability to heal is compromised.

Undernourishment, smoking, and fragile skin are other risk factors that can contribute to the development of pressure injuries.


Early identification of pressure injuries is crucial for prompt treatment. Some common symptoms include red patches on the skin that do not go away, blisters, open sores, and signs of infection such as fever, chills, and increased confusion.

These symptoms should not be ignored, as they may indicate the presence of a pressure injury and the need for medical attention.


Pressure injuries can be classified into four stages, depending on their severity. Stage 1 is characterized by persistent redness of the skin, while stage 2 involves the formation of blisters or shallow open sores.

In stage 3, the wound deepens and extends into the underlying tissues, and in stage 4, the wound becomes even deeper and exposes muscle, tendons, or bone. Understanding the stages of pressure injuries is essential for determining the appropriate treatment and prevention methods.


Early detection and diagnosis of pressure injuries are vital for effective management. Healthcare professionals, including doctors, nurses, and health aides, play a crucial role in identifying and diagnosing these wounds.

However, individuals can also perform self-examinations to spot any signs of pressure injuries. Regular inspections by family and friends are also beneficial, as they can provide an additional set of eyes.


Early treatment of pressure injuries significantly improves healing outcomes.

Prevention and relief of pressure on affected areas are essential.

This can be achieved through body position changes, the use of smooth bedding, heel elevation, proper wheelchair positioning, and the utilization of alternating air mattresses. Cleaning the wounds with sterile solutions and applying special bandages can help promote healing and prevent infection.

Additionally, adequate nutrition is crucial for wound healing. In severe cases, hospitalization and surgery may be necessary to treat and manage pressure injuries effectively.


Prevention is key when it comes to pressure injuries. Regular position changes are crucial, as they redistribute pressure and promote blood flow.

Using smooth bedding and elevating the heels are effective measures to reduce pressure on sensitive areas. Proper positioning in wheelchairs and the use of alternating air mattresses can also help prevent the development of pressure injuries.

Lastly, caregivers and healthcare professionals should be trained in proper lifting techniques to minimize the risk of injury to patients.

Rapid Worsening of Bedsores

Bedsores can worsen rapidly if not treated promptly. Infection is a common complication, as bacteria can easily enter through open wounds.

Deepening sores can lead to more severe complications such as osteomyelitis (bone infection) and sepsis. Therefore, early intervention and treatment are crucial to prevent the rapid progression of pressure injuries.

Healthcare Professional Intervention

Recognizing the first sign of a pressure injury, such as a soft, red patch, is essential. Healthcare professionals should be contacted as soon as possible for proper assessment and treatment.

It is particularly important to be aware that pressure injuries can be difficult to identify in individuals with darker skin tones, as the redness may not be as apparent. Regular skin inspections by healthcare professionals can help ensure early detection and intervention, ensuring the best possible outcomes for patients.


In conclusion, pressure injuries are a serious concern for individuals who are bedridden or wheelchair-bound. Understanding the causes, risk factors, symptoms, stages, diagnosis, treatment, and prevention of pressure injuries is crucial for effective management.

Early detection and intervention can prevent the rapid worsening of these wounds and improve healing outcomes. By implementing preventive measures and seeking timely medical attention, individuals can significantly reduce the risk of developing and experiencing the detrimental effects of pressure injuries.

3) Initial


When it comes to treating pressure injuries, early intervention is crucial. The first step is to relieve pressure on the affected area.

This can be done by changing body positions frequently or using specialized cushions or mattresses that help distribute pressure evenly. In bedridden individuals, it is important to keep the sheets dry and smooth to reduce friction and moisture buildup.

Powdering sheets with cornstarch or using moisture-wicking fabrics can help achieve this. Cleaning the pressure injury is an essential part of its initial treatment.

First, the wound should be gently cleaned with a saline solution or saltwater to remove any debris or bacteria. Saline rinses can be easily made by dissolving half a teaspoon of salt in 8 ounces of warm water.

It is important to avoid using harsh soaps or antiseptics, as they can irritate the wound and delay healing. After cleaning, a special bandage should be applied to protect the wound and promote healing.

These bandages can provide a moist environment that promotes cell growth and reduces the risk of infection. Some bandages may contain substances like collagen or antimicrobial agents to further aid in wound healing.

It is important to follow the instructions provided by healthcare professionals when applying these bandages and to change them regularly to prevent infection. Advanced


In some cases, pressure injuries may require more advanced treatment methods.

Prescription dressings may be recommended by healthcare professionals to ensure proper wound healing. These dressings are specifically designed to create an optimal environment for healing and prevent infection.

Additionally, various therapies can aid in the healing process of pressure injuries. Therapeutic techniques, such as ultrasound therapy, electrical stimulation, and negative pressure wound therapy, may be utilized to improve blood flow, stimulate cell growth, and remove excess fluid from the wound.

Nutrition plays a significant role in the healing of pressure injuries. Consuming adequate calories and protein is essential, as they provide the necessary building blocks for tissue repair.

Vitamin C and zinc are also important for wound healing, as they assist in collagen synthesis and promote a healthy immune system. In some cases, nutritional supplements may be recommended to ensure individuals receive the necessary nutrients for optimal healing.

In more severe cases, hospitalization may be required to properly treat and manage pressure injuries. During a hospital stay, healthcare professionals can closely monitor the wound, provide specialized treatments, administer medications, and assess the overall progress of healing.

In rare instances where the pressure injury is extremely severe or does not respond to other treatments, surgery may be necessary. Surgical intervention often involves removing damaged tissue, closing the wound, and optimizing blood flow to promote healing.

Role of Nutrition

Proper nutrition plays a crucial role in the treatment and healing of pressure injuries. Consuming an adequate amount of calories is essential to provide the body with the energy it needs to repair damaged tissues.

Protein is particularly important, as it is vital for the synthesis of new cells and collagen, which is necessary for wound healing. Including lean meats, dairy products, legumes, and nuts in the diet can help meet protein requirements.

In addition to calories and protein, specific nutrients are important for wound healing. Vitamin C is essential for the production of collagen, which is a key component in tissue repair.

Citrus fruits, strawberries, broccoli, and peppers are excellent sources of vitamin C. Zinc is another important nutrient that aids in wound healing.

Foods rich in zinc include oysters, beef, pumpkin seeds, and spinach. It is important to consult with a healthcare professional or registered dietitian to develop a personalized nutrition plan for individuals with pressure injuries.

They can assess individual needs and recommend appropriate dietary modifications or supplements to support the healing process.

4) Techniques for Bed Rest

For individuals on bed rest, proper techniques can help prevent the development of pressure injuries. Regular posture changes are vital to relieve pressure on specific areas.

Shifting positions every one to two hours redistributes pressure, allowing blood flow to the affected areas. Additionally, using smooth bedding and avoiding wrinkled sheets can reduce friction and shear forces that contribute to pressure injuries.

Proper leg positioning is crucial to prevent pressure injuries on the heels and ankles. Placing pillows or foam wedges under the lower legs can elevate the heels, reducing pressure on these vulnerable areas.

The use of heel protectors or specialized cushions can also provide added support and alleviate pressure.

Techniques for Wheelchair Users

Wheelchair users are particularly susceptible to pressure injuries due to the constant pressure on certain areas of the body. Frequent changes in position are essential to relieve pressure and promote blood circulation.

It is recommended to shift positions every 15 to 30 minutes. For individuals who are unable to perform position changes independently, assistance from caregivers or healthcare professionals is necessary.

Using a standing wheelchair can be beneficial for wheelchair users, as it allows them to periodically bear weight on their legs. This helps to relieve pressure on the buttocks and other susceptible areas.

Another useful technique is the wheelchair pushup. Individuals with upper body strength can lift themselves up using their arms, taking the pressure off their buttocks momentarily.

Techniques for Immobility

Individuals with limited mobility or immobility, such as those in comatose states or with paralysis, require special attention and techniques to prevent pressure injuries. Alternating air mattresses can be used to distribute pressure evenly and reduce the risk of developing pressure injuries.

These mattresses contain air-filled cells that inflate and deflate, constantly adjusting the pressure exerted on the body. The use of pressure detection technologies is also beneficial for individuals with limited mobility.

These devices can alert caregivers or healthcare professionals when pressure has been exerted on a specific area for too long, prompting a position change to alleviate pressure. Proper lifting techniques are essential when transferring individuals with limited mobility.

Caregivers should be trained on how to safely lift and move patients to prevent excessive pressure on vulnerable areas. Additionally, individuals with fragile skin require gentle handling and protection from friction or shear forces that can lead to pressure injuries.

By implementing these prevention techniques, individuals can significantly reduce the risk of developing pressure injuries and promote overall well-being. Regular monitoring by healthcare professionals and adherence to proper care protocols are crucial for long-term prevention and successful management.

In conclusion, the treatment and prevention of pressure injuries are of paramount importance in maintaining the health and well-being of individuals who are bedridden, wheelchair-bound, or have limited mobility. Early treatment, which includes pressure relief, proper cleaning, and specialized bandages, can prevent the rapid worsening of these injuries.

Advanced treatment options such as prescription dressings, therapies, and nutritional support aid in the healing process.

Prevention techniques, such as posture changes, smooth bedding, regular position changes, and the use of pressure detection technologies, are essential in reducing the risk of pressure injuries.

By understanding these strategies and implementing them effectively, individuals can proactively manage and prevent the development of pressure injuries, ensuring their overall health and quality of life. Remember, early identification and intervention are key to successful management.

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