Pressure Injuries: The Hidden “Gentle Trap” You Must Know

Pressure Injury Education – Episode 1

Pressure injuries, often called bedsores, might not seem scary at first glance, but they can be a silent threat to health if not understood and treated properly. In this episode, we dive deep into pressure injuries and how to effectively prevent them with scientific care.

What Are Pressure Injuries?

Pressure injuries involve the breakdown and necrosis of the skin and underlying tissue, commonly caused by prolonged pressure on specific areas of the body. This pressure impairs blood circulation, leading to ischemia, hypoxia, and malnutrition in the affected tissues. Over time, this leads to tissue damage and even necrosis.

Prevalence of Pressure Injuries Worldwide

According to research published in Chinese Nursing Management (July 2018), the prevalence of pressure ulcers (PUs) among hospitalized patients in China was reported as:

· 1.67% for general patients

· 0.68% for hospital-acquired pressure ulcers (HAPUs)

In contrast, Germany (2001-2007) reported an overall pressure ulcer prevalence of 10.2%, while in the United States, the prevalence of PUs across all care settings ranged from 9.3% to 13.5%, and HAPU prevalence ranged from 3.1% to 6.2%.

Globally, pressure injuries contributed to 24,400 deaths in 2019 alone, according to The Merck Manual. Despite the alarming figures, many cases are preventable with the right education and care.

What Causes Pressure Injuries?

Pressure injuries are most common among individuals who are bedridden or confined to a wheelchair, especially the elderly. They typically occur in areas such as:

· Sacrum (tailbone)

· Back

· Heels

· Ischial tuberosities (sitting bones)

The main cause is prolonged pressure on these areas, which cuts off blood flow and causes ischemia and tissue breakdown. In fact, about 80% of pressure injuries occur in the sacral and heel areas.

Pressure Injuries Are Closer Than You Think

Though more common among long-term bedridden patients, younger individuals are not immune. Pressure injuries can also develop in patients who experience:

· Short-term bed rest due to conditions like fractures, cerebral infarction, heart failure, or poor peripheral circulation

· Paralysis resulting from trauma or motor vehicle accidents

· Improperly fitting casts, splints, or medical devices (which can cause device-related pressure injuries)

Stages of Pressure Injuries: Early Recognition Saves Lives

Early detection and classification are essential to preventing the progression of pressure injuries. According to the National Pressure Injury Advisory Panel (NPIAP), pressure injuries are classified into six stages:

Stage I: Non-blanchable Erythema

· Intact skin with localized redness that does not turn white when pressed. The area may be painful, firm, soft, warm, or cool compared to adjacent tissue.

Stage II: Partial-Thickness Skin Loss

· Partial loss of skin thickness, presenting as a red or pink wound bed, possibly with intact or ruptured blisters filled with clear fluid.

Stage III: Full-Thickness Skin Loss

· Full-thickness tissue loss, with subcutaneous fat visible, but no bone, tendon, or muscle exposed. Depth may vary depending on the body location.

Stage IV: Full-Thickness Tissue Loss

· Full-thickness tissue loss, with exposed bone, tendon, or muscle. Slough or eschar may cover parts of the wound bed, and undermining or tunneling may occur.

Unstageable Pressure Injury

· Full-thickness tissue loss in which the base of the wound is covered by slough and/or eschar, making it impossible to determine the true depth until enough slough/eschar is removed.

Suspected Deep Tissue Pressure Injury (DTPI)

· The depth is unknown, but the skin may show purple or maroon discoloration. The affected area might feel firm, painful, warm, or cool, and can rapidly progress despite optimal care.

Why Does This Matter?

With the aging global population, the rates of pressure injuries are rising. Many factors increase the risk of pressure injuries, including:

· Inadequate care

· Short-term bed rest

· Improperly fitted medical devices

Pressure injuries drastically reduce the quality of life for affected patients, often leading to increased pain, infection, and even death. Therefore, early detection and effective prevention are essential.

If you notice early signs of pressure injuries, seek medical attention promptly. A personalized prevention and treatment plan should be developed with the guidance of healthcare professionals.

Next Issue Preview

In the next issue, we will explore the major causes of pressure injury formation and provide further insight into how preventative measures can be implemented to minimize risk.