Pressure Injuries


Pressure injuries occur when the skin and soft tissues are compressed between a bony prominence and a firm structure such as a chair, bed or medical device. The severity of pressure injury is indicated by staging. There are 6 stages of pressure injury: stages I-IV, deep tissue injury and unstageable injuries. Pressure injuries cannot be staged if the depth of the pressure injury cannot be seen. Deep tissue injury is the early stage of an evolving pressure injury and indicates an immediate need to initiate pressure reducing strategies to prevent further injury. Risk factors for pressure injury includes immobility, flexion contractures, malnutrition, and incontinence of urine or feces. Identified risk factors must be addressed to achieve wound healing. Management of pressure injuries includes steps to reduce pressure from contact with critical surfaces such as beds or wheelchairs, eradication of wound infection and surgical closure for patients with stage III or stage IV pressure injury. Patients with poor insight into their condition and poor social support systems are at high risk for ulcer recurrence. The complexity of pressure ulcer management requires a multidisciplinary approach to successfully achieve a healed wound. 

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