By Meghan McGowan
Read time: 3 mins.
Pressure injuries are a persistent concern in healthcare settings where mobility is limited. In nursing homes, intensive care units, and long-term care environments, these wounds can complicate care, affect recovery, and significantly impact patient comfort and outcomes.
Although pressure injuries are treatable, they often progress quietly. Identifying risk early — and responding thoughtfully — is critical to protecting skin integrity and reducing complications over time.
Dynarex offers a full line of mattresses and cushions to support pressure management across care settings.
How Pressure Injuries Develop
A pressure injury is localized damage to the skin and underlying tissue caused by sustained pressure, friction, or shear that restricts blood flow to vulnerable areas of the body. Over time, this reduced circulation can lead to tissue breakdown, even when surface changes appear minimal.
Pressure injuries most often affect patients with reduced mobility, including those who are confined to a bed or wheelchair or living with partial or complete paralysis. Patients who are able to reposition independently face significantly lower risk, as even small changes in movement help relieve pressure.
Risk Factors
Pressure injuries tend to develop in areas of the body that bear sustained pressure in seated or lying positions, particularly where there is minimal tissue between the skin and a bony surface. Common sites include the heels, sacrum, hips, and the back of the head.
Certain conditions can further increase a patient’s vulnerability, including:
- Incontinence
- Poor nutrition
- Impaired sensory perception
- Compromised circulation
When these factors overlap with limited mobility, the likelihood of skin breakdown rises substantially.
Assessing Risk: The Braden Scale
The Braden Scale is widely used to help care teams assess pressure injury risk. Patients are rated across six categories, each scored numerically to reflect level of risk. Lower numbers indicate greater vulnerability:
- Sensory perception: Ability to feel and respond to pressure-related discomfort
- Moisture: Degree of skin exposure to moisture or incontinence
- Activity: Level of physical activity or time spent immobile
- Mobility: Ability to change or control body position
- Nutrition: Adequacy of usual food and fluid intake
- Friction and shear: Exposure to sliding forces during movement or repositioning
Why Pressure Injuries Often Go Undetected
Early pressure injuries can be difficult to identify. Initial signs may appear as subtle skin changes, such as redness that does not blanch when pressed — details that are easy to miss during routine care.
In patients with darker skin tones, early-stage injuries may present with blue or purple discoloration rather than redness. In addition, pressure injuries can mask their true severity, with tissue damage developing beneath the skin’s surface before it becomes visible.
When pressure injuries do occur, they are clinically classified into four stages. Stage 1 involves non-blanchable (does not fade when pressed) skin changes; Stage 2 includes partial-thickness skin loss; Stage 3 reflects full-thickness tissue loss; and Stage 4 represents the most extensive tissue damage.
Reducing risk early remains essential for maintaining patient comfort and minimizing complications.
Reducing Pressure Injury Risk
Pressure injuries are not always entirely avoidable, but proactive care can significantly reduce both their likelihood and severity.
Supporting mobility is a key part of risk reduction. Even modest position changes — such as transferring between bed and wheelchair — help redistribute pressure and limit prolonged stress on the same areas of the body. Skin care also plays an important role, particularly for patients with continence concerns.
Pressure-redistributing support surfaces and positioning aids can further support risk-reduction efforts, including multi-zone mattresses, wheelchair cushions designed to promote even weight distribution, and positioning wedges that help relieve sustained pressure.
Taking a Load Off Patient Care
Reducing pressure injury risk requires consistency and coordination across care teams. These efforts support skin integrity, patient comfort, and quality of life over time.
By prioritizing early assessment and thoughtful risk-reduction strategies, healthcare providers can address what lies beneath the surface — before pressure injuries take hold.
Explore Dynarex Mattresses and Cushions today!