Pressure injury occurs when an external force or pressure is applied to the surface of the skin. Severe pressure injuries can affect the subcutaneous tissues, muscles and bones.

• Pressure: When the capillary blood vessels between the skin and the bones are under external pressure for a prolonged time, this may affect the blood circulation and cause insult to the skin tissue
• Friction and shearing force: When the patient slides down from a propped up bed surface, the skin and deep tissue may be damaged
• Moisture over skin: Moisture over skin (such as from sweating and incontinence, etc) may facilitate the growth of microorganisms and make the skin wet and soften, which will further expose the skin to damage by pressure

• Check the skin regularly to see if there is any redness and damage, which are signs of onset of pressure injury
• Change positions frequently; the ideal frequency is once every two hours
• Keep your skin clean and avoid using hot water and irritating shower gel/soap when bathing; if necessary, apply an appropriate amount of lotion
• When the bedsheets get wet, change them immediately; remove debris from the bedsheets and straighten the sheets to avoid wrinkles
• Improve the nutrition of the patient. Those who are underweight should take foods high in protein, carbohydrate and vitamin content. Overweight patients should lose some weight (Consult a dietitian if necessary)
• Try to increase the amount of activity to promote blood circulation and reduce the chance of vascular blockage (thrombosis)
• Patients with incontinence should change diapers frequently to keep themselves clean and dry; preventive ointments can be used locally to protect the skin
• Use appropriate pressure relief devices, such as:
  • Cut-out pillow: Two hollow positions to reduce pressure over the ears upon lying on the side
    
  • Heel protector: To reduce the pressure over the heel and ankle areas
    
• Pay attention to correct posture when sitting on a chair, changing positions in bed or when lifting and transfer
  • Change position often to avoid putting pressure on the same body part for a long time
  • For transfer method or techniques of manual massage, browse Care Tips > Transfer Methods and Manual Massage

Based on individual needs, occupational therapists can conduct seating assessment to review the posture and recommend suitable cushions and pressure relieving devices to help patients to improve their seating postures and reduce the risk of pressure injury. Consult your occupational therapist for more details.

• Prevention of pressure injury (Chinese version ONLY)
• Home physiotherapy – palliative care (Chinese version ONLY)
• Occupational Therapy - Tips for daily living (Chinese version ONLY)