Understanding Pressure Injuries: Identifying Risk Factors and Concerns

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Santa Ana, CA 92701

Pressure injuries, formerly known as pressure ulcers, are skin sores that typically develop in areas where bones are prominent, such as the elbows, lower spine, and hips. These injuries primarily affect individuals with limited mobility, including older adults and those with chronic health conditions that restrict movement. Recognizing the risk factors associated with pressure injuries is vital for prevention, as these wounds can be both painful and difficult to manage. This article will explain the risk factors and help you to determine if your loved one is at risk of developing a pressure injury.

Understanding the Risk Factors for Pressure Injuries

Pressure injuries can develop due to various factors, including immobility, age, moisture, and more. Let’s explore each of those factors now, in depth. 


One of the primary risk factors for developing pressure injuries is immobility. When individuals lose the ability to move and become inactive, their vulnerability to bedsores significantly increases. Why? Because immobility creates prolonged and continuous pressure on specific areas of the body, making the skin in those areas susceptible to damage. For this reason, individuals who are confined to a bed or have limited mobility are at the greatest risk of developing pressure injuries. 

Sensory Loss

Sensory loss, reduced sensation and nerve damage are significant risk factors for pressure injuries. Without the ability to feel discomfort or pain caused by prolonged pressure, individuals are more susceptible to developing skin-related injuries unknowingly. Nerve damage can stem from conditions like spinal cord injury, diabetes-related neuropathy, and neurological disorders. When pressure sensation is compromised, individuals can’t detect normal warning signs to change positions, lift limbs, and relieve pressure. As a result, pressure injuries can silently get worse and worse. 


Shear and friction are the result of skin and fatty tissues rubbing against the bones. This often happens when the head of the bed is elevated, causing the spine to move downward while the skin and fatty tissues remain stationary. The force generated can harm blood vessels, leading to internal tissue damage, while surface damage may be less apparent. That’s why shear is so dangerous and understanding its impact is vital to prevent severe tissue damage and related complications. 


Moisture poses a significant challenge for individuals who experience incontinence and rely on diapers. Additionally, sweat-induced moisture is a problem too because too much wetness has adverse effects on the skin in general. Why? Firstly, it depletes the skin’s natural oils, which help protect the skin. Plus, moisture softens the skin’s connective tissues, diminishing the skin’s natural strength and resilience. With the loss of essential oils and compromised connective tissues, the skin becomes more vulnerable to the damaging effects of shear and friction thus causing skin damage. 


Bowel movement and urine incontinence are a problem because they make the skin wet, increasing the risk of skin breakdown. Bowel movement incontinence is particularly risky because it contains harmful bacteria and enzymes that can lead to skin damage and ulcers. Plus, weakened skin from bowel movement incontinence is more susceptible to infection. The combination of wetness, exposure to bacteria and enzymes, and a weakened skin barrier heightens the risk of infection and worsens pressure wound issues. 

Poor Nutrition

Poor nutrition leads to weight loss, which increases pressure on bony areas and contributes to pressure ulcer development. On the other hand, proper nutrition is crucial for healing pressure ulcers because essential nutrients support tissue repair, skin cell regeneration, and infection prevention. That’s why maintaining a balanced diet is vital to prevent weight loss, reduce pressure on bony areas, and promote pressure ulcer healing. Providing the body with necessary nutrients supports natural healing and improves overall wound healing outcomes.


As individuals age, their skin naturally undergoes changes, becoming thinner and more delicate. This thinning of the skin makes it more susceptible to damage and increases the risk of skin breakdown. The reduced thickness of the skin compromises its protective barrier and diminishes its ability to withstand external pressures, friction, and shear forces. Consequently, older adults are more prone to developing pressure ulcers, as their fragile skin is less resilient and more susceptible to injury. 


In conclusion, having a comprehensive understanding of the risk factors associated with pressure injuries is essential for effective prevention and management. Various factors, including immobility, sensory loss, shear, moisture, incontinence, poor nutrition, and age, contribute to the heightened vulnerability of pressure ulcers in certain populations. Recognizing these risk factors enables us to take proactive measures to safeguard the skin and enhance the overall well-being of individuals at risk. 

Strategies for Preventing Pressure Wounds

  • Identify the early signs of damage
  • Promote mobility 
  • Alleviate prolonged pressure on specific areas
  • Ensure adequate relief of pressure through repositioning
  • Maintain proper skin hygiene to minimize the risk of infection
  • Identify signs of infection as soon as they start
  • Manage moisture effectively to prevent skin breakdown
  • Provide a well-balanced and nutrient-rich diet to support tissue repair and regeneration
  • Encourage the consumption of vitamins and minerals
  • Utilize appropriate support surfaces to distribute pressure evenly

By addressing these concerns and implementing the preventive measures above, we can significantly reduce the likelihood of pressure ulcers. If your loved one has any of the risk factors mentioned above, it’s important that you take steps to prevent a pressure ulcer from developing. Talk to your doctor or wound care specialist about your concerns. 

Contact Wound Care OC for wound treatment in Orange County, CA

Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.

To make an appointment

1533 E 4th St,

Santa Ana, CA 92701

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