Pressure injuries, also known as decubitus ulcers or bedsores, are localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure in combination with shear, friction, and/or excessive skin moisture and temperature.

Pressure ulcers occur due to pressure applied to soft tissue resulting in completely or partially obstructed blood flow. Shear is also a cause, as it can pull on blood vessels that feed the skin and damage tissue structures.

Pressure ulcers most commonly develop in persons who are not moving about or are confined to wheelchairs. It is widely believed that the following factors also influence tolerance of skin to pressure and shear, thereby increasing the risk of pressure ulcer development: 

  • Malnutrition
  • Microclimate (skin wetness caused by sweating or incontinence and elevated skin temperature)
  • Diseases that reduce skin blood flow, such as arteriosclerosis
  • Diseases that reduce sensation in the skin, such as paralysis or neuropathy.