Pressure injuries (commonly called bedsores) occur when body weight presses the skin over bony prominences for too long. Think of it like a kink in a hose: constant pressure reduces blood flow. Without adequate blood supply, the skin and underlying tissues receive less oxygen and nutrients, leading to tissue damage—and in severe cases, tissue death.

This is especially common when someone stays in the same position for prolonged periods, because pressure concentrates on areas such as the tailbone/sacrum, heels, shoulder blades, elbows, and hips.

The hidden dangers: pressure and shear

·   Pressure: Constant pressure compresses tiny blood vessels, reducing oxygen and nutrient delivery to the tissues.

·   Shear force: When the head of the bed is raised (often above ~30°), the body may slide downward. The skin can remain “fixed” against the bed sheet or clothing, while deeper tissues continue to shift. This creates a tearing force—shear—which can damage blood vessels and accelerate skin breakdown.

Other common risk factors

·   Incontinence / moisture: Skin that stays wet from urine or stool becomes softer and more fragile, making it easier to break down.

·   Poor nutrition: Inadequate protein, vitamins, and calories weaken the skin and reduce the body’s ability to repair tissue.

·   Health conditions: Diabetes, anemia, edema (swelling), and poor circulation can all increase risk by reducing tissue resilience and slowing recovery.

How to prevent pressure injuries: relieve pressure and keep skin clean and dry

1) Reposition regularly and reduce pressure

· Change position routinely: Help the person turn or shift weight at least every 2–4 hours (more often if the skin is fragile or at high risk).

· The “30-degree” approach: When medically appropriate, avoid sitting the person fully upright or lying fully on the side for long periods. Keeping the head of bed and side-lying angle around 30° can reduce shear and friction.

· Use pressure-relief equipment: Consider an air mattress or pressure-relieving mattress/cushions to distribute weight more evenly.

· Pad bony areas: Use pillows/soft pads between the knees, ankles, and behind the back so bones don’t press or rub against each other.

· Protect the heels: Place a pillow under the calves so the heels “float” off the bed (no direct heel contact).

· Move safely: Never drag a patient across the sheets. Use a draw sheet / slide sheet to lift and move, reducing friction and shear.

2) Skin inspection, cleansing, and daily care

·  Check skin every day: Inspect the whole body, especially bony areas. Watch for redness that doesn’t fade, swelling, blisters, or broken skin—these can be early warning signs.

·  Keep skin clean and dry: Change wet clothing and bedding promptly. After incontinence episodes, cleanse gently and pat dry—do not scrub.

·  Moisturise appropriately: Apply a light moisturiser to prevent dryness and cracking. In areas exposed to urine/stool, consider a barrier cream to protect the skin.

When to seek help

If you notice persistent redness, blisters, open skin, increasing pain, warmth, or signs of infection (e.g., foul odour, pus, fever), seek professional advice promptly.

If your loved one is frail or has incontinence, it’s best to start prevention early. If you’re unsure about risk level, repositioning plans, or early skin changes, contact the YDCare Wound Nursing Team for assessment and practical guidance—so you can address problems before they worsen.

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