Checking the Skin for Risk Factors

Skin that remains under pressure may develop pressure ulcers in as little as 2 hours. In particular, a bone that pushes against the skin (bony prominence) is more likely to cause injury. Continuous pressure on any soft parts of the body (tissue) may lead to the development of pressure ulcers as well.¹

Shear and friction contribute to the formation of pressure ulcers.^{2, 3}

Shear is the result of gravity pulling tissue in one direction while friction keeps the skin still or causes it to go in the opposite direction. ³

Shear often occurs when the head of the bed is in an upright position. Friction may be caused when the skin is dragged across a rough surface such as bed linens.²

Extra moisture on the skin may be the result of incontinence (from urine or feces). It can also come from fluid that comes out of a wound, as well as sweat.^{2, 4} Although this moisture on the skin does not directly cause pressure ulcers, it softens (macerates) the skin, making it much easier for damage to occur from friction or shear.²

When skin loses its moisture, it becomes dry, flaky, and less flexible. Ulcers are more likely to develop in dry skin. ²

Poor nutrition may contribute to the development of pressure ulcers. ² Making sure patients maintain a proper diet may help prevent them.