What Causes Pressure Injuries?
We just finished discussing backrests over the past several blogs. We will now move onto another support surface: Cushions. But first, I want to take one step back and discuss pressure. Pressure is one of the reasons that we all spend so much time considering the support surfaces for our clients. Today we will have a little review on pressure from Ana Endsjo, US Clinical Education Manager LTC Division.
When we talk about wounds caused by pressure, we often only consider the pressure on our bottom. However, pressure can be created by any support surface that comes in contact with the body such as the: the backrest, cushion, arm rests, and head support.
So, let’s clarify the definition of pressure when considering it from the seated posture.
Pressure is a continuous force applied on or against an object through direct contact. In seating, equipment such as the seat and/or back support surface is in constant contact with the body, creating peak pressures.
Peak pressure is a constant pressure directly under or against the bony prominences that will cause a pressure injury without proper pressure redistribution through appropriate cushion and back support choices. Peak pressures are commonly found at the ITs, sacrum, coccyx, and on the spinous process, injuring the skin and underlying tissue, muscle, and, in extreme cases, bone.
Pressure from a seated posture comes from:
- downward pressure from gravity
- upward pressure from the seat surface
- horizontal pressure along the spine from the back support
When these peak pressures are not addressed through proper pressure redistribution techniques with the appropriate cushion and back support, the skin, tissue, and bone is compromised. Sustained loading against the back support and/or seat surface causes constant compression of that skin and tissue under a bony prominence, leading to a pressure injury. The degree of injury depends on the layers of skin impacted.
It is important that we as therapists begin to understand the critical role that the seated posture plays in the prevention and treatment of pressure injuries.
Thank you Ana.
The next several blogs we will be discussing cushions. From materials of cushions to what type of cushion will be best for your client, cushions can vary greatly, and it can be challenging to look at a room full of cushions and know which ones to pick for your client.