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The Top Myths about Pressure Injuries


Here are the top three misconceptions about pressure injuries.


Those of us who work in wound care know that pressure injuries (sometimes referred to as “pressure ulcers”) are a core part of what we do. But there are a lot of misunderstandings, misconceptions, and plain out misinformation floating around about pressure inujuries that can make it harder to do our jobs sometimes. How many of these have you heard?


1. PRESSURE INJURIES ONLY HAPPEN IN NURSING FACILITIES.

Wrong! Skilled nursing facilities admit patients constantly who come in with pressure inujuries - in fact, pressure injuries can arise in any healthcare setting, including hospital, ambulance, transport, emergency room, ICU, or nursing home stay. The data shows that nursing homes admit twice as many pressure injuries as they create.


What’s more, nursing facilities have become much better at pressure injury prevention, as a decline in pressure injury incidence from 2005-2009 shows. Most research studies vary in their reports of the incidence of pressure injuries in hospitals. In 2006, there were 503,300 hospital stays during which pressure injuries were noted: a 78.9% increase from 1993, when there were about 281,300 hospital stays related to pressure injuries.


The truth: Pressure injuries can happen anywhere - we treat them where we encounter them, which for us, is nearly always in the long-term care facility.


2. PRESSURE INJURIES CAN BE PREVENTED IF YOU TURN EVERY TWO HOURS.

False! Pressure injuries begin to form as the compressing pressure exceeds that intracapillary blood pressure, and lymphatic pressure. Lack of blood flow to any area of the body causes the inflammatory cascade, and cells start to die.


Pressure injuries were originally believed to be a result of patients lying immobile in bed. However, we have now found that patients may form pressure injuries from prolonged sitting, improperly fitting casts, and improper fitting of oxygen tubing.


Indeed, even the question of whether pressure injuries can be prevented is debatable. In one study where patients were turned after hip fracture, researchers did not find that repositioning patients at least every two hours is associated with a decreased incidence of pressure injuries, suggesting that manual repositioning at this frequency may not effectively prevent pressure injuries.


The truth: Pressure injuries can form quickly, usually after two hours of pressure, but they can form sooner than that as well.


3. PRESSURE INJURIES ARE A SIGN OF NEGLECT AND POOR CARE.

Wrong! This is the most harmful, and the most untrue, misconception about pressure injuries. The treatment of pressure injuries in the United States is estimated to cost more than $5–8 billion annually. Yet there is very little research or study on their etiology, progression, and prevention (although Skilled Wound Care has pioneered some of the research studies that do exist).


Unfortunately, given the lack of proper research, education, and public policy, pressure injuriers have been negatively stigmatized as “avoidable” and as pointed to as preventable diseases that are a marker of poor care.


Pressure injuries actually result from skin failure and chronic medical disease in the presence of pressure. Patients can develop pressure injuries even before the classic teaching of turning every two hours.


The truth: In actuality, pressure injuries occur even during periods of great care. And when properly staged, treated, and handled by a skilled wound care team of experts, they can be healed and/or managed well.



Skilled Wound Care is a mobile surgical practice committed to transforming the chronic wound care model in nursing facilities. Wound care experts make weekly bedside visits to patients in long-term care facilities, avoiding transfers to hospitals or clinics. Our expert physicians give patients the most up-to-date and effective wound treatments, and educate facility staff on how to help patients continue to heal quickly and effectively between visits. This model of collaborative care allows SWC’s physicians to improve patients’ lives and health outcomes, to empower nursing staff, and to raise public awareness. Skilled Wound Care, along with its nurse and nursing home partners, is working every day to positively transform traditional nursing home wound care.

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