Chapter 10: Pressure Injuries


  • Karen Smith, MD, FRCP(C), DABEM, DABPMR
  • Jolene Heil, BScN, CNS, IIWCC, MClSc


Learning Objectives

  • Review pressure injury risk assessment focusing on the patient as a whole
  • Examine the principles of pressure redistribution
  • Classify Pressure Injuries, the impact on patient well-being and the plan of care


In this chapter, you will find an overview of how to reduce the risk for pressure injury (PI) formation and how to treat a person with an existing PI. It is important to understand that treatment of the wound itself is in conjunction with understanding the cause, as well as factors that affect wound healing.

Pressure injuries (PI) are defined as “localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device” (European Pressure Injury Advisory Panel [EPIAP], National Pressure injury Advisory Panel [NPIAP], Pan Pacific Pressure Injury Alliance [PPPIA], 2019)

PI’s add significant cost to the healthcare system. A study conducted in the United States reported that a hospital acquired PI could cost $10,708 USD on average per person, and stage 3 & 4 PI’s are associated with an average 14 day increase in length of stay (Padula & Delarmente, 2019). PI’s also can have a significant effect on a person’s quality of life and well-being.

Staging  of Pressure Injuries

Documentation of tissue type involved in PI is important. The National Pressure Injury Advisory Panel developed a staging system to provide consistent documentation across all care sectors.


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