Pressure Injuries 101: The Early Signs

Pay attention—these indicators signal that a pressure injury may be brewing


Pressure injuries are a long-standing issue within the medical profession, and their significance has only increased over time, causing major problems for patient care in hospitals. In the United States, 2.5 million people develop pressure injuries, with 60,000 hospital acquired pressure ulcer (HAPU) deaths reported every year. (Of note: up to 45% of these HAPUs come directly from the operating room.) The gravity of this issue makes pressure injury risk assessment and monitoring a necessary focus for medical professionals, health care administrators and caregivers alike.

Several factors are involved in learning how to mitigate risk in pressure sore development, with one leading the list: learning how to identify the early signs of pressure injuries in patients. By understanding how pressure injuries develop, it’s easier to see the early signs of tissue breakdown before a pressure ulcer reaches deeper tissue increasing risk of infection. XSENSOR helps with this mission; our technology empowers health care professionals to provide a better standard of care at every stage of a patient’s journey.

 where pressure sores form on the body


What is a pressure injury?

A pressure sore is a skin injury resulting from pressure to the skin. These injuries range in severity, from early-stage pressure sores that simply result in reddened skin all the way to late-stage sores that progress to open wounds, exposing muscle and bone. Pressure injuries manifest quickly from one stage to the next, so it’s important to learn about the four main stages of pressure injuries for early recognition and treatment.

Stage 1 Pressure Injury and Ulcers: Early on in pressure ulcer development, the skin is developing injury. While no open sores or broken skin is present yet, skin may appear redder, warmer or firmer than usual. Known as a non-blanchable erythema of intact skin, the color change may even indicate the beginnings of a serious deep tissue injury.

Stage 2 Pressure Injuries and Ulcers: During stage 2, the true sore, or ulcer, develops as a break in the skin. This is often very painful, and can create serious skin damage. Known as partial-thickness skin loss with exposed dermis, these bed wounds can quickly progress to something much worse.

Stage 3 Pressure Injuries and Ulcers: Here, the pressure ulcer has developed into the skin and underlying tissue. Known as full-thickness skin loss, this pressure sore stage may showcase a deep open wound, especially in an affected area with more adipose tissue. 

Stage 4 Pressure Injuries and Ulcers: By the final and most serious stage of a pressure sore, the skin may have receded into the muscle tissue or the bone, causing lasting damage to the skin and underlying areas. Known as full-thickness skin and tissue loss, this stage can involve visible or palpable fascia, bone, muscle or tendon.


How are pressure sores caused?

Pressure sores, also known as decubitus ulcers, have been called “bed sores” colloquially for a reason — many times, they are caused by excessive pressure brought on from lying in a hospital bed for prolonged periods, without repositioning to relieve it. This may affect blood supply to the bony prominences below or skin surface. When too much pressure is placed on the skin (constricting blood flow), pressure sores will develop, often in the form of a blood filled blister. The key to preventing pressure sores is utilizing techniques and technology that relieve pressure, assess risk holistically and allow for a hospital environment in which pressure sore prevention is prioritized.


beginning sign of pressure sore

The early signs of a pressure sore

It’s crucial to understand the early indicators of a pressure injury; recognizing a stage one pressure sore quickly will help prevent it from becoming a stage four pressure sore. Early warning signs include:

  • Discoloration or dark skin, whether redder, more purple or bluer than usual
  • An area of skin feeling warmer to the touch than surrounding skin
  • Skin that feels firmer in one spot than usual
  • Itchy, painful skin
  • When the skin is pressed down on, it doesn’t blanch (appear lighter)
  • Swelling on the skin

When monitoring for early signs, it’s helpful to know which areas of a patient’s body are most at risk of developing an injury. According to the Mayo Clinic, there are several areas that are more prone to pressure sores. For those spending a long time in bed (which includes hospital beds), monitor the patient’s shoulder blades, hips, lower back, tailbone, back and sides of the head, heels, ankles and skin behind the knees. For those in a wheelchair, pressure injury can often develop on the tailbone, spine, shoulder blades, buttocks or contact points between the wheelchair and the arms and legs. It’s also a good idea to look behind tendons and joints. 

 technology to prevent pressure sores


Equipment to prevent pressure injuries

Fortunately for health providers—and the patients they serve—pressure injuries can be prevented entirely with the right techniques and equipment. XSENSOR’s continuous pressure monitoring technology empowers health care professionals with the data and prevention methods they need to mitigate risk for patients in every hospital setting. At XSENSOR, we offer technology to prevent pressure injuries from forming on surgical tables, hospital beds or wheelchair seats. Our goal? To give medical professionals smart data and patients utmost comfort. 

  • For hospital beds: Our unique ForeSite Intelligent Surface system has more than 1500 sensor cells on the surface of the mattress or overlay to measure patient body surface pressures, displaying data in real time for continuous monitoring. The system includes AI powered body position tracking and a turn clock to track repositioning that informs better patient care.
  • For surgical tables: Our ForeSite OR system carries the same technology through to the operating room, which is excellent for safe positioning and managing risk in longer surgeries.
  • For wheelchairs: Our ForeSite SS system utilizes high accuracy sensing to design safe seating for those in wheelchairs.

At XSENSOR, we strive to produce intelligent, dynamic sensing technology that puts patients first. We support health providers with the right data to inform good patient care, elevating your health care environment at each and every step. Contact us today, and we’ll create a new standard of care together. 

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