Pressure injuries and skin tears are the most common wounds that affect older people as a result of being in hospital.

Definitions

A pressure injury is ‘a localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, shear and/or friction, or a combination of these factors’.1 Pressure injuries can also be called pressure ulcers or bed sores.

As pressure injuries usually occur over bony prominences, such as the sacrum or base of the spine, heels and hips, they are often not visible.

The severity of pressure injuries can be classified using a staging system. Management and treatment of pressure injuries depends on the stage.

A skin tear is ‘a wound caused by shear, friction and/or blunt force resulting in separation of skin layers’.2

Skin tear severity can be classified according to the Skin Tear Audit classification system. Management and treatment of skin tears depends on its classification.

Impacts

Hospital acquired pressure injuries and skin tears are considered an adverse event and can have a profound physical, social and psychological impact on the lives of older people.

This is going to affect her mobility, and emotionally this is going to make her shattered.
- Family member, Western Health

Older people who experience pressure injuries and skin tears while in hospital are at increased risk of:

  • morbidity and mortality
  • pain
  • reduced mobility and loss of independence; which increases the risk of developing pressure injuries
  • longer hospital stay
  • reduced quality of life
  • anxiety and worry
  • reduced social contact and increased social isolation.
  • loneliness.

1. Australian Wound Management Association, Pan pacific clinical practice guideline for the prevention and management of pressure injury, 2012: Cambridge Media Osborne Park, WA.

2. LeBlanc, K. and S. Baranoski, Skin tears: state of the science - consensus statements for the prevention, prediction, assessment, and treatment of skin tears(c). Advances in Skin and Wound Care, 2011. 24(9 Suppl): pp. 2-15.