Pressure Wounds and Skin Integrity Issues

Gillette Children’s Specialty Healthcare specializes in addressing pressure wounds and skin integrity issues caused by limited mobility or loss of sensation. To help prevent these types of concerns, we use pressure mapping technology to identify problem areas and teach patients or caregivers how to keep skin healthy. When a person develops a pressure wound or has a skin integrity issue, our certified wound care experts offer treatment and support.

Why Choose Gillette?

  • We have nurses and nurse practitioners who are certified in wound care—assessing skin integrity, helping with wound management and educating patients or caregivers.
  • Our pressure mapping technology shows pressure distribution, allowing our specialists to address potential problems and adjust seating systems.
  • Our plastic surgeons are experts at closing wounds that don’t respond to typical treatments.
  • We believe that people who have disabilities deserve a lifetime of excellent health care—from birth through adulthood.


Skin integrity means that the skin is healthy, undamaged and able to perform its basic functions. A skin integrity issue might mean that the skin is damaged, vulnerable to injury or unable to heal quickly.

A pressure wound (also called a pressure sore, bed sore or pressure ulcer) is an injury to the skin and surrounding tissue. Pressure wounds usually form over boney parts of the body, such as the, hips, sitting bones, shoulder blades or base of the spine. If not treated early, wounds can become infected or require surgery to repair.


The most common cause of pressure wounds and skin integrity issues is constant pressure from squeezing skin against a surface (such as a bed or wheelchair) which can reduce blood flow to the area and cause injury. This typically happens if someone remains in one position for a prolonged period of time.

Other causes of pressure wounds and skin integrity issues are:

  • Sliding down a chair or bed
  • Pulling across a chair or bed
  • Irritation from sweat or other bodily fluids

Risk Factors

People at risk of developing pressure wounds and skin integrity issues:

  • Are paralyzed
  • Can’t feel pain or pressure
  • Use braces, casts or a wheelchair
  • Spend a lot of time in one position
  • Don’t have control of their bowels or bladder
  • Have trouble thinking clearly
  • Have difficulty managing their health
  • Don’t eat a balanced diet or drink enough water
  • Are overweight

Symptoms and Prevention

People who are at risk of pressure wounds and skin integrity issues—or their caregivers—should check for signs of problems every day. A health care provider should evaluate any signs of developing wounds.

Some of the most common early signs of pressure wounds and skin integrity issues include:

  • A red or pink appearance on people who have light colored skin
  • An ashen, blue or purple appearance on people who have darker skin
  • Pain in the area
  • A firmer, softer, warmer or cooler feeling in the area compared to other parts of the body
  • An area that doesn’t blanch (lose color when pressed)

Although daily skin checks are the best way of preventing problems, people at risk of pressure wounds and skin integrity issues should also:

  • Drink plenty of water
  • Eat a balanced diet
  • Keep skin clean
  • Use a barrier cream over the buttocks and groin, if incontinent, at every change of brief/diaper to prevent the skin from absorbing excess moisture
  • Schedule regular visits with orthotists, seating practitioners and durable medical equipment vendors to make sure braces and seating fit properly
  • Change position every two hours when in bed
  • Change position for at least two minutes every hour if using a wheelchair
  • Get out of a wheelchair every few hours
  • Avoid excessive layers of clothing, sheets or materials
  • Avoid dragging or pulling skin across surfaces when transferring (such as moving from a wheelchair to a bed)

Our Services

Gillette offers several services to help prevent, treat and manage pressure wounds and skin integrity issues.

Education and Resources

Gillette specialists certified in wound care evaluate skin integrity, help with wound management, and educate patients and families about pressure wound prevention and skin integrity issues. Patients who notice issues during a routine skin check or who have questions about preventing pressure wounds should contact Gillette and speak to a nurse.

Our videos about lower extremity skin care and evaluation for insensate feet provide useful tips for people who are at risk of pressure wounds and skin integrity issues because of immobility or loss of sensation.

Pressure Mapping
Our physical therapists and seating specialists use pressure mapping technology to measure the pressure a patient experiences when sitting or lying in different positions. Special mats produce a map of pressure distribution, pinpointing the highest areas of pressure. This information helps therapists and seating specialists recommend ways to reduce pressure in these locations.

Wound Surgery
If pressure wounds don’t respond to typical treatments, Gillette plastic surgeons, who specialize in closing difficult-to-treat wounds, can provide surgical care. Our experts focus on providing the best outcomes possible for patients who have pressure wounds.

For more information about the services we offer at Gillette, search Conditions and Care.

Why Gillette?

Because all children deserve a lifetime of amazing health care.

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