Clinical meaning
Pressure injuries (formerly 'pressure ulcers' or 'bedsores') develop when sustained pressure on soft tissue exceeds capillary closing pressure (~32 mmHg), causing localized ischemia, tissue hypoxia, and cell death. The damage occurs from the inside out: deep tissue injury often precedes visible skin changes.
The Braden Scale is the most widely used evidence-based tool for predicting pressure injury risk. It assesses SIX subscales, each scored 1-4 (except friction/shear which is 1-3):
1. Sensory Perception (1-4): Ability to respond to pressure-related discomfort. Score 1 = completely limited (unconscious/paralyzed), Score 4 = no impairment. 2. Moisture (1-4): Degree to which skin is exposed to moisture. Score 1 = constantly moist, Score 4 = rarely moist. 3. Activity (1-4): Degree of physical activity. Score 1 = bedfast, Score 4 = walks frequently. 4. Mobility (1-4): Ability to change and control body position. Score 1 = completely immobile, Score 4 = no limitations. 5. Nutrition (1-4): Usual food intake pattern. Score 1 = very poor, Score 4 = excellent. 6. Friction and Shear (1-3): Score 1 = problem (requires assistance, slides in bed), Score 3 = no apparent problem.
Total Score: Range 6-23. LOWER scores = HIGHER risk. • 15-18 = Mild risk • 13-14 = Moderate risk • 10-12 = High risk • ≤9 = Very high risk