Your Child’s Equipment
Preventing pressure injuries
What are pressure injuries?
A pressure injury is when your child’s skin and the tissues underneath are damaged by constant pressure to 1 or more places on the skin.
Children with limited mobility or physical disabilities are at higher risk for pressure injuries. This can happen when your child is in 1 position for a long time, like sitting or laying. Equipment that fits snugly, like ankle foot orthosis (AFO), standing frames, or wheelchairs, can also cause pressure areas. This can happen when your child is outgrowing their equipment or has poor positioning in their equipment.
Pressure injuries usually happen over bony areas, such as your child’s sit bones (bum), hips, lower back, elbows, heels, and shoulders. They can also occur in places where your child’s equipment presses on their skin:
- AFOs can cause pressure on the ankles and heels.
- Wheelchair laterals that help keep your child stable can cause pressure under their armpits.
- Headrests can cause pressure against the ears or cheeks.
- Masks and other equipment or devices, like oxygen or I.V. tubing, can cause pressure where they touch your child’s skin.
Pressure injuries can look like discoloured areas on the surface of the skin. This could be pink or red on lighter skin tones or purple or darker than surrounding skin on darker skin tones. Pressure injuries can cause severe tissue damage that goes deep into muscle and bone. These types of injuries are hard to treat and slow to heal.
What causes pressure injuries?
Pressure injuries (also called bedsores) happen when there’s too much pressure on the same spot on your child’s skin for a long time. Other things that can increase the risk include:
- Wet skin from sweat, pee, or poop that can make the skin break down more easily.
- Clothing problems, like tight clothes, seams, zippers, or wrinkles in clothes that press on the skin.
- Medical equipment that’s too small or doesn’t fit your child properly.
- Sliding down in bed or sliding down in a chair. This can pull and stretch the skin (this is called shear).
- Being pulled across sheets or surfaces. This can rub the skin and cause damage (this is called friction).
- Not eating enough healthy food. This can make it harder for your child’s body to keep their skin strong and able to heal well.
What are the symptoms?
When you take your child out of their equipment, you may notice an area that’s discoloured. On lighter skin tones, the skin can look pink or red. On darker skin tones, the area may appear as patches of darker, maroon, or purple skin. This red or dark spot would be over an area where your child’s bones are closer to the skin and that are in contact with their equipment. If the spot doesn’t fade to your child’s normal skin colour within 30 minutes, this may be the start of a pressure injury. The injury may be tender and warm to the touch.
If you’re noticing discoloured areas or you’re worried that your child is starting to get a pressure injury:
- Contact your child’s healthcare provider as soon as possible.
- If possible, limit use of equipment that comes in contact with the affected area until your child sees their healthcare provider or therapist.
How to prevent a pressure injury?
The best way to prevent a pressure injury is to change your child’s position frequently throughout the day. When pressure stays on 1 part of the body, it can hurt the skin and the tissue underneath. Move your child often so the same areas of skin aren’t always in contact with equipment. This helps protect their skin.
- Change positions often. Especially if your child has limited mobility or uses equipment like a wheelchair or braces (see 24-hour position management for ideas).
- Use safe lifting and moving techniques. Ask your child’s healthcare team to show you how to transfer your child in a way that protects their skin.
- Regularly check the fit of your child’s equipment. This includes wheelchairs, braces (AFOs), bath seats, or standing frames. Make sure nothing is too tight or rubbing (learn how to do a growth check).
- Take care of your child’s skin every day:
- Look at their skin every day. Check for areas that are discoloured, open areas, or anything that doesn’t look right. Especially on bony areas like hips, elbows, knees, and heels.
- If your child wears diapers, clean their skin as soon as you can after they pee or poop. Use a barrier cream or ointment to help protect their skin from getting too wet.
- Bathe your child as needed to stay clean and comfortable. Use warm (not hot) water and a gentle soap. Dry their skin fully, especially in areas where the skin folds.
- If your child has dry skin, use lotion or cream to help keep it soft and keep it from cracking.
How are pressure injuries treated?
If you think your child is developing a pressure injury, it’s important to treat it as soon as possible. Treatment will help the pressure injury heal. This involves keeping pressure off the area. Injuries with broken skin need to be kept clean and bandaged. Talk to your healthcare provider about how to treat your child’s pressure injury.
When should you call for help?
Contact your primary healthcare provider if:
- Your child has any open wounds or is in pain.
Contact your therapist if:
- Your child is not comfortable in the equipment.
- Your child has grown.
Contact the vendor if:
- There are broken parts on the equipment.
- Annual maintenance for moving parts.
To see this information online and learn more, visit MyHealth.Alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_childs_equip_pressure_injury_inst.
Related to Pressure Injuries
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: August 1, 2025
Author: Pediatric Rehabilitation Services, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.
