A device related pressure ulcer (DRPU) can be defined as: An involvement / interaction with a device or object that is in direct contact with skin … or is transdermally be implanted under the skin, causing focal and localised forces that deform the superficial and deep underlying tissues. A DRPU, which is caused by a device or object, is distinct from a PU, which is caused primarily by body-weight forces. The localised nature of the device’s interaction with the patient’s tissue results in the appearance of skin and deeper tissue damage that mimics that of the device in shape and distribution. (Geffen et al 2022)

It is known that a significant proportion of pressure ulcers in critically ill or immobile patients are related to the use of medical devices (Black et al, 2010). These are not always avoidable and require techniques to help reduce or prevent skin damage beneath medical devices. Medical devices including naso-gastric tubes and ventilation masks can be made of rigid material, which in turn, can cause rubbing or create pressure on the soft tissues (Jaul, 2010).

Medical device related pressure ulcers/ injury can be caused by:

  • The rigid material from which device is made
  • Poor device selection
  • Placement on body sites with little adipose tissue
  • Changes caused by the device to the microclimate of the underlying skin
  • Fixation methods employed to secure device.

Dyer (2015)

It is important to be aware that not all medical-device related damage occurs over a bony prominence. Young (2017)

Many device related pressure ulcers occur because of poor positioning or fixation of equipment, or simply failure to check the device is repositioned correctly.

Preventing device related pressure ulcers:

  • Correct positioning and care of equipment with appropriate fixation and stabilisation of the device
  • Use thin hydrocolloids, film dressings or barrier products underneath the device to reduce moisture friction and shear
  • Use of pressure reducing dermal gel pads

(Fletcher, 2012)

  • Early removal of devices, medical devices that have an increased potential to harm by causing pressure damage should be removed as soon as is medically feasible
  • Monitoring appearance of skin and presence of pain, the skin under and around a medical device should be inspected at least twice a day
  • Patient education. Involving the patient and/or carer by explaining the rationale for use and points to be aware of to reduce damage.

Young (2017)