Pressure injuries caused by medical devices from the perspective of nurses’ actions – Systematized Literature Review

Michele Trajano Morais, Isabel Cruz


Objective: Pressure injury (PPI) occurs as any damage to the skin, muscles and subcutaneous tissue caused by prolonged pressure that leads to occlusion of local blood flow. This results in tissue ischemia, impairing the supply of oxygen and nutrients to tissues. The injury can also be caused by friction, when two surfaces are in friction, and by shear, which is the interaction between gravity and friction, causing the destruction of small vessels and interrupting local blood flow. On the other hand, medical device-related pressure ulcers (UPRDM) originate from the pressure exerted by devices used for medical diagnosis and treatment purposes. The objective of this review study was to identify protocols for preventing pressure injuries derived from medical devices in patients admitted to intensive care units. Method: This is a systematic review of the literature carried out in the SciELo databases; Pubmed; VHL; Cochrane and specialized nursing journals, between June and July 2023, using the PICOT strategy. Results: 18 articles were selected that directly addressed pressure injuries caused by medical devices, highlighting their prevalence in ICU patients. Conclusion: The literature converges on the importance of formal nurse education, through training and workshops, to improve the early detection of injuries and improve the quality of life of ICU patients. The main causes are highlighted, with emphasis on injuries associated with mechanical ventilation. Furthermore, the areas most susceptible to LPRDM are the nose, mouth and ears, aggravated by the use of fixators.

Keywords: Medical device pressure injury. Pressure injury. Intensive care unit. Nursing.

Full Text:



Cavalcanti EdO, Kamada I. Lesão Por Pressão Relacionada a Dispositivos Médicos: Frequência E Fatores Associados. Estima (Online) 2022; 20(1):e0322-e0322. Available from: URL:

Kim JY, Lee YJ. Medical device-related pressure ulcer (MDRPU) in acute care hospitals and its perceived importance and prevention performance by clinical nurses. Int Wound J 2019; 16 Suppl 1(Suppl 1):51–61.

Cavalcanti EdO, Kamada I. Medical-device-related pressure injury on adults: an integrative review. Texto & Contexto - Enfermagem 2020; 29. Available from: URL:〈=en.

European Pressure Ulcer Advisory Panel. Prevenção e tratamento de úlceras/lesões por pressão: guia de consulta rápida. [s.l.]: EPUAP/NPIAP/PPPIA; 2019.

Skillman J, Thomas S. An audit of pressure sores caused by intermittent compression devices used to prevent venous thromboembolism. J Perioper Pract 2011; 21(12):418–20.

Pittman J, Beeson T, Kitterman J, Lancaster S, Shelly A. Medical device-related hospital-acquired pressure ulcers: development of an evidence-based position statement. J Wound Ostomy Continence Nurs 2015; 42(2):151-4; quiz E1-2.

Black JM, Cuddigan JE, Walko MA, Didier LA, Lander MJ, Kelpe MR. Medical device related pressure ulcers in hospitalized patients. Int Wound J 2010; 7(5):358–65.

Lopes VV, Moura JPd, Silva JVd, Silva ÁDMe. Lesões por pressão provocadas por dispositivos médicos em Unidades de Terapia Intensiva. RSD 2021; 10(14):e182101421737.

Mehta C, Ali M, Mehta Y, George JV, Singh MK. MDRPU -an uncommonly recognized common problem in ICU: A point prevalence study. J Tissue Viability 2019; 28(1):35–9. Available from: URL:

Galetto SGdS, Nascimento ERP, Hermida PMV, Busanello J, Malfussi LBH, Lazzari DD. Medical device-related pressure injuries in critical patients: prevalence and associated factors. Revista da Escola de Enfermagem da USP 2021; 55. Available from: URL:〈=en.

Domingos JEP, Silva NOd, Cavalcante VdO, Andrade VdS, Silva Filho JAd, Gadelha NAdS et al. Indicadores diagnósticos para risco de lesão por pressão em pacientes com trauma ortopédico. Rev. Enferm. Atual In Derme 2022; 96(40).

Barakat-Johnson M, Lai M, Wand T, Li M, White K, Coyer F. The incidence and prevalence of medical device-related pressure ulcers in intensive care: a systematic review. J Wound Care 2019; 28(8):512–21. Available from: URL:

Gaspar MDDR, Rinaldi EAC, Mello RG, Santos FA, Nadal JM, Cabral LPA et al. Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review. J Infect Dev Ctries 2023; 17(2):194–201.

Zakaria AY, Taema KM, Ismael MS, Elhabashy S. Impact of a suggested nursing protocol on the occurrence of medical device-related pressure ulcers in critically ill patients. Cent Eur J Nurs Midw 2018; 9(4):924–31.

Soldera D, Balbinot Reis Girondi J, Silveira de Almeida Hammerschmidt K, Amante LN, Luz Ouriques Neta E. Lesões por pressão relacionadas a dispositivos médicos na prática clínica de enfermeiros. revenf 2021; 12(2).

Sousa MBV, Bezerra AMFA, Costa CV, Gomes EB, Fonseca HTA, Quaresma OB et al. Assistência de enfermagem no cuidado de feridas na atenção primária em saúde: revisão integrativa. Acervo Saúde 2020 [cited 2023 Mar 10]; (48):e3303. Available from: URL: 10.25248/reas.e3303.2020.

Santos LLd, Medeiros ACLL, Rocha DEAd, Caminha EdLG, Barreto LLG, Souza MTd et al. Intervenções de enfermagem para prevenir lesão por pressão em UTI. EACAD 2022; 3(1):e133198.

Lovegrove J, Fulbrook P, Miles S, Steele M. Effectiveness of interventions to prevent pressure injury in adults admitted to intensive care settings: A systematic review and meta-analysis of randomised controlled trials. Aust Crit Care 2022; 35(2):186–203.

Parvizi A, Haddadi S, Mollaei A, Ghorbani Vajargah P, Takasi P, Firooz M et al. A systematic review of nurses' knowledge and related factors towards the prevention of medical device-related pressure ulcers. Int Wound J 2023.


Share |