Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

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Which of the following is a primary mechanism of ischemia in pressure injuries?

Friction injuries
Occluded capillaries
Excessive moisture
Temperature changes

The correct answer is: Occluded capillaries

The primary mechanism of ischemia in pressure injuries relates to occluded capillaries. Ischemia occurs when there is a reduction or complete stoppage of blood flow to a tissue. In the case of pressure injuries, sustained pressure on a bony prominence can compress the capillaries supplying blood to the overlying skin and tissues. When these capillaries are occluded, oxygen and nutrients are unable to reach the tissue, leading to cell death and the eventual formation of pressure injuries. While friction injuries can exacerbate skin damage, they do not directly cause ischemia. Excessive moisture can lead to maceration of the skin, which makes it more susceptible to injury, but it is not a primary mechanism of ischemia itself. Similarly, temperature changes can affect skin integrity and healing processes but do not directly block blood flow. The focus on occluded capillaries highlights the critical nature of maintaining adequate blood circulation to prevent tissue ischemia, thereby emphasizing its role as a primary mechanism in the development of pressure injuries.