Understanding Pressure Sores: A Preventable Challenge in Patient Comfort

July 25, 2025

By Dr. Yizhi Chua

Founder & CEO – Ergo Creations
www.ergocreations.com

What Are Pressure Sores?

Pressure sores—also called pressure ulcers or bedsores—are localized injuries to the skin and underlying tissue, typically over bony prominences, caused by prolonged pressure, shear, or friction [5]. These injuries often affect patients who are elderly, post-surgery, or have limited mobility.

Although commonly associated with hospital beds and wheelchairs, one overlooked setting is the bathroom—specifically, hard, non-padded toilet seats. Even brief, repeated exposure to pressure on hard surfaces can contribute to the development of these wounds.

While often associated with hospital beds or wheelchairs, one overlooked setting is the bathroom, specifically, hard toilet seats.

(https://www.brownandcrouppen.com/how-to-prevent-bed-sores-in-elderly/)

(https://justpoint.com/knowledge-base/pressure-injury-guidelines-stage-3-pressure-ulcers/)

How Do Pressure Sores Develop?

When blood flow to soft tissue is restricted for more than a couple of hours, tissue begins to die due to oxygen deprivation. The development of pressure sores occurs in four stages, ranging from skin discolouration to full-thickness tissue loss exposing muscle or bone [2]. Friction and shear further exacerbate damage, especially in patients who lack the ability to shift positions or sense discomfort.

Deep Tissue Injuries (DTIs) are particularly dangerous because they start beneath the surface, making early detection difficult. DTIs often occur where muscles and fat are compressed against bone—exactly the type of scenario seen in toilet sitting for patients with frail skin and impaired circulation [1].

(Getty Images – Pressure Sore Stages)

(https://nursinghomesabuse.org/faqs/what-are-the-stages-of-bedsores/)

The Hidden Risk: Toilets and Deep Tissue Injuries

A 2018 clinical study published in Clinical Biomechanics examined how prolonged sitting on hard toilet seats affected soft tissue health. The findings were alarming:

Tissue oxygenation decreased by 49% during just 10–15 minutes of sitting on hard toilet seats
This sustained compression and friction can lead to deep tissue injury (DTI), a severe form of pressure sore that begins below the skin surface
Using a padded toilet cushion reduced internal tissue stress by up to 88% (Gefen, 2018)

This evidence underscores how even short bathroom visits can put vulnerable patients at risk. Traditional toilet seats are not designed for patients with frail skin or healing wounds.

Who’s Most at Risk?

Patients who fall into the following categories face a significantly higher risk of developing pressure sores:

Elderly residents in care homes
Post-operative patients, especially those recovering from hip or knee surgery
Individuals with neurological conditions (e.g., Parkinson’s, stroke, or spinal cord injury)
People recovering at home who lack access to adaptive equipment or daily care
Patients with limited sensation (e.g., from diabetes or spinal conditions)

Even routine activities like toileting become pressure points—both literally and figuratively—when the surfaces are hard, slippery, or not ergonomically designed.

What Facilities Can Do

Pressure sore prevention isn’t just about bedding or repositioning. it’s about total-environment thinking. That includes evaluating the comfort and safety of: