Braden Scale for Pressure Injury Risk

The Braden Scale estimates a person's likelihood of developing a pressure injury. It is a prevention tool, not a wound diagnosis and not a staging system. A lower total means greater risk. A pressure injury is localized damage to the skin or underlying soft tissue, usually over a bony prominence or beneath a medical device. Sustained pressure, often combined with shear, reduces tissue tolerance. Damage is produced by several mechanisms at once: local ischemia during loading, inflammatory and oxidative injury when blood flow returns, direct deformation of cells, and impaired movement of lymph and interstitial waste. The familiar explanation that pressure becomes harmful when it exceeds capillary closing pressure is incomplete. There is no single pressure-time threshold that reliably predicts injury in every person. Direct deformation can injure cells within minutes under high loading, while ischemic cellular changes in animal models have been described after approximately 90 minutes. Muscle is less tolerant than skin, so injury can begin at the bone-muscle interface and appear at the skin later. This is why an apparently intact surface does not always mean that...