Pressure Ulcer Prevention in the Winter: Why Pressure Injuries Increase and How to Prevent Them — A Clinical Perspective for OTs, TVNs & Wheelchair Services

Pressure ulcer prevention in the winter is a growing priority across acute, community and long-term care settings. Winter consistently correlates with increased pressure injury incidence, meaning Occupational Therapists, Tissue Viability Nurses, Wheelchair Services, Community Therapy Teams and Rehabilitation Clinicians must prepare proactively as tissue tolerance naturally decreases in colder conditions.

Although the core pathology of pressure, shear, friction and moisture remains unchanged, winter-specific extrinsic factors significantly reduce skin resilience, making pressure ulcer prevention in the winter even more essential. Cold-induced vasoconstriction, dry indoor heating, increased immobility, delayed transfers and microclimate disruption all amplify pressure injury risk, particularly in wheelchairs, complex seating systems and bed-based environments.

This guide outlines key winter risk factors and demonstrates how Gel Ovations silicone-based products strengthen pressure ulcer prevention in the winter across all care settings.

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❄️ Why Winter Increases Pressure Injury Risk

1. Vasoconstriction and Reduced Peripheral Perfusion

Cold temperatures trigger vasoconstriction, lowering tissue perfusion and reducing skin’s load tolerance. This creates a clinically important challenge for pressure ulcer prevention in the winter, as early warning signs such as hyperaemia are harder to detect.

2. Seasonal Dryness Weakens the Epidermal Barrier

Low humidity indoors and outdoors increases dryness and reduces skin elasticity. Winter dryness directly affects shear tolerance, making pressure ulcer prevention more complex and requiring enhanced skin protection in the winter.

3. Increased Immobility Due to Seasonal Illness

Winter viruses, respiratory infections and cardiac exacerbations contribute to increased bedrest and reduced activity. Combined with staffing and system pressures, this makes pressure ulcer prevention in the winter more difficult as repositioning may be delayed.

4. Heavier Clothing & Bedding Affect Biomechanics

Winter layers alter posture, increase shear forces and disrupt microclimate stability. This is especially important for wheelchair users, where optimal pressure ulcer prevention requires seating reassessment under winter conditions.

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❄️ Winter Prevention Priorities for Clinical Teams

1. Winter Microclimate Management

Effective microclimate control is central to pressure ulcer prevention in the winter, when temperature and humidity vary widely.

Clinical actions:

• Avoid overheating due to heavy bedding or winter clothing.

• Monitor moisture levels in chairs, hoists and beds.

• Reassess pressure-relieving surfaces for winter performance.

How Gel Ovations Products Support This:

Silicone products maintain microclimate stability and remain soft in cold conditions — supporting pressure ulcer prevention in the winter where foam may harden.

• Dimensional Gel, RippleGel, and AirGel help maintain a stable microclimate.
• Silicone construction prevents moisture absorption and stays responsive in cold temperatures.

(Silicone does not firm up in cold environments, unlike some foams.)

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2. Increased Skin Surveillance in Winter

Reduced skin temperature and increased dryness make early damage harder to see.

Winter clinical actions:

• Increase manual palpation

• Focus on bony prominence’s

• Monitor individuals seated for long periods

Gel Ovations products that support pressure ulcer prevention in the winter:

• Silicone Heel Pads

• Elbow Pads

• Head Donuts

Their ability to redistribute load makes them valuable during winter vulnerability.

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3. Seating, Wheelchair & Postural Adjustments

Winter clothing impacts posture and shear risk, making seating reviews essential for pressure ulcer prevention in the winter.

Winter seating challenges:

• Bulky layers increase shear

• Clothing slippage increases posterior pelvic tilt

• Reduced sensation masks discomfort

• Longer sitting times increase load duration

Gel Ovations winter solutions:

• GT Series Arm Pads

• Arm Troughs

• Elbow Supports

• Aqua Footboxes

• Gel Footplate Covers

These retrofit accessories make pressure ulcer prevention in the winter easier when referrals surge.

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4. Moisture & Continence Management

Fragile winter skin requires protection from both dryness and excessive moisture.

Best practice for winter:

• Correct use of emollients

• Protect friction-prone areas

• Maintain continence protocols despite pressures

Silicone’s impermeable, wipe-clean nature makes Gel Ovations ideal for pressure ulcer prevention in the winter where moisture control is critical.

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5. Preparing for Winter Operational Demand

NICE CG179 emphasises proactive preventative care — especially vital for pressure ulcer prevention in the winter.

Community OT actions:

• Review high-risk individuals

• Anticipate reduced mobility

• Deploy gel supports early

Wheelchair Services:

• Rapid adjustments to armrests, footplates and cushions

• Use retrofit Gel Ovations products to manage winter backlogs

Silicone pads, inserts and protectors support pressure ulcer prevention in the winter across all settings.

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💠 Why Silicone Supports Pressure Ulcer Prevention in the Winter

Silicone-based pressure care is uniquely suited to winter challenges:

✔ Remains soft in cold conditions

✔ Provides instant pressure redistribution

✔ Maintains a stable microclimate

✔ Does not absorb moisture

✔ Fits existing equipment easily

These qualities make Gel Ovations products ideal for pressure ulcer prevention in the winter, regardless of care setting.

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🔵 Conclusion: A Winter Shift in Prevention Strategy

Winter presents predictable, preventable challenges:

• Lower tissue tolerance

• Increased immobility

• Dry, fragile skin

• Microclimate instability

• Altered posture due to heavy clothing

Integrating Gel Ovations supports a clinically robust approach to pressure ulcer prevention in the winter, protecting high-risk individuals during the most demanding season.

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FAQ’S