Pressure ulcers (also known as pressure injuries) remain one of the most persistent and costly challenges in long-term care. Widely recognised as an indicator of care quality, pressure ulcers (PUs) affect an estimated 10.7 % of UK care home residents ⁽¹⁾. Given the UK’s 441,000 care home residents, this equates to over 47,000 people living with pressure ulcers, the majority of which are in early stages.
Yet under current Care Quality Commission (CQC) guidance, only the most severe cases – Stage III and IV – require mandatory reporting. That leaves approximately 80 % of pressure ulcers, primarily Stages I and II, outside the formal oversight system. These early-stage ulcers may be less clinically severe, but they account for over half (54 %) of all PU-related costs in care homes ⁽²⁾.
The core issue? Visibility.
| PU Stage | Percent of Care Home Residents (1) | Residents Affected | PU-related Expenditure (2) |
|---|---|---|---|
|
Stage I |
5.0 % |
22,074 |
15.4 % |
|
Stage II |
3.4 % |
15,010 |
38.9 % |
|
Stage III |
1.5 % |
6,622 |
27.6 % |
|
Stage IV |
0.8 % |
3,532 |
18.0 % |
|
Totals |
10.7 % |
47,238 |
100 % |
Early-stage ulcers are frequently missed or underreported, largely due to reliance on manual skin assessments – subjective and error-prone methods that too often fail to detect damage until it’s too late. The result is delayed intervention, avoidable pain, and increased long-term costs.
This is where thermography offers a breakthrough.
Thermidas, a pioneer in clinical thermography, provides an innovative solution that detects subtle temperature changes in the skin – a key early marker of tissue damage – before any visible signs appear. Used routinely in Finland and Germany, and now being trialled in UK care homes under NHS supervision, Thermidas thermal imaging tablets integrate easily into daily assessments. The technology gives carers a fast, objective tool to identify PU risk early and intervene sooner.
Multiple studies, including those by Cai ⁽³⁾ and Judy ⁽⁴⁾, have demonstrated the effectiveness of thermography in reducing acquired pressure ulcers to zero. Cai reported that, “The efficiency of infrared thermography for diagnosing pressure injury was better than that of Braden scale,” while Judy reported 100 % accuracy in predicting both the presence and location of future ulcers.
The implications are significant: improved resident safety, reduced hospitalisations, and more efficient use of care staff time. Thermography supports clinicians’ judgement, enhances early detection, and aligns perfectly with the Department of Health and Social Care’s commitment to digital care and eliminating avoidable harm.
A thermal scan during a routine check-up of a 78-year-old immobile resident revealed a warmer area on the back, despite no visible signs of pressure injury; thermal imaging gave carers actionable insights for precise repositioning.
If the sector is serious about reducing pressure ulcer prevalence and costs, it must close the earlystage visibility gap. By integrating technologies like Thermidas into everyday care, care homes can shift from reactive treatment to proactive prevention – improving outcomes for residents and providers alike.
This article was originally published in the July 2025 issue of Healthcare Matters.
(1) Sugathapala RDUP, Latimer S, Balasuriya A, Chaboyer W, Thalib L, Gillespie BM. Prevalence and incidence of pressure injuries among older people living in nursing homes: A systematic review and meta-analysis. Int J Nurs Stud. 2023 Dec;148:104605. doi: 10.1016/j.ijnurstu.2023.104605. Epub 2023 Sep 14. PMID: 37801939.
(2) NHS Pressure Ulcer Productivity Calculator https://www.gov.uk/government/publications/pressure-ulcers-productivity-calculator
(3) Cai F, Jiang X, Hou X, Wang D, Wang Y, Deng H, Guo H, Wang H, Li X. Application of infrared thermography in the early warning of pressure injury: A prospective observational study. J Clin Nurs. 2021 Feb;30(3-4):559-571. doi: 10.1111/jocn.15576. Epub 2021 Jan 26. PMID: 33258199.
(4) Judy D, Brooks B, Fennie K, Lyder C, Burton C. Improving the detection of pressure ulcers using the TMI ImageMed system. Adv Skin Wound Care. 2011 Jan;24(1):18-24. doi: 10.1097/01.ASW.0000392925.83594.50. PMID: 21173587.