What process is most likely to cause undermining and tunneling of pressure injuries?

Shearing is the friction that occurs between the skin and the underlying tissue, particularly when a patient moves or is moved while seated or lying down. This movement can cause the layers of skin to slide over each other, leading to damage in the deeper layers of tissue without affecting the outer layer of skin. This damage disrupts blood flow and can create areas of necrosis, contributing to the formation of undermining and tunneling in pressure injuries.

Undermining refers to the destruction of tissue under the skin's surface, resulting in a gap or pocket that can be felt when the wound is assessed. Tunneling is a similar process where a channel or tunnel forms, often extending in a specific direction, caused by the shearing forces. Understanding the mechanics of shearing can help in preventing and managing pressure injuries effectively.