Deep Tissue Pressure Injury

Dianne Rudolph's picture

By Dianne Rudolph, APRN, GNP-BC, CWOCN, UTHSCSA

Pressure injuries (PIs) are defined by the National Pressure Injury Advisory Panel as “localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device.” Pressure injuries may present as intact skin or as an open ulcer. These wound may be painful. Pressure injuries occur after exposure to prolonged pressure or as a result of pressure in combination with shear. Other factors may affect soft tissue tolerance, such as nutrition, perfusion, microclimate, the presence of comorbidities, and the condition of the soft tissue.

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By: Mary Brennan, RN, MBA, CWON, Karen Lou Kennedy-Evans, RN, FNP, APRN-BC, and Diane Krasner, PhD, RN, CWCN, CWS, MAPWCA, FAAN

What is the best way to differentiate between a Trombley-Brennan terminal tissue injury (TB-TTI) and deep tissue injury (DTI)?

Mary: This is the most challenging because these injuries resemble one another. The difference is that a TB-TTI does not evolve as a DTI does. There may be an increase in surface area but no change in the appearance or type of tissue. A TB-TTI will look the same in color and appearance on day 3 or 5 as it does on day 1.

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WoundSource Practice Accelerator's picture
The Future of Pressure Injury Prevention

By the WoundSource Editors

Pressure injuries represent a great challenge in patient care, as well as a significant burden on the health care system. This burden is likely to continue to increase as a result of the growing geriatric population, along with the increasing rates of obesity, diabetes, and cardiovascular disease. Recent estimates in the United States show annual costs of pressure injury treatment to be approximately $9.1 to $11.6 billion. In addition to cost, these localized injuries to the skin are often very painful for patients, particularly as the injuries become more severe.

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Pressure Injury Interventions in Special Populations

By the WoundSource Editors

Pressure injuries require complex care. They can be incredibly painful for patients, and they represent an enormous financial burden on the health care system. Nationally, pressure ulcers cost between approximately $9.1 and $11.6 billion annually to treat. A subset of these patients includes those who are particularly prone to developing pressure ulcers as a result of comorbid conditions. This subset includes patients who may have cognitive disabilities, those who have a spinal injury or have undergone an amputation, and bariatric patients.

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Skin Care for Pressure Injury Prevention

By the WoundSource Editors

Pressure injuries are a significant risk for patients and pose a tremendous clinical challenge to medical providers. Serious pressure injuries can present a substantial threat to patients' survival when comorbidities are present, and even less serious pressure injuries can negatively affect a patient's comfort and well-being. Although some pressure injuries are unavoidable, best practices in patient skin care can greatly reduce the risk in many circumstances, with some research demonstrating that up to 95% of pressure injuries are preventable.

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Patient Preparation for Pressure Injury Prevention

By the WoundSource Editors

With aging populations facing increasingly complex comorbid medical conditions coupled with polypharmacy and multidrug-resistant organisms, wound healing can often feel like an uphill, never-ending battle. There are often elements that cannot be allayed, and some factors will always be outside the control of the patient and the practitioner. Barriers that can be eliminated should be, but sometimes compliance is a concern.

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Palliative Care

by the WoundSource Editors

Pressure Injury/Ulcer Risk Management in Palliative Care and Hospice

Palliative care and hospice care are not the same, but they both share one goal. They both focus on a patient's physical, mental, social, and spiritual needs. Palliative care can begin at diagnosis and treatment or for patients at any stage of their illness. Patients may not want to receive aggressive treatment of non-healing wounds because of underlying diseases, pain, and/or cost.1

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