Sullivan R
Ostomy/wound management. Date of publication 2013 Sep 1;volume 59(9):30-9.
1. Ostomy Wound Manage. 2013 Sep;59(9):30-9.
A two-year retrospective review of suspected deep tissue injury evolution in
adult acute care patients.
Sullivan R(1).
Author information:
(1)Mayo Clinic-Florida Campus, Jacksonville, FL; email: sullivan.rhonda@mayo.edu.
Suspected deep tissue injury (sDTI) was recently defined as a pressure ulcer
category, and knowledge about the evolution of these ulcers is limited. The
purpose of this single-site, 2-year, retrospective, IRB-approved study was to
increase understanding of the evolution and outcomes of sDTI. Inclusion criteria
were hospitalized patients, 18 years or older, with a sDTI confirmed by a wound
care nurse. Patient charts and WOC nurse notes were examined and patient
demographics and DTI variables abstracted. All patients received standardized,
comprehensive care for pressure ulcer prevention and treatment. Seventy-seven
(77) patients, average age 67.5 years (range 32-91 years), with 128 sDTIs were
identified and included in the study. The majority were men (52, 67.5%) and
non-Hispanic Caucasian (68, 88.3%). Twenty-three (23, 31%) were overweight. The
most common comorbidities were coronary artery disease (38, 50%) and diabetes
mellitus (33, 43%), and the vast majority (67, 88.1%) had altered mobility (67,
88.1%), spent time in the intensive care unit (64, 84.2%), and were incontinent
(64, 84.2%). The most common areas involved were the sacrum (51, 39.8%) and the
heel/Achilles region (37, 28.9%). Maroon-purple discoloration of intact skin was
the most commonly documented presentation (115 ulcers, 89.9%). Average length of
follow-up was 6 days (range 1 day to 14 weeks). At the final assessment, 85 sDTIs
(66.4%) completely resolved or were progressing toward resolution, 31 remained
unchanged and were still documented as purple-maroon discoloration or a
blood-filled blister, and deterioration to full-thickness tissue loss occurredin
12 (9.3%). These observations may offer important insights into the evolution of
sDTIs. Research is needed to identify sDTI risk factors and most effective
protocols of care.
PMID: 24018390 [Indexed for MEDLINE]
