Black JM, Brindle CT, Honaker JS, et al.
International wound journal. Date of publication 2016 Aug 1;volume 13(4):531-9.
1. Int Wound J. 2016 Aug;13(4):531-9. doi: 10.1111/iwj.12471. Epub 2015 Jun 30.
Differential diagnosis of suspected deep tissue injury.
Black JM(1), Brindle CT(2), Honaker JS(3).
Author information:
(1)College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA.
(2)Wound Care Team, Virginia Commonwealth University Medical Center, Richmond,
VA, USA.
(3)Department of Dermatology, University Hospitals of Cleveland, Cleveland, OH,
USA.
Deep tissue injury (DTI) can be difficult to diagnose because many other skin and
wound problems can appear as purple skin or rapidly appearing eschar. The
diagnosis of DTI begins with a thorough history to account for times of exposure
to pressure, such as 'time down' at the scene or time during which the patient
was flat and could not respond. Patients with light skin tones present with
classic skin discolouration of purple or maroon tissue, a defined border around
the area of injury, and often surrounding erythema is evident. Persistent
erythema and hyperpigmentation, rather than blanching, should be used to
determine pressure injury in dark skin tone patients. Differential diagnosis
includes stage 2 pressure ulcers, incontinence-associated dermatitis, skin tears,
bruising, haematoma, venous engorgement, arterial insufficiency, necrotising
fasciitis and terminal skin ulcers. Many skin problems can also have a purple hue
or rapidly developing eschar, and a working knowledge of dermatology is needed.
© 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.
DOI: 10.1111/iwj.12471
PMID: 26123043 [Indexed for MEDLINE]
