Black J, Cox J, Capasso V, Bliss DZ, Delmore B, Iyer V, Massaro J, Munro C, Pittman J, Ayello EA, et al.
Advances in skin & wound care. Date of publication 2023 Sep 1;volume 36(9):470-480.
1. Adv Skin Wound Care. 2023 Sep 1;36(9):470-480. doi:
10.1097/ASW.0000000000000032. Epub 2023 Aug 7.
Current Perspectives on Pressure Injuries in Persons with Dark Skin Tones from
the National Pressure Injury Advisory Panel.
Black J(1), Cox J, Capasso V, Bliss DZ, Delmore B, Iyer V, Massaro J, Munro C,
Pittman J, Ayello EA.
Author information:
(1)Joyce Black, PhD, RN, FAAN, is President, National Pressure Injury Advisory
Panel, and Florence Niedfelt Professor of Nursing, College of Nursing,
University of Nebraska, Lincoln, USA. Jill Cox, PhD, RN, APN-C, CWOCN, FAAN, is
Member, Board of Directors, National Pressure Injury Advisory Panel; Clinical
Professor, Rutgers University School of Nursing, New Jersey; and
Wound/Ostomy/Continence Advanced Practice Nurse, Englewood Health, New Jersey.
Virginia Capasso, PhD, CNP, CNS, CWS, FAAN, is Member, Board of Directors,
National Pressure Injury Advisory Panel; Instructor in Surgery, Harvard Medical
School, Boston, Massachusetts; and Advanced Practice Nurse and Nurse Scientist,
Massachusetts General Hospital, Boston. Donna Z. Bliss, PhD, RN, FAAN, is School
of Nursing Foundation Professor of Nursing Research, and Chair, Adult and
Gerontological Health Cooperative, University of Minnesota School of Nursing,
Minneapolis. Barbara Delmore, PhD, RN, CWCN, MAPWCA, IIWCC, FAAN, is Alumna,
Board of Directors, National Pressure Injury Advisory Panel, and Senior Nurse
Scientist and Clinical Assistant Professor, NYU Langone Health, New York.
Vignesh Iyer, MS, is Director, Medical Affairs, Bruin Biometrics, Los Angeles,
California. Jacqueline Massaro, MSN, RN, CWOCN, is Wound/Ostomy/Continence
Nurse, Brigham and Women's Hospital, Boston, Massachusetts. Cassendra Munro,
PhD, RN, CNOR, is Nurse Scientist, Office of Research Patient Care Services,
Stanford Health Care, Palo Alto, California. Joyce Pittman, PhD, RN, ANP-BC,
FNP-BC, CWOCN, FAAN, is Alumna, Board of Directors, National Pressure Injury
Advisory Panel, and Associate Professor, College of Nursing, University of South
Alabama, Mobile. Elizabeth A. Ayello, PhD, RN, CWON, MAPWCA, FAAN, is Alumna,
Board of Directors, and Past President, National Pressure Injury Advisory Panel,
and President, Ayello, Harris & Associates, Inc, New York.
BACKGROUND: Pressure injury (PI) development is multifactorial. In patients with
dark skin tones, identifying impending PIs by visual skin assessment can be
especially challenging. The need for improved skin assessment techniques,
especially for persons with dark skin tones, continues to increase. Similarly,
greater awareness of the need for inclusivity with regard to representation of
diverse skin colors/tones in education materials is apparent.
OBJECTIVE: To provide current perspectives from the literature surrounding skin
assessment and PI development in patients with dark skin tones.
METHODS: The following elements will be discussed through the lens of skin tone:
(1) historical perspectives of PI staging from the National Pressure Injury
Advisory Panel, (2) epidemiology of PI, (3) anatomy and physiology of the skin,
(3) skin tone assessment and measurement, (4) augmented visual assessment
modalities, (5) PI prevention, (6) PI healing, (7) social determinants of
health, and (8) gaps in clinician education.
CONCLUSIONS: This article highlights the gap in our clinical knowledge regarding
PIs in patients with dark skin tones. Racial disparities with regard to PI
development and healing are especially clear among patients with dark skin
tones. Skin tone color assessment must be standardized and quantifiable in
clinical education, practice, and research. This work is urgently needed, and
support from private and governmental agencies is essential.
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
DOI: 10.1097/ASW.0000000000000032
PMID: 37590446 [Indexed for MEDLINE]
