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ARCHIVES - 2005 NEWS
WOCN Society Response to NPUAP White Papers: Deep Tissue Injury, Stage I Pressure Ulcers, and Stage II Pressure Ulcers
The following descriptor for deep tissue injury has been excerpted from
Joyce M. Black, PhD, RN; Steven B. Black, MD, FACS
Wounds 15(11):380, 2003. ? 2003 Health Management Publications, Inc.
"Deep tissue injury is an evolving term to describe a variation of pressure
ulcers that appear initially as bruised or dark tissue.[1] Historically,
these lesions have been called malignant lesions,[2] closed pressure
ulcers,[3] and purple or evolving pressure ulcers in clinical records. The
location of injury is the muscle bed or subcutaneous fat. The skin is
usually intact at the time of initial assessment and may be described as a
form of a stage 1 pressure ulcer.[4] However, its rapid deterioration to a
full-thickness injury is unlike a true stage 1, which is a resolvable
lesion. Areas of superficial blistering or broken blisters appear within 24
hours, similar to those seen with fractures or ischemic flaps. The tissues
evolve to appear necrotic superficially on the sacrum or heel and can evolve
into full-thickness ulcers despite the best of care. Complete offloading,
with the patient turning only from side to side, was used in this case along
with a low air-loss bed."
References:
- NPUAP. Deep Tissue Injury Task Force. Reston, VA: National Pressure
Ulcer Advisory Panel, 2002.
- Groth KE. Clinical observations and experimental studies on the origin
of decubiti. Acta Clin Scand 1942;87(76 Suppl):1-209.
- Shea JD. Pressure sores: Classification and management. Clinical
Orthopedics 1875;112:89-100.
- Russell L. Pressure ulcer classification: Defining early skin damage. Br
J Nurs 2002;11(16):33-41.
- Daniel RK, Kerrigan CL. Principles and physiology of skin flap surgery.
In: McCarthy J (ed). Plastic Surgery. Philadelphia, PA: WB Saunders,
1990:275-328.
- Russell L. Pressure ulcer classification: Defining early skin damage. Br J Nurs 2002;11(16):S33-S41.
Click here to access the document
Wound Care Strategies appoints Lucinda J. Rook, RN, CPC as Coding and Documentation Analyst
For more information,
please read the press release.(PDF format)
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