Differential diagnosis of suspected deep tissue injury

Joyce M. Black, Christopher T. Brindle, Jeremy S. Honaker

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)531-539
Number of pages9
JournalInternational Wound Journal
Volume13
Issue number4
DOIs
StatePublished - Aug 1 2016

Fingerprint

Differential Diagnosis
Skin
Wounds and Injuries
Skin Pigmentation
Erythema
Skin Ulcer
Necrotizing Fasciitis
Pressure
Hyperpigmentation
Pressure Ulcer
Hyperemia
Dermatitis
Dermatology
Hematoma
History
Light

Keywords

  • Differential diagnosis
  • Pressure ulcers
  • Suspected deep tissue injury

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

Differential diagnosis of suspected deep tissue injury. / Black, Joyce M.; Brindle, Christopher T.; Honaker, Jeremy S.

In: International Wound Journal, Vol. 13, No. 4, 01.08.2016, p. 531-539.

Research output: Contribution to journalArticle

Black, Joyce M. ; Brindle, Christopher T. ; Honaker, Jeremy S. / Differential diagnosis of suspected deep tissue injury. In: International Wound Journal. 2016 ; Vol. 13, No. 4. pp. 531-539.
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