A two-year retrospective review of suspected deep tissue injury evolution in adult acute care patients.

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.