Wound Management

All About Deep Tissue Injury

A deep tissue injury is just what it sounds like; an injury to underlying tissue below the skin's surface. This injury is a unique form of pressure ulcer that restricts blood flow to the tissue causing it to die. Unlike a pressure sore, a deep tissue injury affects deeper tissue as opposed to the surface of the skin.

A deep tissue injury (DTI) can be painful and debilitating and lead to life-threatening issues. Even with treatment, it can quickly deteriorate into your worst nightmare, and since it's not an obvious injury, it's easy to miss.  

Anatomy of a Deep Tissue Injury  

What differentiates a deep-tissue injury from a pressure sore?

According to the National Pressure Ulcer Advisory Panel (NPUAP), a DTI is defined as a purple/maroon area of discolored intact skin or a blood-filled blister due to damage to underlying soft tissue. It is potentially dangerous because DTIs begin in the muscle closest to the bone and may not be apparent in its early stages, making early identification and aggressive treatment imperative. Three proactive treatments to prevent DTIs include:  

1. Movement of immobile patients and proper support surfaces  
2. Keep skin dry and clean  
3. Proper hydration/nutrition  

Stages & Symptoms of DTI  

If a deep tissue injury is similar to a pressure ulcer but more dangerous, how do you determine you're dealing with a DTI?

Since treatment may differ, it's imperative to get it right for proper healing. The NPUAP identifies the symptoms of DTI as follows:  

• Intact/non-intact skin with localized non-blanchable deep red, maroon, or purple discoloration  
• Pain and temperature change proceeding skin color change
• Tissue that is painful, firm, mushy, or warmer/cooler than surrounding tissue  
• DTIs can be more difficult to diagnose in people with darker skin tones  

When diagnosing a DTI/pressure ulcer, understanding the severity can determine the course of treatment. Experts identify the six stages of pressure injuries as follows:  

• Stage 1: Skin may be painful, but no breaks/tears. Appearance may be red/discolored, and the temperature is often warmer.  
• Stage 2: Painful/tender ulcer appears due to skin breakdown. Sore can look like an abrasion, shallow crater, or blister.  
• Stage 3: Sore extends to tissue below the skin, forming a crater. Fat may appear in the sore.  
• Stage 4: Sore extends into muscle and bone, causing extensive damage. Damage to deeper tissue, tendons, and joints may occur.  
• Unstageable: The base of the sore is covered by other tissue and pus, making it difficult to identify the stage.
• Suspected deep tissue injury (sDTI): When deep tissue injury is suspected but can't be confirmed. The skin may look purple, or a blood-filled blister may be present.  

When treating a deep tissue injury, the right products can make all the difference. There are a plethora of medical aids available at HPFY to deal with deep tissue injuries. Three medical aids that may benefit your treatment include:  

1. 3M Tegaderm Transparent Film Dressing-Picture Frame Style: These FSA-eligible dressings are designed to protect wounds and maintain a moist wound bed. They can be used as a primary/secondary dressing over chronic wounds and are waterproof and transparent.  
2. MTS SafetySure Transfer Slide: Perfect for those who are immobile or have limited mobility, the frictionless inner liner facilitates a smooth transfer and extra comfort for skin issues. Limits strain on caregivers.  
3. Hollister Restore Extra Thin Hydrocolloid Dressing: This dressing helps protect skin from friction injuries and is FSA approved. Protects against bacterial and viral contaminants without leakage.  

Any skin breakdown can lead to serious problems down the road. Early identification of a deep tissue injury can be crucial in treating it successfully. Work with your doctor or nurse to develop a wound care plan that works for you. Establish a plan, be proactive, and be diligent!! Visit Health Products For You for all of your wound care for skin needs. 

 

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