Preston Ave, Rao Aditi, Strauss Robyn, Stamm Rebecca, Zalman Demetra
Ave Preston is a clinical nurse specialist at the Hospital of the University of Pennsylvania, Philadelphia, where Aditi Rao is director of nursing practice and Magnet program director, Robyn Strauss is a clinical nurse specialist, Rebecca Stamm is associate director of clinical implementation, and Demetra Zalman is an NP. Contact author: Ave Preston,
Am J Nurs. 2017 May;117(5):50-57. doi: 10.1097/01.NAJ.0000516273.66604.c7.
: A deep tissue pressure injury (DTPI) is a serious type of pressure injury that begins in the muscle closest to the bone and may not be visible in its early stages. Its hallmark is rapid deterioration despite the use of appropriate preventive interventions. In 2007, the National Pressure Ulcer Advisory Panel added suspected deep tissue injuries to the traditional classification system, and by 2010 DTPIs had accounted for about 9% of all pressure injuries and were for the first time more prevalent than stage 3 or 4 pressure injuries. On average, patients who develop these injuries are older and have a lower body mass index than patients who develop other pressure injuries. Most commonly, DTPIs appear on the skin over the coccyx or sacrum, the buttocks, and the heels. This article discusses the pathophysiology; risk factors; and assessment, prevention, and treatment of DTPIs, using a composite case to illustrate the progression of this serious type of pressure injury.
深部组织压力性损伤（DTPI）是一种严重的压力性损伤，始于最靠近骨骼的肌肉，在早期可能不明显。其特点是尽管采取了适当的预防措施，仍会迅速恶化。2007年，国家压力性溃疡咨询小组将疑似深部组织损伤纳入传统分类系统，到2010年，DTPI占所有压力性损伤的约9%，首次比3期或4期压力性损伤更为普遍。平均而言，发生这些损伤的患者比发生其他压力性损伤的患者年龄更大，体重指数更低。最常见的是，DTPI出现在尾骨或骶骨、臀部和足跟上方的皮肤上。本文讨论了DTPI的病理生理学、危险因素以及评估、预防和治疗，并通过一个综合案例来说明这种严重类型压力性损伤的进展。
