Lecturer, Adult Nursing, University of Salford, Mary Seacole Building.
Br J Nurs. 2021 Mar 11;30(5):S32-S37. doi: 10.12968/bjon.2021.30.5.S32.
Deep tissue injuries (DTIs) were added to pressure ulcer grading systems in 2009. Since then, they have been associated with the same aetiological processes as other forms of pressure injury (PI). This is despite notable clinical differences in their presentation along with variations in natural history that suggest they are the consequence of processes distinct from those that cause other PIs. Understanding the aetiology of DTIs is essential to guide prevention and treatment in addition to ensuring healthcare governance processes deeply tied to pressure injury are effective and efficient. Current understanding of the aetiology of DTI has significant gaps, with several key challenges impeding progress in this area of PI research, including inconsistent reporting by healthcare services and the limitations of animal and computer models in addition to the ethical barriers to conducting studies on human subjects. Synthesis of early studies with studies undertaken before 2009 is also limited by the variety in definitions of DTI used before that published by the European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance in 2009. To date, few prospective clinical studies have been conducted. This article presents a narrative review on the clinical and animal study evidence indicating contemporary understanding of DTI.
深部组织损伤（DTI）于 2009 年被纳入压疮分级系统。从那时起，它们与其他形式的压疮（PI）具有相同的病因过程。尽管在临床表现上存在明显的差异，其自然病史也存在差异，但这表明它们是由与导致其他 PI 的过程不同的过程引起的。了解 DTI 的病因对于指导预防和治疗至关重要，此外还确保与压疮密切相关的医疗保健治理流程既有效又高效。目前对 DTI 病因的理解存在重大差距，其中包括几个关键挑战，这些挑战阻碍了 PI 研究领域的进展，包括医疗服务机构报告不一致、动物和计算机模型的局限性以及对人类进行研究的伦理障碍主题。此外，在 2009 年欧洲压疮咨询小组、国家压疮咨询小组和泛太平洋压疮联盟发表之前，早期研究与 2009 年之前进行的研究的综合也受到 DTI 定义多样性的限制。迄今为止，很少有前瞻性临床研究。本文对临床和动物研究证据进行了叙述性综述，这些证据表明了对 DTI 的当代理解。
