Joyce Black, PhD, RN, FAAN, is President, National Pressure Injury Advisory Panel, and Florence Niedfelt Professor of Nursing, College of Nursing, University of Nebraska, Lincoln, USA. Jill Cox, PhD, RN, APN-C, CWOCN, FAAN, is Member, Board of Directors, National Pressure Injury Advisory Panel; Clinical Professor, Rutgers University School of Nursing, New Jersey; and Wound/Ostomy/Continence Advanced Practice Nurse, Englewood Health, New Jersey. Virginia Capasso, PhD, CNP, CNS, CWS, FAAN, is Member, Board of Directors, National Pressure Injury Advisory Panel; Instructor in Surgery, Harvard Medical School, Boston, Massachusetts; and Advanced Practice Nurse and Nurse Scientist, Massachusetts General Hospital, Boston. Donna Z. Bliss, PhD, RN, FAAN, is School of Nursing Foundation Professor of Nursing Research, and Chair, Adult and Gerontological Health Cooperative, University of Minnesota School of Nursing, Minneapolis. Barbara Delmore, PhD, RN, CWCN, MAPWCA, IIWCC, FAAN, is Alumna, Board of Directors, National Pressure Injury Advisory Panel, and Senior Nurse Scientist and Clinical Assistant Professor, NYU Langone Health, New York. Vignesh Iyer, MS, is Director, Medical Affairs, Bruin Biometrics, Los Angeles, California. Jacqueline Massaro, MSN, RN, CWOCN, is Wound/Ostomy/Continence Nurse, Brigham and Women's Hospital, Boston, Massachusetts. Cassendra Munro, PhD, RN, CNOR, is Nurse Scientist, Office of Research Patient Care Services, Stanford Health Care, Palo Alto, California. Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, is Alumna, Board of Directors, National Pressure Injury Advisory Panel, and Associate Professor, College of Nursing, University of South Alabama, Mobile. Elizabeth A. Ayello, PhD, RN, CWON, MAPWCA, FAAN, is Alumna, Board of Directors, and Past President, National Pressure Injury Advisory Panel, and President, Ayello, Harris & Associates, Inc, New York.
Adv Skin Wound Care. 2023 Sep 1;36(9):470-480. doi: 10.1097/ASW.0000000000000032. Epub 2023 Aug 7.
Pressure injury (PI) development is multifactorial. In patients with dark skin tones, identifying impending PIs by visual skin assessment can be especially challenging. The need for improved skin assessment techniques, especially for persons with dark skin tones, continues to increase. Similarly, greater awareness of the need for inclusivity with regard to representation of diverse skin colors/tones in education materials is apparent.
To provide current perspectives from the literature surrounding skin assessment and PI development in patients with dark skin tones.
The following elements will be discussed through the lens of skin tone: (1) historical perspectives of PI staging from the National Pressure Injury Advisory Panel, (2) epidemiology of PI, (3) anatomy and physiology of the skin, (3) skin tone assessment and measurement, (4) augmented visual assessment modalities, (5) PI prevention, (6) PI healing, (7) social determinants of health, and (8) gaps in clinician education.
This article highlights the gap in our clinical knowledge regarding PIs in patients with dark skin tones. Racial disparities with regard to PI development and healing are especially clear among patients with dark skin tones. Skin tone color assessment must be standardized and quantifiable in clinical education, practice, and research. This work is urgently needed, and support from private and governmental agencies is essential.
压力性损伤（PI）的发生是多因素的。对于肤色较深的患者，通过肉眼评估皮肤来识别即将发生的 PI 可能特别具有挑战性。因此，需要改进皮肤评估技术，特别是对于肤色较深的人群。同样，人们越来越意识到，在教育材料中，需要更加关注代表性别的多样性，包括不同的肤色/色调。
提供有关深色皮肤人群 PI 评估和发展的文献综述。
将从皮肤色调的角度讨论以下内容：（1）国家压力性损伤咨询小组对 PI 分期的历史观点，（2）PI 的流行病学，（3）皮肤的解剖和生理学，（3）皮肤色调评估和测量，（4）增强的视觉评估方式，（5）PI 预防，（6）PI 愈合，（7）健康的社会决定因素，以及（8）临床医生教育中的差距。
本文强调了我们在深色皮肤人群 PI 方面的临床知识差距。在深色皮肤人群中，PI 的发生和愈合方面的种族差异尤为明显。皮肤色调的评估必须在临床教育、实践和研究中标准化和量化。这项工作迫在眉睫，私人和政府机构的支持至关重要。
