Suspected Deep Tissue Injury and Managing Shearing Force

J Korean Wound Management Soc > Volume 10(2); 2014 > Article

Review

Journal of the Korean Wound Management Society 2014;10(2): 89-93.

심부조직손상의심 욕창(Suspected Deep Tissue Injury)과전단력(Shearing Force) 관리

박경희

삼성서울병원 간호본부

Suspected Deep Tissue Injury and Managing Shearing Force

Kyung Hee Park

Department of Nursing, Samsung Medical Center, Seoul, Korea

Published online: 30 November 2014.

ABSTRACT

Pressure ulcer (PU) is the most serious manifestation of impaired skin integrity. It develops in all types of medicalfacilities. Recently, Unstageable and suspected Deep Tissue Injury (sDTI) are newly added to the original 4 stagesof PU by National Pressure Ulcer Advisory Panel (NPUAP). Normally, it is difficult to distinguish the stages of PU withbare eyes unless health care providers are well trained. sDTI is especially tricky one to be distinguished from StageI or Stage II PU and it is very progressed stage. Especially sDTI is caused by the imposed shearing force when thebody slides down due to the gravity and it turn out to be necrosis seriously. Thus, maintaining immobile patientsin a supine position in order to decrease shear forces and friction caused by sliding down in the bed may reducethe risk for PU development, but most critically ill patients at risk of developing a PU cannot remain in a supine positiondue to respiratory or enteral feeding problems. As a result, many are positioned with the head of bed (HOB) elevatedto 30o and it causes continuous shearing force. Therefore we should understand shearing force and search thestrategies to prevent serious DTI. (J Korean Wound Management Soc 2014;10:89-93)

Key Words: Pressure ulcer, Shearing force, Prevention, Deep Tissue Injury