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KMID : 1190620140100020489
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Journal of the Korean Wound Care Society
2014 Volume.10 No. 2 p.489 ~ p.93
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Suspected Deep Tissue Injury and Managing Shearing Force
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Park Kyung-Hee
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Abstract
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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.
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KEYWORD
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Pressure ulcer, Shearing force, Prevention, Deep Tissue Injury
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