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Deep Tissue Injury

chippiebites

Registered User
Jun 27, 2018
83
Hello Can anyone explain the difference between a deep tissue injury and a pressure sore? My husband was in a nursing home for a week to give me a break. When I collected him the home's manager explained that husband had a grade 2 pressure sore on his heel. She said the sore had started the day before. I was advised to inform the DNs. After 7 days one of the nurses said the sore was a now deep tissue injury. My husband had a air mattress in the nursing home, as he does in our home. I have been keeping his heels off the mattress as advised. The sore now looks like a large blood blister, very dark but skin still in tact. Has any one got any experience of this? I wondered how likely it is to clear up without the skin breaking? I have another DN visit on Friday and they are going to redo the care plans. Any information or advice gratefully received.
 

canary

Registered User
Feb 25, 2014
11,630
South coast
Hi @chippiebites
A deep tissue injury is a particular type of pressure sore. Usually the skin gets broken in a pressure sore, but with a deep tissue injury the skin remains intact and the pressure affects the deeper tissue underneath. It looks like a purple bruise or (as in your husbands case) a large blood blister. It can deteriorate quite quickly, so its good that its been recognised and the DNs are on the case.
 

chippiebites

Registered User
Jun 27, 2018
83
Thank you both for your replies. It is nice to know that hopefully the skin will stay intact, I am not sure I would like to see what is underneath. Although the DNs are visiting they are only monitoring, I presume they would only dress the wound if the skin breaks.
 

Palerider

Registered User
Aug 9, 2015
1,428
North West
Thank you both for your replies. It is nice to know that hopefully the skin will stay intact, I am not sure I would like to see what is underneath. Although the DNs are visiting they are only monitoring, I presume they would only dress the wound if the skin breaks.
The sigificant fact to remember about pressure ulcers is that when they become deep the pain stops, because the peripheral nerves have been eroded and destroyed, this is why people forget they have one -no pain anymore. The second feature is to monitor for signs of infection the biggest risk. If you become suspicious about anything point it out to the DN or if you think it can't wait get to the GP or if really unwell hospital.
 

chippiebites

Registered User
Jun 27, 2018
83
Hi @Palerider can there still be infection if the skin doesn't break? My husband is often very quiet and very sleepy, and I wonder how easily I will know if an infection starts.
 

Palerider

Registered User
Aug 9, 2015
1,428
North West
Hi @Palerider can there still be infection if the skin doesn't break? My husband is often very quiet and very sleepy, and I wonder how easily I will know if an infection starts.
Thats a difficult question because although there are no obvious breaks to the skin you can't be certain and the other problem is the bodies response to the build up of essentially puss that lies beneath the skin, which may need surgical debridement. Generally speaking most people don't have big problems as the DN's are amazing at managing pressure ulcers and they know when they need to refer on