How to Treat a Suspected Deep Tissue Injury
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- How to Treat a Suspected Deep Tissue Injury
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Definition
- Localized area of discoloration (purple/maroon) with the skin intact, or a blood filled blister
- The area may be painful, firm, mushy, boggy, warmer, cooler prior to discoloration
Goal
- If possible, remove cause
- Attempt to prevent further tissue damage
Treatment
Obtain a physician order:
- Use Standard Precautions
- Cleanse area gently
- Pat dry: do not rub
- Apply a thin Hydrocolloid Dressing such as Duo Derm Extra Thin or Tegaderm Clear to area
- Change once a week and/or PRN
- Apply skin prep for intact heels
- Educate patient and family about pressure ulcers, turning frequently (as patient chooses/allows) and document education/response by caregiver
- Document per agency protocol
Mattress Recommendation
- Foam
* Note: These are wound care guidelines only. Consult with the primary physician for specific orders.
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