The aetiology of deep tissue injury: a literature review

Deep tissue injury affects patients of all ages in a variety of healthcare settings. It is therefore essential that nurses are aware of the underlying pathogenesis, in order to accurately assess the pressure ulcer risk of vulnerable patients, and to subsequently reduce patient harm. The majority of pressure ulcers are avoidable, however, a variety of intrinsic and extrinsic factors can contribute towards the development of deep tissue injury. Understanding the body's internal responses to external pressure will enable nurses to recognise that a visual assessment alone may not necessarily identify patients at risk of deep tissue damage. This article reviews the evidence for the internal causative mechanisms of deep tissue injury, while linking to clinical practice and pressure ulcer prevention.