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  1. VanGilder, Catherine MBA, BS, MT, CCRA
  2. MacFarlane, Gordon D. PhD
  3. Harrison, Patrick BA
  4. Lachenbruch, Charlie PhD
  5. Meyer, Stephanie


OBJECTIVE: Suspected deep tissue injury (sDTI) was identified in 2001 and added as a staging definition by the National Pressure Ulcer Advisory Panel in 2007. Clinical data on sDTI are sparse. This article reports the overall prevalence data and describes the demographics of subjects with sDTI from the International Pressure Ulcer Prevalence survey 2006-2009.


METHODS: Participating healthcare facilities performed prevalence surveys in their facility during a pre-determined 24-hour period within a pre-selected 2- to 3-day window. All generated data was incorporated into the database, even if specific data fields were absent.


RESULTS: Approximately 79,000 to 92,000 patients were surveyed each year from 2006 to 2009. The overall and nosocomial pressure ulcer (PrU) prevalence decreased by approximately 1% in 2009 (P < .001), after remaining fairly constant in the years 2006-2008. The proportion of ulcers identified as sDTI has increased 3 fold, to 9% of all observed ulcers in 2009 and is more prevalent than either Stage III or IV ulcers. Over the same period, the proportion of Stage I and II ulcers have decreased, and the proportion of Stage III and IV ulcers has remained nearly constant. Patients with sDTIs are older than patients with Stage III, IV, and Unstageable ulcers. The anatomic location of sDTIs are more commonly found at the heel (41%), the sacrum (19%), or the buttocks (13%). Compared with other staged ulcers, sDTIs are significantly more prevalent at the heel (P < .001) and the ankle and foot (P < .001) and less prevalent at the sacrum and coccyx (P < .001) and at the buttocks and ischial tuberosities (P < 0.001).


CONCLUSION: The survey data indicate that a decrease in overall prevalence of PrUs, as well as hospital-acquired PrUs, may have occurred in 2009. Suspected deep tissue injuries have become more commonly identified, which may be secondary to education of staging definitions.