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Differentiating Deep Tissue Pressure Injury (DTPI) From Other Causes of Purpura in the Sacrococcygeal Area

A Multiple Case Series

Solmos, Susan; Radkevich-Brown, Olga; LaFond, Cynthia

Journal of Wound Ostomy & Continence Nursing: May/June 2019 - Volume 46 - Issue 3 - p 256–262
doi: 10.1097/WON.0000000000000525
Challenges in Practice
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BACKGROUND: Recent revisions to the pressure injury staging system include guidance on differential diagnoses for deep tissue pressure injury (DTPI). Accurately identifying DTPI is critical; however, purpura in the setting of vascular disorders and systemic infectious processes can share similar features confounding diagnosis.

CASES: In this three-case series, we describe suspected DTPI with an uncharacteristic shape or occurring in the presence of additional lesions distributed outside of typical pressure areas prompted further evaluation.

CONCLUSIONS: The interdisciplinary approach we adapted was useful in determining the cause of purpura when the DTPI was ruled out by the certified wound care nurse.

Susan Solmos, MSN, RN, CWCN, Center for Nursing Professional Practice & Research, The University of Chicago Medicine, Chicago, Illinois.

Olga Radkevich-Brown, MD, PhD, Section of Dermatology, Department of Medicine, The University of Chicago Medicine, Chicago, Illinois.

Cynthia LaFond, PhD, RN, CCRN-K, Center for Nursing Professional Practice & Research, The University of Chicago Medicine, Chicago, Illinois.

Correspondence: Susan Solmos, MSN, RN, CWCN, Center for Nursing Professional Practice & Research, The University of Chicago Medicine, 5841 S. Maryland Ave, Rm Wyler C145, MC1083, Chicago, IL 60637 (susan.solmos@uchospitals.edu).

Conflicts of Interest: None declared.

© 2019 by the Wound, Ostomy and Continence Nurses Society.