Friction Injury Versus Deep Tissue Injury Level of Tissue Involvement A Comparison of 2 CasesBerke, Christine ThiesJournal of Wound, Ostomy and Continence Nursing: November/December 2019 - Volume 46 - Issue 6 - p 539–542 doi: 10.1097/WON.0000000000000596 Challenges in Practice Buy Abstract Author InformationAuthors Article MetricsMetrics BACKGROUND: Friction injuries are postulated to be caused by acute or chronic abrasive/friction forces during sliding, scooting, or slouching behaviors prevalent in individuals with impaired mobility and particularly when transferring and repositioning. CASES: Patient histories for 2 cases were collected for determination of wound etiology. Outpatient wound clinic visits including photographic documentation for both cases were reviewed, compared, and contrasted for level of tissue involvement with each wound type/etiology. With serial sharp debridement of both wounds, differences were noted in level of tissue involvement/destruction. Healing progression and scarring were also different for both wounds. CONCLUSION: A comparison of 2 cases is presented to compare and contrast level of tissue involvement and destruction in an acute friction injury (top-down) versus a deep tissue injury (bottom-up). The importance of knowing a wound's history is critical for accurate diagnosis and coding. Christine Thies Berke, MSN, APRN-NP, CWOCN-AP, AGPCNP-BC, 981201 Nebraska Medicine, Omaha. Correspondence: Christine Thies Berke, MSN, APRN-NP, CWOCN-AP, AGPCNP-BC, 981201 Nebraska Medicine, Omaha, NE 68198 (email@example.com or firstname.lastname@example.org). The author declares no conflicts of interest. © 2019 by the Wound, Ostomy and Continence Nurses Society.