OASIS-C: Difference between DTI and Stage One pressure ulcer


Are your nurses confident they can tell the difference between a Stage I pressure ulcer and a Deep Tissue Injury (DTI)? It is important! A DTI will probably break down and become a Stage III or IV pressure ulcer, or it will become an area of necrosis. A stage I will just go away if the source of the pressure that is causing it is removed. Go through this expert information on wound care management provided by our speaker in a healthcare event.

If a DTI is mis-assessed as a Stage I it won't look very good on in your records when it suddenly becomes a Stage III or IV. That is why it is so significant to get it right!

A Stage I is pink or red. It's erythema. So, it's going to be some of a pale pink to a bright red. It's non-blanchable. It doesn't subside with pressure relief. So, you roll your patient over. The erythema is there. It doesn't blanch. If it’s still there in 15 to 20 minutes, it's likely a stage one.

Our expert mentioned this in one of the home health wound care conferences that you must remember that pressure ulcers are often over bony prominences but not always. We see in home care lots of TV remotes and medicine bottles, even had a handgun. But the point that your nurses need to understand is that stage one is red. In many cases, it's going to subside with pressure relief.

Feb 23, 2018
Barbara J. Cobuzzi
Feb 27, 2018
Duane C. Abbey

A DTI is purple, lavender, maroon, or some other shade of purple. It is purple, purple, purple. Or, it is a blood-filled blister (a serum-filled blister is a Stage II). The tissue injury then is different from a stage one. And it is vitally important that these be correctly identified on the CMS OASIS as such because if you sometimes see just purple – the area over the sacrum that looks a little benign, it's light purple discoloration with skin intact, if that's misidentified as a stage one, and you could be in trouble in a few weeks because while a stage one might resolve without an open wound, ever manifesting itself. A DTI wound is often going to progress to necrosis either a dry stable eschar to full fitness even a soft necrotic area. And so it's very important that nurses are able to tell the difference keeping in line with the recent home health guidelines.

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