Which statement describes a deep tissue pressure injury?

Which statement describes a deep tissue pressure injury?

• A. Intact or nonintact skin with a deep red, purple, maroon discoloration; usually presents after 48 hours.
• B. Full thickness tissue loss with bone visible.
• C. Slough-covered wound with no color
• D. Localized edema without color change

Answer: (B)

Deep tissue pressure injury is shown by intact or nonintact skin with a deep red, maroon, or purple discoloration, and may include epidermal separation; it often becomes evident after some time—about 48 hours or more. This pattern signals underlying tissue damage beneath the surface rather than an open, full-thickness wound. It differs from a full-thickness tissue loss with bone exposure, which is a Stage 4 pressure injury where structures such as bone are visible. A slough-covered wound with no color change suggests the wound bed is obscured (unstageable until debridement reveals it), and localized edema without color change does not describe tissue loss. Therefore, the described deep red, maroon, or purple discoloration on the skin is the hallmark of a deep tissue pressure injury.

Deep tissue pressure injury is shown by intact or nonintact skin with a deep red, maroon, or purple discoloration, and may include epidermal separation; it often becomes evident after some time—about 48 hours or more. This pattern signals underlying tissue damage beneath the surface rather than an open, full-thickness wound. It differs from a full-thickness tissue loss with bone exposure, which is a Stage 4 pressure injury where structures such as bone are visible. A slough-covered wound with no color change suggests the wound bed is obscured (unstageable until debridement reveals it), and localized edema without color change does not describe tissue loss. Therefore, the described deep red, maroon, or purple discoloration on the skin is the hallmark of a deep tissue pressure injury.