A Retrospective Analysis of Deep Tissue Pressure Injury Prevalence and Incidence Using a Large-Scale Wound Care Database in Long-Term Care Settings Across Two Large Countries

Fraser, R, Mohammed, HT, Wynn, M ORCID: 0000-0001-9021-4747, Gupta, R, Ramachandram, D, Mustafa, S, Goldstone, LG, Pols, C, Rameriz-Garcia Luna, J, Woo, K, Moralejes, J, Cassata, A and Black, J A Retrospective Analysis of Deep Tissue Pressure Injury Prevalence and Incidence Using a Large-Scale Wound Care Database in Long-Term Care Settings Across Two Large Countries. Advances in Skin & Wound Care. ISSN 1527-7941 (Accepted)

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Abstract

Objective: Deep tissue pressure injuries (DTPIs) are a severe form of pressure injuries (PIs) that originate in deeper skin layers and are associated with high morbidity and healthcare costs, particularly in elderly population in long-term care. The Centers for Medicare & Medicaid Services have prioritized DTPIs prevention as a quality measure for skilled nursing facilities (SNFs). Early detection through regular skin inspection and risk assessment is critical. Digital Wound Care Solutions (DWCS) support standardized wound evaluation through images and documentation. This study used DWCS dataset from over two million residents and 100,000 DTPIs to explore prevalence and incidence in SNFs (2019–2023).

Methods: A retrospective study was conducted to extract DTPI data from 3,920,280 wound care data of 937,363 residents across SNFs. DTPI prevalence was subcategorized by age and sex. Chi-squared tests and post-hoc Bonferroni correction assessed associations between residents’ characteristics and DTPI distribution. The dataset included 204,706 unique DTPI wounds from 120,689 residents across 4,053 SNFs using DWCS.

Results: Annual DTPI prevalence ranged from 5.17% in 2019 to 7.16% in 2021, then stabilized at 6.2% in 2022-2023. Older patients (81-90 years) and females exhibited higher DTPI rates. Incidence rose from 4.94 per 100,000 in 2019 to 6.76 in 2021, followed by a decline in 2022 and slight rebound to 6.11 in 2023.

Conclusions: The rise in DTPI incidence during 2020–2021 may reflect healthcare strain from the COVID-19 pandemic, while stabilization in 2022–2023 suggests improvements in prevention. DWCS are valuable tools for monitoring and advancing DTPI research.

Item Type:	Article
Uncontrolled Keywords:	Deep Tissue Pressure Injury; Digital Wound Care Solution; Incidence; Pressure Injuries; Prevalence; Retrospective Analysis
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RL Dermatology R Medicine > RT Nursing
Divisions:	Nursing and Advanced Practice
Publisher:	Lippincott, Williams & Wilkins
Date of acceptance:	19 November 2025
Date Deposited:	12 Dec 2025 13:07
Last Modified:	12 Dec 2025 13:07
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27707

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