Neesha Oozageer Gunowa, Marie Hutchinson, Joanne Brooke, Debra Jackson

In this paper we aimed to explore the literature to ascertain what research evidence exists in relation to the identification of pressure injuries (PIs) in people with dark skin tones (DSTs). PI development has been widely researched and documented; however, much of this work does not address ethnicity or race, and assumes Caucasian-ness. Thus, the perceptions of people with DSTs and the influence of skin pigmentation on identification and management of PIs is under examined. Literature review. A comprehensive electronic database search was undertaken of PubMed, Cumulative Index for Nursing and Allied Health Literature, Cochrane and British Nursing Index between 1990 - July 2016. Alongside the electronic data, journals, books, papers from conferences, relevant national and international organisations and reference lists were also used to help source key studies. A search of the literature revealed 11 relevant articles. The foci of studies included: risk of sustaining a PI based on skin tones; identification of PIs amongst people with DSTs; PI and place of care; and socio-economic impact on PI development. Overall, findings indicate that people with darker skin tones are more likely to develop higher stage pressure injuries. Reasons for this are not fully elucidated; however, it may be associated with current skin assessment protocols being less effective for people who have darker skin tones resulting in early damage arising from pressure not being recognised. From the literature reviewed it can be seen that there is a lack of guidance and evidence, people with darker skin tones are more likely in comparison to people presenting as Caucasian to develop higher stage pressure injuries. The current literature suggests a need for researchers and clinicians to consider skin tone variances rather than ethnicity when exploring comprehensive skin assessment. This article is protected by copyright. All rights reserved.