Association of skin tone and pressure injury severity in an international prevalence survey sample

BACKGROUND: Decades of research show that individuals who are Black experience higher-stage pressure injuries (PIs) than other racial/ethnic groups. Investigators primarily attribute differences to difficulty visualizing early injury in dark skin tones. Yet, few have actually measured skin tone. PURPOSE: This novel study examined the relationship between Monk Skin Tone Scale assessments and PI stage using an international PI prevalence database. METHODS: Multinomial logistic regression models for hospital-acquired and community-acquired PI stage were employed, controlling for common covariates. DISCUSSION: Medium-DST (Monk 06-10) were associated with a two- to fourfold relative risk of developing a stage 2 or stage 3+ PI versus stage 1. CONCLUSION: Recent literature combined with study results indicates a widespread skin tone-research gap. Comprehensive efforts are needed. Leaders must set research priorities, shape policy, and model standards in education and practice that promote representation across the spectrum of human skin tones.