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Subepidermal Moisture Predicts Erythema and Stage 1 Pressure Ulcers in Nursing Home Residents: A Pilot Study

2007; Wiley; Volume: 55; Issue: 8 Linguagem: Inglês

10.1111/j.1532-5415.2007.01261.x

1532-5415

Barbara M. Bates‐Jensen, Heather McCreath, Ayumi Kono, Neil Christopher R. Apeles, Cathy A. Alessi,

Diagnosis and Treatment of Venous Diseases

OBJECTIVES: To examine the relationship between a measure of subepidermal moisture (SEM) and visual skin assessment (VSA) of erythema and Stage 1 pressure ulcers (PUs) performed a week later in nursing home (NH) residents. DESIGN: Descriptive, cohort study. SETTING: Two NHs. PARTICIPANTS: Thirty‐five residents. METHODS: Concurrent VSAs and SEM readings were obtained at the sacrum, right and left trochanters, buttocks, and ischial tuberosities weekly for 52 weeks. SEM was measured using a handheld dermal phase meter, with higher readings indicating greater SEM (range 0–999 dermal phase units [DPUs]). VSA was rated as normal, erythema/Stage 1 PU, or Stage 2+PU. SEM was modeled as a predictor of VSA of erythema and PUs 1 week later (controlling for clustering), with concurrent moisture, Braden Scale PU risk status, anatomic site, and ethnicity as covariates. RESULTS: Participants had a mean age of 84.7, 83% were female, and 80% were non‐Hispanic white. SEM measures were lowest for normal skin (97±122 DPU), higher for erythema/Stage 1 PUs (192±188 DPU), and highest for Stage 2+PUs (569±320 DPU) across all sites (all P <.001). SEM was responsive to changes in VSA, and higher SEM predicted greater likelihood of erythema/Stage 1 PU the next week (odds ratio=1.26 for every 100‐DPU increase in SEM, P =.04). CONCLUSION: SEM measures are associated with concurrent erythema and PUs and future (1 week later) development of erythema/Stage 1 PUs. SEM may assist in predicting early PU damage, allowing for earlier intervention to prevent skin damage.