Can ultrasonographic evaluation of subcutaneous fat predict pressure ulceration?

Abstract

High-resolution ultrasound may be able to detect pressure ulcers before clinical signs emerge. This retrospective study found that one such early indicator is inflammatory oedema in the subcutaneous fat, which resolves as healing occurs.

Screening of Foot Inflammation in Diabetic Patients by Non-Invasive Imaging Modalities

“…Ultrasonography is a non-invasive, inexpensive and portable technique, and thus it has been gradually used in the broad area of medicine. For the assessment of the skin, a 20 MHz probe is more widely used for the search and imaging of lymph nodes, chronic ulcers and subcutaneous tumors in a variety of clinical settings (Schmid-Wendtner & Burgdorf, 2005;Yabunaka et al, 2009). However, we focused on the subcutaneous tissue damage using a 10 MHz probe in this study, because it is known that the deep tissue damages precede skin breakdown when the callus is developed into the full thickness skin ulcer (Apelqvist et al, 2000;Apelqvist et al, 2008;Edmonds & Foster, 2006).…”

“…20 MHz ultrasonography is more popular among dermatologic specialists because of higher image resolution of the more superficial skin layer such as the epidermis and the dermis (Schmid-Wendtner & Burgdorf, 2005). However, 20 MHz ultrasonography can only produce images 20 mm below the skin surface (Yabunaka et al, 2009). We selected 10MHz ultrasonography in this study for focusing on the subcutaneous or muscle layers which may be more prone to be damaged by external forces (Nishide et al, 2009).…”

“…We selected 10MHz ultrasonography in this study for focusing on the subcutaneous or muscle layers which may be more prone to be damaged by external forces (Nishide et al, 2009). Our group routinely uses 10 MHz ultrasonography for obtaining sufficient visualization of the pressure-related deep tissue injury Nagase et al, 2007;Yabunaka et al, 2009), providing considerable justification for our choice in this study.…”

“…Delayed healing of pressure ulcers due to latent inflammation could be prospectively evaluated by high temperature of wound bed visualized by thermography (Nakagami et al, 2010). Also, the subcutaneous tissue damages such as edema or the discontinuous fascia could be clearly visualized by ultrasonography in the patients with pressure ulcers of the deep tissue injury type Nagase et al, 2007;Yabunaka et al, 2009). …”

Three-dimensional ultrasound imaging of the pressure ulcer. A case report

“…Previous reports suggested the use of two-dimensional ultrasound (2D-US) to assess the pathogenesis of PUs [4][5][6][7][8], based on its ability to produce high-quality images of superficial tissue and its safety and utility in daily practice. However, 2D-US does not completely depict a PU in a single image.…”