Histopathology

Parish, Lawrence Charles; Witkowski, Joseph A.; Crissey, John Thorne

doi:10.1007/978-3-642-60509-3_8

Cited by 1 publication

(1 citation statement)

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“…All of these cellular changes result in inflammation and edema at the site of injury. Inflammation is the earliest sign of impending ulceration 17-20 and inflammatory changes exist in the tissues before damage is fully visible on the skin surface. Inflammatory changes and tissue edema occur from 3-10 days before visible skin breakdown 21,22 .Thus, in the physiological cascade leading to frank ulceration, detecting damage to the tissue before it is visible could lead to more effective prevention practices and less severe skin damage.…”

Section: Introductionmentioning

confidence: 99%

Subepidermal Moisture Is Associated With Early Pressure Ulcer Damage in Nursing Home Residents With Dark Skin Tones

Bates‐Jensen

McCreath

Pongquan

2009

Journal of Wound, Ostomy &Amp; Continence Nursing

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OBJECTIVE To examine the relationship between a measure of skin and tissue water, sub-epidermal skin moisture (SEM), and visual assessment of early PU damage in nursing home (NH) residents with dark skin tones. DESIGN, SETTING AND PARTICIPANTS Descriptive, cohort study with 66 residents in four U.S. nursing homes (NH). METHODS Data were pooled from two previous NH studies to evaluate persons with dark skin tones. Data were analyzed for concurrent visual assessments and SEM which were obtained at the right and left buttocks and sacrum weekly for 20 weeks. SEM was measured with a surface electrical capacitance dermal phase meter, where higher readings indicate greater SEM (range: 0-999 dermal phase units [DPU]). Visual assessment was rated as normal, erythema/stage I PU, or stage II+ PU. SEM and specific SEM threshold values (50, 150, 300 DPU) were modeled as detectors of visual assessment of early PU one week later (controlling for clustering and incontinence); with concurrent SEM, and PU risk status, in separate analyses for persons with light and dark skin tones. RESULTS Participants had a mean age of 84 years, were 83% female, 77% non-Hispanic white. Higher SEM predicted greater likelihood of erythema/stage I PU and stage II+ PU in persons with dark skin tones the next week (OR=1.88 for every 100 DPU increase in SEM, p=0.004). When SEM was greater than 50, 150, and 300 DPU, persons with dark skin tones were 8.5, 13, and 10 times more likely to present with stage II+ PU the following week compared to persons with light skin who were 7.2, 3.5, and 4.3 times more likely to present with stage II PU (50, 150, 300 DPU, respectively). SEM threshold of 50 DPU was also significant for detecting erythema/stage I PU in persons with dark skin tones (OR 5.3, CI 1.87—15.11, P<.001). CONCLUSIONS SEM was associated with future (one week later) PU in persons with dark skin tones. SEM threshold values may assist in detecting early PU in persons with dark skin tones, allowing for earlier intervention to prevent PU. These findings should be further evaluated in persons with dark skin tones.

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Section: Introductionmentioning

confidence: 99%