Sacral Skin Temperature Assessed by Thermal Imaging

Abstract

Although infrared thermal screening may provide visually impressive and potentially useful images in some cases, the use of temperature differentials to detect patients at particularly high risk for pressure injury owing to local blood flow is not supported by results of this study.

Application of infrared thermography in the early warning of pressure injury: A prospective observational study

“…What's more, when the yellow abnormal colour gradation appeared in infrared thermal images, no abnormality was found with naked eyes, and thus, early warnings of pressure injury provided the possibility for early interventions. In addition, similar studies have proposed that −1.5° C and −0.75°C as optimal cut‐off values of relative temperature for predicting PI, which were different from ours (Judy et al, 2011; Mayrovitz et al, 2018). Because the relative temperature in our study was obtained before the diagnosis of PI (non‐blanchable erythema appeared), which was mostly of stage 1 PI, the change in skin temperature was inconspicuous.…”

“…Based on the formation mechanism of PI, many scholars have proposed that the development of PI begins with muscle tissue damage, penetrating from the deep to surface within 48 h (Bennett et al, 2017; Judy et al, 2011; Mayrovitz et al, 2018; Moore et al, 2017). When the pressure goes beyond tissue resistance threshold, tissue damage starts immediately, which often precedes visual recognition (Bennett et al, 2017; Judy et al, 2011; Mayrovitz et al, 2018; Moore et al, 2017). Therefore, how to identify potential damage within 48 h before visual recognition provides a possibility to reduce the incidence of PI to some extent.…”

“…The inclusion criteria were as follows: (1) patients who were over 18 years old with informed consent, (2) patients with a Braden score of less than 18 points (including 18 points), (3) patients who were on the first day of admission, (4) patients who were with a more‐than‐10‐days expected length of hospitalisation, and which is a common length of hospital stay for ICU patients in China, and (5) who were able to maintain the 90° lateral position for 4 min and expose skin of observation area (Mayrovitz et al, 2018).…”

“…The skin temperature in the circular area with a diameter of 5 cm was obtained, and the average temperature was recorded (T1). (2) Control point positioning: in previous studies (Mayrovitz et al, 2018), a remote region, located at least 10 cm proximal to sacrum, with an average sacrum‐to‐remote distance of 10 cm was deemed to be at minimal risk of PI formation. So, another movable cross‐shaped temperature measurement point was placed on the midpoint of the anterior superior iliac spine and gluteal cleft line, being centred (P2).…”

“…In addition, research data showed that symptoms initially appearing to be a stage 1 PI may conceal a deep tissue injury. The tissue damage of deep tissue pressure injury in an area of intact skin penetrates from the deep layers to surface within 48 h, and within 7–10 days, further deterioration to necrotic state is observed (Mayrovitz et al, 2018), which indicates that the pathophysiology of injury development occurs below the skin surface and is often not visible even for the trained evaluators. Therefore, the superficial nature of visual skin assessment may be one of the important reasons for the difficulty in detecting the early PI.…”