An Observational, Prospective Cohort Pilot Study to Compare the Use of Subepidermal Moisture Measurements Versus Ultrasound and Visual Skin Assessments for Early Detection of Pressure Injury

Abstract

A pilot study was conducted to evaluate consistency between SEM and US examinations of suspected deep tissue injury (sDTI). Using an observational, prospective cohort study design, patients >55 years of age were recruited. VSA, SEM, and US assessments were performed daily for a minimum of 3 and maximum of 10 consecutive days following enrollment. US results were considered indicative of sDTI if hypoechoic lesions were present. SEM readings were considered abnormal when ∆ ≥0.6 was noted for at least 2 consecutive days. Boolean analysis was utilized to systematically determine consistency between US and SEM where sDTI was the clinical judgment. Among the 15 participants (10 women, mean age 74 ± 10.9 years), there was consistent agreement between SEM and US when sDTIs existed. For 1 patient who developed a heel sDTI during the study, SEM readings were abnormal 2 days before VSA indicated tissue damage and 3 days before the appearance of a hypoechoic lesion in the US. US and SEM results were similar, and in an evolving sDTI case, SEM detected a lesion earlier than US.