The effect of prolonged 60° head of bed elevation on sacral subepidermal oedema in healthy adults: A quantitative prospective exploratory study.

Abstract

Head of bed elevation is used to manage some medical and surgical conditions however this may increase a patient's risk of sacral pressure injuries. Novel point-of-care technologies that measure subepidermal moisture can identify changes in localised subepidermal oedema and potential pressure injury risk. This prospective exploratory study investigated variations in sacral subepidermal oedema in healthy adults during 120-min of 60° head of bed elevation. Sacral subepidermal oedema was measured at 20-min intervals using the Provisio® subepidermal moisture scanner. Descriptive analysis, one-way repeated measures analysis of variance and an independent t-test were conducted. Slightly more male volunteers (n = 11; 55%) were recruited and the sample mean age was 39.3 years (SD 14.7) with an average body mass index of 25.8 (SD 4.3). Little variation in the mean sacral subepidermal moisture of healthy adults was observed. There was a statistically significant difference in the mean sacral subepidermal moisture measurements between males and females (Mean difference 0.18; 95% confidence intervals: 0.02 to 0.35; P = .03). Healthy adults can tolerate prolonged 60° head of bed elevation without developing increased subepidermal sacral oedema. This warrants further investigation in other populations, in various positions and over different time periods.