Bates-Jensen Barbara M, McCreath Heather E, Pongquan Voranan, Apeles Neil Christopher R
School of Nursing, UCLA, Los Angeles, California 90095-6919, USA.
Wound Repair Regen. 2008 Mar-Apr;16(2):189-97. doi: 10.1111/j.1524-475X.2008.00359.x.
The objective of this descriptive cohort study was to examine the relationship between subepidermal moisture (SEM) and visual assessment of early pressure ulcers (PUs) in 31 nursing home (NH) residents residing in two NHs. Concurrent visual assessments and SEM were obtained at the sacrum, right and left trochanters, buttocks, and ischium weekly for 20 weeks. Visual assessment was rated as normal, erythema, stage I PU, or stage II+ PU. SEM, measured with a dermal phase meter where higher readings indicate greater SEM (range: 0-999 dermal phase units [DPU]), was modeled as a predictor of concurrent visual assessment of skin damage and erythema and stage I PUs at the sacrum 1 week later with covariate PU risk. Participants had a mean age of 84.1 years, were 83% female, 72% non-Hispanic white. SEM was lowest for normal skin (104 DPU, SD 114), higher for erythema (185 DPU, SD 138), stage I PUs (264 DPU, SD 208), and highest for stage II+ PUs (727 DPU, SD 287) across all sites (all p<0.01). SEM was responsive to visual assessment changes, differentiated between erythema and stage I PU, and higher SEM predicted greater likelihood of erythema/stage I PU at the sacrum the next week (odds ratio=1.32 for every 100 DPU increase, p=0.03). SEM was associated with concurrent skin damage and future (1 week later) development of sacral erythema/stage I PUs. SEM differentiates between erythema and stage I PUs. SEM may assist in predicting early PU damage, allowing for earlier intervention to prevent PUs.
这项描述性队列研究的目的是，在居住于两家疗养院的31名疗养院（NH）居民中，研究表皮下水分（SEM）与早期压疮（PU）视觉评估之间的关系。在20周内，每周对骶骨、左右转子、臀部和坐骨进行同步视觉评估和SEM测量。视觉评估分为正常、红斑、I期PU或II期及以上PU。使用真皮相位仪测量SEM，读数越高表明SEM越高（范围：0 - 999真皮相位单位[DPU]），将其作为1周后骶骨皮肤损伤、红斑和I期PU同步视觉评估的预测指标，并纳入协变量PU风险。参与者的平均年龄为84.1岁，83%为女性，72%为非西班牙裔白人。在所有部位，正常皮肤的SEM最低（104 DPU，标准差114），红斑（185 DPU，标准差138）、I期PU（264 DPU，标准差208）时较高，II期及以上PU时最高（7,27 DPU，标准差287）（所有p<0.01）。SEM对视觉评估变化有反应，能区分红斑和I期PU，SEM越高预测下周骶骨出现红斑/I期PU的可能性越大（每增加100 DPU，优势比=1.32，p = 0.03）。SEM与同步皮肤损伤以及未来（1周后）骶骨红斑/I期PU的发生相关。SEM能区分红斑和I期PU。SEM可能有助于预测早期PU损伤，从而实现更早干预以预防PU。
