Contribution of skin temperature regularity to the risk of developing pressure ulcers in nursing facility residents.

OBJECTIVES

The purpose of the study was to determine whether characterizing skin temperature regulation as a functional property of the skin as it relates to tissue tolerance improves the clinician's understanding of pressure ulcer risk prediction.

DESIGN

A 2-group time-series design was used to observe skin temperature regularity (entropy) and self-similarity (spectral exponent).

METHODS

Twenty nursing facility residents wore skin temperature monitors continuously for 5 days. One bathing episode was observed because bathing is a commonly occurring care procedure.

PRIMARY OUTCOME MEASURE

Difference in skin temperature multiscale entropy and spectral exponent by risk category and pressure ulcer outcome.

RESULTS

Multiscale entropy (MSE) for skin temperature was lowest in those who developed pressure ulcers, F1,18 = 35.14, P < .001. Skin temperature mean MSE, F1,17 = 5.55, P = .031 and the skin temperature spectral exponent, F1,17 = 6.19, P = .023 differentiated the risk groups. The change in skin temperature entropy during bathing was significant, t(16) = 2.55, P = .021.

CONCLUSIONS

Skin temperature MSE and the spectral exponent were significantly different between low-risk and higher risk residents and residents who did and did not develop pressure ulcers. The study supports measurement of skin temperature regulation as a component of tissue tolerance to pressure.