Guihan Marylou, Bates-Jenson Barbara M, Chun Sophia, Parachuri Rama, Chin Amy S, McCreath Heather
VA SCI QUERI Research Coordinating Center, Edward Hines Jr. VA Hospital, Hines, IL, USA.
J Spinal Cord Med. 2012 Jan;35(1):46-52. doi: 10.1179/204577211X13209212104141.
Persons with spinal cord injury (SCI) are at high risk for pressure ulcers (PrUs) throughout their lifetime due to decreased mobility, lack of sensation, and other physiological changes. The high prevalence and recurrence rates, and costs associated with PrUs in veterans with SCI indicate the need for a reliable and practical method of detecting early PrUs.
To assess the feasibility of obtaining biophysical measures of sub-epidermal moisture (SEM) using a handheld dermal phase meter to predict PrUs.
DESIGN/METHODS: Prospective observational design. Thirty-four veterans at two VA SCI centers (Hines, Long Beach) received daily (n = 12) or weekly (n = 22) SEM and concurrent visual skin assessment (VSA) across nine anatomic locations for up to 6 weeks. Outcome measures: SEM, visual skin assessment (VSA), and stage I PrUs.
FINDINGS/RESULTS: SEM was lowest for normal skin (39.3 dermal phase units (DPU), SD = 12.6) and higher for erythema/stage 1 PrUs (40.8 DPU, SD = 10.4) across all anatomic sites. Buttocks SEM were different between normal skin (40.5 DPU, SD = 10.3) and erythema/stage1 PrUs (43.8, SD = 9.5). SEM taken at heels were lower across all skin conditions (normal skin 28.2 DPU; erythema/stage 1 PrUs 34.7 DPU). SEM was taken when generalized edema present was lower than without generalized edema.
Preliminary results of using SEM to detect early PrU damage may translate from nursing home (NH) residents to persons with SCI. This study provides a foundation for a larger study to implement and assess SEM use as a method of prevention of PrUs.
由于活动能力下降、感觉缺失及其他生理变化，脊髓损伤（SCI）患者一生都面临着发生压疮（PrUs）的高风险。SCI退伍军人中压疮的高患病率、复发率以及相关费用表明，需要一种可靠且实用的早期压疮检测方法。
评估使用手持式皮肤相位仪获取表皮下水分（SEM）生物物理测量值以预测压疮的可行性。
设计/方法：前瞻性观察性设计。两个退伍军人事务部脊髓损伤中心（Hines、长滩）的34名退伍军人在九个解剖部位接受每日（n = 12）或每周（n = 22）的SEM测量及同步的皮肤视觉评估（VSA），为期长达6周。结果指标：SEM、皮肤视觉评估（VSA）以及I期压疮。
在所有解剖部位，正常皮肤的SEM最低（39.3皮肤相位单位（DPU），标准差 = 12.6），红斑/I期压疮的SEM较高（40.8 DPU，标准差 = 10.4）。臀部正常皮肤（40.5 DPU，标准差 = 10.3）与红斑/I期压疮（43.8，标准差 = 9.5）的SEM存在差异。在所有皮肤状况下，足跟处的SEM较低（正常皮肤28.2 DPU；红斑/I期压疮34.7 DPU）。出现全身性水肿时测得的SEM低于未出现全身性水肿时。
使用SEM检测早期压疮损伤的初步结果可能从疗养院居民推广至脊髓损伤患者。本研究为开展更大规模研究以实施和评估将SEM用作预防压疮的方法奠定了基础。
