Subepidermal moisture predicts erythema and stage 1 pressure ulcers in nursing home residents: a pilot study.
OBJECTIVE
To examine the relationship between a measure of subepidermal moisture (SEM) and visual skin assessment (VSA) of erythema and Stage 1 pressure ulcers (PUs) performed a week later in nursing home (NH) residents.


METHODS
Descriptive, cohort study.


METHODS
Two NHs.


METHODS
Thirty-five residents.


METHODS
Concurrent VSAs and SEM readings were obtained at the sacrum, right and left trochanters, buttocks, and ischial tuberosities weekly for 52 weeks. SEM was measured using a handheld dermal phase meter, with higher readings indicating greater SEM (range 0-999 dermal phase units [DPUs]). VSA was rated as normal, erythema/Stage 1 PU, or Stage 2+PU. SEM was modeled as a predictor of VSA of erythema and PUs 1 week later (controlling for clustering), with concurrent moisture, Braden Scale PU risk status, anatomic site, and ethnicity as covariates.


RESULTS
Participants had a mean age of 84.7, 83% were female, and 80% were non-Hispanic white. SEM measures were lowest for normal skin (97+/-122 DPU), higher for erythema/Stage 1 PUs (192+/-188 DPU), and highest for Stage 2+PUs (569+/-320 DPU) across all sites (all P<.001). SEM was responsive to changes in VSA, and higher SEM predicted greater likelihood of erythema/Stage 1 PU the next week (odds ratio=1.26 for every 100-DPU increase in SEM, P=.04).


CONCLUSIONS
SEM measures are associated with concurrent erythema and PUs and future (1 week later) development of erythema/Stage 1 PUs. SEM may assist in predicting early PU damage, allowing for earlier intervention to prevent skin damage.
School of Nursing, University of California at Los Angeles, Los Angeles, California, USA. bbatesjensen@sonnet.ucla.edu
Barbara M
BM
Bates-Jensen
Heather E
HE
McCreath
Ayumi
A
Kono
Neil Christopher R
NC
Apeles
Cathy
C
Alessi
D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D042241:Early Diagnosis; D004817:Epidermis / Q000502:physiology*; D004890:Erythema / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010865:Pilot Projects; D011237:Predictive Value of Tests; D003668:Pressure Ulcer / Q000150:complications / Q000175:diagnosis*