title: Assessing the feasibility of subepidermal moisture to predict erythema and stage 1 pressure ulcers in persons with spinal cord injury: a pilot study.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To assess the feasibility of obtaining biophysical measures of sub-epidermal moisture (SEM) using a handheld dermal phase meter to predict PrUs.
  
  
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: VA SCI QUERI Research Coordinating Center, Edward Hines Jr. VA Hospital, Hines, IL, USA. Marylou.guihan@va.gov
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Bates-Jenson
authors.forename: Sophia
authors.initials: S
authors.lastname: Chun
authors.forename: Rama
authors.initials: R
authors.lastname: Parachuri
authors.forename: Amy S
authors.initials: AS
authors.lastname: Chin
authors.forename: Heather
authors.initials: H
authors.lastname: McCreath
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001703:Biophysics; D018450:Disease Progression; D042241:Early Diagnosis; D004817:Epidermis / Q000502:physiology*; D004890:Erythema / Q000175:diagnosis* / Q000209:etiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000209:etiology*; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*