title: Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/non blanching erythema in the sacral area.
abstract: Early detection of non blanching erythema (pressure ulcer category I) is necessary to prevent any further skin damage. An objective method to discriminate between blanching/non blanching erythema is presently not available. The purpose of this investigation was to explore if a non invasive objective method could differentiate between blanching/non blanching erythema in the sacral area of patients undergoing hip fracture surgery. Seventy-eight patients were included. The sacral area of all patients was assessed using (i) conventional finger-press test and (ii) digital reading of the erythema index assessed with reflectance spectrophotometry. The patients were examined at admission and during 5 days postsurgery. Reflectance spectrophotometry measurements proved able to discriminate between blanching/non blanching erythema. The reliability, quantified by the intra-class correlation coefficient, was excellent between repeated measurements over the measurement period, varying between 0·82 and 0·96, and a significant change was recorded in the areas from day 1 to day 5 (P < 0·0001). The value from the reference point did not show any significant changes over the same period (P = 0·32). An objective method proven to identify early pressure damage to tissue can be a valuable tool in clinical practice.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden; Department of Nursing, Sophiahemmet University, Stockholm, Sweden.
authors.forename: Eila
authors.initials: E
authors.lastname: Sterner
authors.forename: Bjöörn
authors.initials: B
authors.lastname: Fossum
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Berg
authors.forename: Christina
authors.initials: C
authors.lastname: Lindholm
authors.forename: André
authors.initials: A
authors.lastname: Stark
mesh_terms: D000368:Aged; D042241:Early Diagnosis; D004890:Erythema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000150:complications* / Q000151:congenital / Q000175:diagnosis / Q000517:prevention & control; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012447:Sacrum; D012867:Skin / Q000473:pathology*; D013053:Spectrophotometry / Q000379:methods*
keywords: Blanching/non blanching erythema; Category I; Hip fracture; Pressure ulcer; Reactive hyperaemia; Reflectance spectrophotometry