title: Lower temperature at the wound edge detected by thermography predicts undermining development in pressure ulcers: a pilot study.
abstract: Undermined pressure ulcers (PUs) are troublesome complications that are likely to delay wound healing. Early skin incision and debridement can prevent the deterioration of undermined PUs, thus it is necessary to identify devitalised tissue areas to determine the appropriate timing for such interventions. This retrospective cohort study evaluated whether a lower temperature at the wound edge than the wound bed and periwound skin, detected by thermography, can predict undermining development in PUs 1 week after the assessment. Twenty-two participants with category III, IV, or unstageable PUs who were examined by interdisciplinary PU team and were followed up for at least two consecutive weeks were analysed. We found 9/11 PUs without a lower temperature at the wound edge did not develop undermining development, whereas 8/11 PUs with the lower temperature did develop undermining. The relative risk of undermining development after 1 week in PUs with the lower temperature was 4·00 (95% confidence intervals: 1·08-14·7). The sensitivity, specificity, positive predictive value and negative predictive value were 0·80, 0·75, 0·73 and 0·81, respectively. A thermal imaging assessment focusing on a lower temperature pattern at the wound edge may provide sufficient information to predict undermining development.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Japan Society for the Promotion of Science, Tokyo, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kitamura
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Gojiro
authors.initials: G
authors.lastname: Nakagami
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Goto
authors.affiliation: Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Miyagaki
authors.affiliation: Department of Plastic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Akitatsu
authors.initials: A
authors.lastname: Hayashi
authors.affiliation: Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Sanae
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Japan Society for the Promotion of Science, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mugita
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Iizaka
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D006801:Humans; D010865:Pilot Projects; D003668:Pressure Ulcer; D012189:Retrospective Studies; D013696:Temperature; D013817:Thermography
keywords: Debridement; Nursing; Wound assessment