Mayrovitz HN, Spagna PE, Taylor MC, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2018 Jan 1;volume 45(1):17-21.
1. J Wound Ostomy Continence Nurs. 2018 Jan/Feb;45(1):17-21. doi:
10.1097/WON.0000000000000392.
Sacral Skin Temperature Assessed by Thermal Imaging: Role of Patient Vascular
Attributes.
Mayrovitz HN(1), Spagna PE, Taylor MC.
Author information:
(1)Harvey N. Mayrovitz, PhD, College of Medical Sciences, Nova Southeastern
University, Fort Lauderdale, Florida. Paige E. Spagna, BS, College of Medical
Sciences, Nova Southeastern University, Fort Lauderdale, Florida. Martha C.
Taylor, BSN, RN, CWON, Holy Cross Hospital, Fort Lauderdale, Florida.
PURPOSE: The purpose of this study was to test the hypothesis that temperature
differentials measured by thermal imaging of sacral versus a remote skin area in
critically ill patients differentiate those with significant vascular disease and
risk for pressure injury of the sacral area.
DESIGN: Prospective cohort study.
SUBJECTS AND SETTING: The sample comprised 100 patients (58 men, 42 women) with
mean ± SD ages of 70.4 ± 14.4 and 74.0 ± 14.5 years, respectively, who were
admitted to a cardiovascular intermediate care unit or a neurosurgical intensive
care unit in the southeastern region of the United States.
METHODS: A commercially available thermal imaging system was used to obtain
simultaneous standard photographic and infrared thermal images (11 × 14 inches)
that included the patient's buttocks and a remote skin area after the patient was
off-loaded for about 4 minutes. Images were processed to determine temperature
differences between the sacral region (deemed to have an elevated risk for
pressure injury) and a remote region of the skin located at least 10-cm proximal
to the sacrum, with an average sacrum-to-remote distance of 17.9 ± 3.0 cm that
was deemed to be at minimal risk. Prior measurements of healthy subjects showed
that sacral skin was on average 0.75°C less than the remote skin site (ΔT
=-0.75°C). For the present analysis, a threshold ΔTTH of twice that amount (ΔT
=-1.5°C) or more was considered to put a patient at greater than normal risk
based on the hypothesis that low sacral temperatures were associated with lowered
blood perfusion issues of various clinical conditions. The vascular status of
patients who equaled or exceeded this threshold was compared to the other
patients.
RESULTS: Thirty-two patients exceeded ΔTTH, with an average ΔT of -1.92°C ±
0.62°C. In 6 patients, ΔT was greater than +1.5°C, with average of +1.98°C ±
0.49°C. The remaining 63 patients had an average ΔT of 0.13°C ± 0.58°C.
Chi-square analysis of the proportions of patients exceeding or not exceeding
thresholds in relation to their known vascular disease status revealed no
significant difference between these subgroups.
CONCLUSIONS: Although infrared thermal screening may provide visually impressive
and potentially useful images in some cases, the use of temperature differentials
to detect patients at particularly high risk for pressure injury owing to local
blood flow is not supported by results of this study.
DOI: 10.1097/WON.0000000000000392
PMID: 29300285 [Indexed for MEDLINE]
