Oliveira AL, Moore Z, O Connor T, Patton D, et al.
Journal of wound care. Date of publication 2017 May 2;volume 26(5):199-215.
1. J Wound Care. 2017 May 2;26(5):199-215. doi: 10.12968/jowc.2017.26.5.199.
Accuracy of ultrasound, thermography and subepidermal moisture in predicting
pressure ulcers: a systematic review.
Oliveira AL(1), Moore Z(1), O Connor T(1), Patton D(1).
Author information:
(1)Royal College of Surgeons in Ireland Dublin, Dublin Ireland.
OBJECTIVE: Our aims were to: establish the clinical significance of ultrasound,
thermography, photography and subepidermal moisture (SEM) measurement; determine
the accuracy of ultrasound, thermography, photography and SEM measurement in
detecting skin/tissue damage; determine the relative accuracy of one of these
assessment methods over another; make recommendations for practice pertaining to
assessment of early skin/tissue damage.
METHOD: The following databases, Cochrane Wounds Group Specialised Register, The
Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE,
Elsevier version, EBSCO CINAHL, ClinicalTrials.gov , WHO International Clinical
Trials Registry (ICTR) and The EU Clinical Trials Register were searched for
terms including; thermography, ultrasound, subepidermal moisture, photograph and
pressure ulcer.
RESULTS: We identified four SEM, one thermography and five ultrasound studies for
inclusion in this review. Data analysis indicated that photography was not a
method which allowed for the early prediction of PU presence. SEM values
increased with increasing tissue damage, with the sacrum and the heels being the
most common anatomical locations for the development of erythema and stage I PUs.
Thermography identified temperature changes in tissues and skin that may give an
indication of early PU development; however the data were not sufficiently
robust. Ultrasound detected pockets of fluid/oedema at different levels of the
skin that were comparable with tissue damage. Thus, SEM and ultrasound were the
best methods for allowing a more accurate assessment of early skin/tissue damage.
Using the EBL Critical Appraisal Tool the overall validities of the studies
varied between 33.3-55.6%, meaning that there is potential for bias within all
the included studies. All of the studies were situated at level IV, V and VII of
the evidence pyramid. Although the methodological quality of the studies warrants
consideration, these studies showed the potential that SEM and ultrasound have in
early PU detection.
CONCLUSION: SEM and ultrasound are promising in the detection and prediction of
early tissue damage and PU presence. However, these methods should be further
studied to clarify their potential for use more widely in PU prevention
strategies.
DOI: 10.12968/jowc.2017.26.5.199
PMID: 28475447 [Indexed for MEDLINE]
