Bates-Jensen BM, McCreath HE, Pongquan V, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2009 May 1;volume 36(3):277-84.
1. J Wound Ostomy Continence Nurs. 2009 May-Jun;36(3):277-84. doi:
10.1097/WON.0b013e3181a19e53.
Subepidermal moisture is associated with early pressure ulcer damage in nursing
home residents with dark skin tones: pilot findings.
Bates-Jensen BM(1), McCreath HE, Pongquan V.
Author information:
(1)School of Nursing, and Division of Geriatrics, David Geffen School of
Medicine, University of California, Los Angeles, California 90095, USA.
bbatesjensen@sonnet.ucla.edu
Comment in
J Wound Ostomy Continence Nurs. 2009 May-Jun;36(3):285.
OBJECTIVE: To examine the relationship between a measure of skin and tissue
water, subepidermal moisture (SEM), and visual assessment of early pressure
ulcer (PU) damage in nursing home (NH) residents with dark skin tones.
DESIGN, SETTING, AND PARTICIPANTS: Descriptive, cohort study with 66 residents
in 4 US NH.
METHODS: Data were pooled from 2 previous NH studies to evaluate persons with
dark skin tones. Data were analyzed for concurrent visual assessments and SEM,
which were obtained at the right and left buttocks and sacrum weekly for 20
weeks. Subepidermal moisture was measured with a surface electrical capacitance
dermal phase meter, where higher readings indicate greater SEM (range: 0-999
dermal phase units [DPUs]). Visual assessment was rated as normal,
erythema/stage I PU, or stage II+ PU. Subepidermal moisture and specific SEM
threshold values (50, 150, 300 DPU) were modeled as detectors of visual
assessment of early PU 1 week later (controlling for clustering and
incontinence); with concurrent SEM, and PU risk status, in separate analyses for
persons with light and dark skin tones.
RESULTS: Participants had a mean age of 84 years, 83% were female, and 77% were
non-Hispanic white. Higher SEM predicted greater likelihood of erythema/stage I
PU and stage II+ PU in persons with dark skin tones the next week (OR = 1.88 for
every 100 DPU increase in SEM, P = .004). When SEM was greater than 50, 150, and
300 DPU, persons with dark skin tones were 8.5, 13, and 10 times more likely to
present with stage II+ PU the following week compared to persons with light skin
who were 7.2, 3.5, and 4.3 times more likely to present with stage II PU (50,
150, 300 DPU, respectively). Subepidermal moisture threshold of 50 DPU was also
significant for detecting erythema/stage I PU in persons with dark skin tones
(OR = 5.3, 95% CI, 1.87-15.11, P < .001).
CONCLUSIONS: Subepidermal moisture was associated with future (1 week later) PU
in persons with dark skin tones. Subepidermal moisture threshold values may
assist in detecting early PU in persons with dark skin tones, allowing for
earlier intervention to prevent PU. These findings should be further evaluated
in persons with dark skin tones.
DOI: 10.1097/WON.0b013e3181a19e53
PMCID: PMC5656450
PMID: 19448508 [Indexed for MEDLINE]
