Sub epidermal moisture measurement and targeted SSKIN bundle interventions, a winning combination for the treatment of early pressure ulcer development

International Wound Journal · 8 authors, 12 centres

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TL;DR

This quasi-experimental study compared SEM measurement with targeted interventions versus usual visual skin assessment in 149 acute hospital patients. The SEM-guided approach led to a statistically significant reduction in mean SEM delta scores and lower odds of developing a SEM-defined pressure ulcer.

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The study used a quasi-experimental observational design to investigate the impact of SEM measurement and targeted interventions versus usual care on early pressure ulcer development. 149 at-risk acute hospital patients participated, with SEM delta scores recorded daily for up to 5 days on the sacrum and heels. Intention-to-treat analysis was used. Results showed the treatment group had a statistically significant reduction in mean SEM delta scores (MD: 0.49; 95% CI: 0.59, 0.39; P < .0001) and lower odds of developing a SEM pressure ulcer (OR: 0.59, 95% CI: 0.24 to 1.00; P = .05). No visual pressure ulcers developed in the treatment group, while one occurred in the control group. Limitations include the absence of a qualitative component and the use of Braden scores and visual PU counting.

STUDY TYPE

cohort

SPECIALTY

dermatology

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ORIGINAL PAPER

PMC10333035

Sub epidermal moisture measurement and targeted SSKIN bundle interventions, a winning combination for the treatment of early pressure ulcer development

International Wound Journal

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ABSTRACT

Abstract This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi‐experimental observational approach was used. A total of 149 at risk acute hospital patients took part, 78 treatment, and 71 control. SEM deltas were recorded daily for a maximum of 5 days using the SEM Scanner (Bruin Biometrics LLC, Los Angeles, California), on three sites: the sacrum, the right heel, and the left heel, with enhanced and targeted PU prevention interventions occurring in those with an elevated SEM delta scores in the treatment group. Intention to treat analysis was used to guide the final composition of results. SEM PU represents PU development as identified by 2 days of sustained abnormal SEM delta scores, ≥0.5, after day one. The mean number of days completed by participants was just under 4 days, participants had many different comorbidities, with the most common being: hypertension, cancer, and chronic obstructive pulmonary disease. Results showed that following the introduction of SEM guided targeted treatments, participants in the treatment group yielded a statistically significant reduction in mean SEM delta scores (MD: 0.49; 95% CI: 0.59, 0.39; P < .0001), and in the odds of developing a SEM PU (OR: 0.59, 95% CI: 0.24 to 1.00; P = .05). In the treatment group, none of the participants developed a visual PU, whereas, in the control group, 1.41% (n = 1/71) developed a visual PU. Based on all the results, the following is concluded, (1). There was a greater reduction in mean SEM delta scores among those cared for using SEM measurement and targeted PU prevention, versus those cared for using visual skin assessment and usual care, and (2). the mean SEM delta scores was statistically significantly lower at the study end for those who received targeted treatments based on abnormal SEM scores. More research is now needed in other and larger at‐risk groups to further validate what was found in this study.

CITATION EXPORT

Sorcha Byrne, Declan Patton, Pinar Avsar et al.. Sub epidermal moisture measurement and targeted SSKIN bundle interventions, a winning combination for the treatment of early pressure ulcer development. International Wound Journal. (2022). https://doi.org/10.1111/iwj.14061

AUTHORS

8 · 12 CENTRES

Sorcha Byrne, Declan Patton, Pinar Avsar, Helen Strapp, Aglecia Budri, Tom O'Connor, Linda Nugent, Zena Moore

1 Connolly Hospital Blanchardstown Dublin Ireland
2 Skin Wounds and Trauma Research Centre RCSI University of Medicine and Health Sciences Dublin Ireland
3 School of Nursing and Midwifery RCSI University of Medicine and Health Sciences Dublin Ireland
4 Fakeeh College of Health Sciences Jeddah Saudi Arabia
5 School of Nursing and Midwifery Griffith University Queensland Australia
6 Faculty of Science, Medicine and Health University of Wollongong Wollongong New South Wales Australia
7 Tallaght Hospital Dublin Ireland
8 Lida Institute Shanghai China
9 Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia
10 Department of Public Health, Faculty of Medicine and Health Sciences Ghent University Ghent Belgium
11 University of Wales Cardiff UK
12 National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care Menzies Health Institute Queensland Griffith Queensland Australia