Subepidermal Moisture Predicts Erythema and Stage 1 Pressure Ulcers in Nursing Home Residents: A Pilot Study

  1. Barbara M. Bates-Jensen PhD, RN1,2,3,
  2. Heather E. McCreath PhD2,
  3. Ayumi Kono PhD, RN4,
  4. Neil Christopher R. Apeles MSN, RN5,
  5. Cathy Alessi MD2,3

Article first published online: 15 JUN 2007

DOI: 10.1111/j.1532-5415.2007.01261.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 55, Issue 8, pages 1199–1205, August 2007

Additional Information

How to Cite

Bates-Jensen, B. M., McCreath, H. E., Kono, A., Apeles, N. C. R. and Alessi, C. (2007), Subepidermal Moisture Predicts Erythema and Stage 1 Pressure Ulcers in Nursing Home Residents: A Pilot Study. Journal of the American Geriatrics Society, 55: 1199–1205. doi: 10.1111/j.1532-5415.2007.01261.x

Author Information

  1. 1

    From the School of Nursing

  2. 2

    Division of Geriatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California

  3. 3

    Veterans Affairs Greater Los Angeles Healthcare System, Geriatric Research, Education, and Clinical Center, Los Angeles, California

  4. 4

    Osaka City University, Osaka, Japan

  5. 5

    Valley Presbyterian Hospital, Van Nuys, California

*Address correspondence to Barbara M. Bates-Jensen, PhD, RN, CWOCN, UCLA/VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, 16111 Plummer St. (11E), Sepulveda, CA 91343. E-mail: bbatesjensen@sonnet.ucla.edu

Publication History

  1. Issue published online: 15 JUN 2007
  2. Article first published online: 15 JUN 2007

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Keywords:

  • erythema;
  • Stage 1 pressure ulcers;
  • moisture

OBJECTIVES: To examine the relationship between a measure of subepidermal moisture (SEM) and visual skin assessment (VSA) of erythema and Stage 1 pressure ulcers (PUs) performed a week later in nursing home (NH) residents.

DESIGN: Descriptive, cohort study.

SETTING: Two NHs.

PARTICIPANTS: Thirty-five residents.

METHODS: Concurrent VSAs and SEM readings were obtained at the sacrum, right and left trochanters, buttocks, and ischial tuberosities weekly for 52 weeks. SEM was measured using a handheld dermal phase meter, with higher readings indicating greater SEM (range 0–999 dermal phase units [DPUs]). VSA was rated as normal, erythema/Stage 1 PU, or Stage 2+PU. SEM was modeled as a predictor of VSA of erythema and PUs 1 week later (controlling for clustering), with concurrent moisture, Braden Scale PU risk status, anatomic site, and ethnicity as covariates.

RESULTS: Participants had a mean age of 84.7, 83% were female, and 80% were non-Hispanic white. SEM measures were lowest for normal skin (97±122 DPU), higher for erythema/Stage 1 PUs (192±188 DPU), and highest for Stage 2+PUs (569±320 DPU) across all sites (all P<.001). SEM was responsive to changes in VSA, and higher SEM predicted greater likelihood of erythema/Stage 1 PU the next week (odds ratio=1.26 for every 100-DPU increase in SEM, P=.04).

CONCLUSION: SEM measures are associated with concurrent erythema and PUs and future (1 week later) development of erythema/Stage 1 PUs. SEM may assist in predicting early PU damage, allowing for earlier intervention to prevent skin damage.

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