Objective: To investigate the relationship between sub-epidermal moisture (SEM) and visual skin assessment (VSA) in pressure ulcers (PU) patients with jaundice in Korea.
Method: This is a longitudinal observational study. Data was collected by a wound care nurse, at a tertiary hospital, for six weeks beginning in June 2013. Once a week for the six weeks, the nurse assessed VSA and measured SEM, for each subject, on seven anatomical sites (both buttocks, both ischial tuberosities, both trochanters, and the sacral coccyx), using a NOVA Petite dermal phase meter for SEM. The measurements ranged from 0 to 999, and higher SEM indicates higher water content in the tissue.
Results: There were 22 adults participated in the study. The SEMs in category I PU were significantly higher than those in patients who had no injury, or blanching erythema. The SEM difference between category I PU and either blanching erythema or no injury was more than 60 points at the sacral coccyx, and the difference between blanching erythema and no PU was more than 100 points at the trochanters. After the covariates were adjusted for, the odds ratios (ORs) for blanching erythema were statistically significant. The ORs for blanching erythema versus normal skin was 1.016 higher than the concurrent SEMs. Also, The ORs of 1-point concurrent SEMs for blanching erythema versus normal skin at Sacral coccyx, right and left ischial tuberosity and left trochanter were 1.015, 1.128, 1.137 and 1.051 respectively (p<0.05).
Conclusion: SEM was associated with concurrent early skin damage, specifically blanching erythema with jaundice. Therefore, SEM may be used to predict early skin damage in patients with jaundice in clinical nursing for effective PU prevention and management.
Keywords: jaundice; pressure injury; pressure ulcer; sub-epidermal moisture; visual skin assessment.