Measuring subepidermal moisture to detect early pressure ulcer development: a systematic review

Area of Science:

• Biomedical Engineering
• Nursing Science
• Dermatology

Background:

• Pressure ulcers (PUs) represent a significant healthcare challenge.
• Early detection of PUs is crucial for effective prevention and management.
• Current methods for detecting early PU development have limitations.

Purpose of the Study:

• To systematically review the evidence on subepidermal moisture (SEM) measurement for early, non-visible pressure ulcer detection.
• To assess the validity, sensitivity, and specificity of SEM measurements in identifying early PU development.
• To evaluate the impact of SEM measurements on PU prevention strategies.

Main Methods:

• Systematic review of quantitative animal and human studies.
• Searched PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases in January 2021.
• Analyzed data using RevMan software and narrative synthesis.

Main Results:

• 17 articles met inclusion criteria; all showed abnormal SEM deviations correlated with visual PU development.
• SEM measurements detected PU development significantly earlier (mean difference of 4.61 days) than visual skin assessment (VSA).
• Sensitivity ranged from 48.3% to 100.0%; specificity ranged from 24.4% to 83.0%.
• One study reported a 93% decrease in PU rates when staff acted on SEM readings.

Conclusions:

• SEM measurement is a valid tool for detecting early, non-visible pressure ulcer development.
• Implementing SEM measurements can enhance PU prevention strategies and reduce incidence.
• SEM measurement offers a valuable addition to existing PU prevention protocols.