Pressure injury detection using alternate light: a proof-of-concept study

Area of Science:

• Medical technology and wound care
• Dermatology and skin integrity assessment

Background:

• Visual skin assessment for early-stage pressure injuries (PIs) can be subjective and unreliable.
• Melanin in darker skin tones can obscure the identification of PIs and bruises.
• Alternate light sources (ALS) have demonstrated efficacy in detecting bruises on darker skin tones.

Purpose of the Study:

• To describe the characteristics of Stage 1 and deep tissue PIs when viewed under an ALS.
• To evaluate the potential of ALS in improving the detection of PIs, particularly in individuals with varying skin pigmentation.

Main Methods:

• Participants were initially assessed using standard white light by a certified wound ostomy continence nurse.
• A second examiner used violet (406nm) and blue (448nm) ALS with colored goggles to evaluate tissue impairment.
• Portable ultrasound was employed to confirm tissue involvement, with data summarized using descriptive statistics.

Main Results:

• The study included 10 participants, with 40% from minority racial/ethnic groups.
• Eighty percent of PIs were deep tissue injuries, and 60% were located on lower extremities.
• ALS revealed larger PI sizes (17.5cm² and 13.7cm² greater under violet and blue light, respectively) compared to white light.

Conclusions:

• ALS identified evidence of tissue damage not visible under white light.
• Ultrasound utility was limited over bony prominences due to insufficient subcutaneous tissue.
• Further research is recommended to explore the application of ALS for early PI detection.