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Measurement and Sequelae of Neonatal Skin Injuries: A Prospective Diagnostic/Feasibility Study
Deanne August1,2,3,4, Stephanie Hall1,4, Nicole Marsh2,3,4
1Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Brisbane, Australia.
International Wound Journal
|August 19, 2025
Summary
This study explored non-invasive technologies for neonatal skin injuries. Skin pH measurement proved to be a feasible, objective, and cost-effective method for assessing neonatal skin injury severity.
Area of Science:
- Neonatal dermatology and wound assessment.
- Medical technology feasibility and diagnostic accuracy.
Background:
- Neonatal skin injuries are common, with inconsistent severity reporting due to lack of standardized metrics.
- Non-invasive technologies for assessing neonatal skin injuries have not been previously explored.
- Variability in visual assessment and metric size complicates accurate injury evaluation.
Purpose of the Study:
- To assess the feasibility and accuracy of non-invasive technologies compared to visual assessment for neonatal skin injuries.
- To evaluate skin pH, laser speckle, and an imaging app for measuring pressure, stripping, and tearing injuries.
- To determine technology feasibility, clinician acceptability, accuracy, cost, and injury sequelae.
Main Methods:
- Prospective diagnostic/feasibility study involving 24 neonates with mechanical force injuries.
- Measurements included skin pH (5.0-7.5), laser speckle (perfusion units/mm²), and imaging app (surface area, cm²).
- Data collected within 72 hours of injury identification; clinician acceptability and cost analysis performed.
Main Results:
- Skin pH assessments were completed in 85% of cases, laser speckle in 75%, and the imaging app in 95%.
- Clinician and researcher assessments showed inconsistency (72%); technologies failed in at least 3% of assessments.
- Injured skin pH was higher than healthy skin; laser speckle and imaging app showed non-significant differences.
- Skin pH acquisition was fastest (3.1 min), and the imaging app had the highest clinician acceptability (7.1/10).
- Skin pH was the most cost-effective ($0.17-$0.41 per assessment), while the app was most expensive ($6.65-$12.82).
Conclusions:
- Skin pH measurement is a feasible, objective, and cost-effective method for comparing intact and injured neonatal skin.
- Non-invasive technologies like laser speckle and imaging apps showed limitations in accuracy and feasibility for neonatal skin injuries.
- Further research is needed to refine non-invasive technologies for reliable neonatal skin injury assessment.
