Do High Frequency Ultrasound Images Support Clinical Skin Assessment?

Abstract

High frequency ultrasound imaging has been reported as a potential method of identifying the suspected tissue damage in patients “at risk” of pressure ulceration. The aim of this study was to explore whether ultrasound images supported the clinical skin assessment in an inpatient population through identification of subcutaneous tissue damage. Skin on the heels and/or sacral coccygeal area of fifty vascular surgery inpatients was assessed clinically by tissue viability nurses and with ultrasound pre operatively and at least every other day until discharge. Images were compared to routine clinical skin assessment outcomes. Qualitative classification of ultrasound images did not match outcomes yielded through the clinical skin assessment. Images corresponding to 16 participants were classified as subgroup 3 damage at the heels (equivalent to grade 2 pressure ulceration); clinical skin assessment rated no heels as greater than grade 1a (blanching erythema). Conversely, all images captured of the sacral coccygeal area were classified as normal; the clinical skin assessment rated two participants as grade 1b (non-blanching erythema). Ultrasound imaging is a potentially useful adjunct to the clinical skin assessment in providing information about the underlying tissue. However, further longitudinal clinical assessment is required to characterise images against actual and “staged” pressure ulceration.

Determining weight‐bearing tissue condition using peak reactive hyperemia response trend and ultrasonographic features: Implications for pressure ulcer prevention

“…Table shows that the abnormal tissue induced by repetitive loading was accompanied with “Mild change” to “Severe change” results from the both raters’ US evaluation. This supports the previous studies where the early PU can be indicated by US evaluation . However, normal tissue examined under histopathology also has US evaluation results “Mild change” to “Severe change”.…”

Use of high frequency ultrasound to detect changes in skin integrity: An image evaluation validation procedure

“…Most images (79.7%) with abnormal ultrasounds did not have documentation of skin erythema in the clinical record. More recently Porter-Armstrong et al 20 evaluated whether HFUS supported clinical skin assessment in an inpatient population by comparing HFUS to clinical assessments of heel and sacral skin. They found that qualitative classification of ultrasound images did not match outcomes yielded through the clinical skin assessment.…”

Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review

“…This information includes lumen and vessel dimensions, plaque morphology, and location, thus enabling determination of the degree of stenosis [ 11 ]. Additional studies reported that high frequency ultrasound imaging was a potential method for identifying the suspected tissue damage and vascular complications in patients at risk of pressure ulceration [ 12 , 13 , 14 ]. Porter-Armstrong et al explored whether ultrasound images supported clinical skin assessment in an inpatient population by identifying subcutaneous tissue damage [ 13 ].…”

“…Additional studies reported that high frequency ultrasound imaging was a potential method for identifying the suspected tissue damage and vascular complications in patients at risk of pressure ulceration [ 12 , 13 , 14 ]. Porter-Armstrong et al explored whether ultrasound images supported clinical skin assessment in an inpatient population by identifying subcutaneous tissue damage [ 13 ]. However, the study demonstrated that qualitative classification of ultrasound images did not match outcomes yielded through clinical skin assessment [ 13 ].…”