Evaluation of four non‐invasive methods for examination and characterization of pressure ulcers

Andersen, Ellen Sloth; Karlsmark, Tonny

doi:10.1111/j.1600-0846.2008.00290.x

Cited by 43 publications

(40 citation statements)

References 8 publications

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“…A hypoechogenic (appearing darker in HFUS images) subepidermal layer has been noted in HFUS images in conjunction with known skin tissue injury. [13][14][15] The hypoechogenic areas are thought to reflect increasing fluid content associated with inflammation indicating soft tissue edema before visible damage is noted at the skin surface. 8,10,[13][14][15][16][17][18] HFUS was validated as a sensitive method for changes in dermal hydration associated with edema formation by nuclear magnetic resonance imaging.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15] The hypoechogenic areas are thought to reflect increasing fluid content associated with inflammation indicating soft tissue edema before visible damage is noted at the skin surface. 8,10,[13][14][15][16][17][18] HFUS was validated as a sensitive method for changes in dermal hydration associated with edema formation by nuclear magnetic resonance imaging. 19 In the acute care setting, HFUS may be used for documentation, detection, and monitoring of soft tissue injury in patients at risk upon hospital or long-term care admission; however, little is known regarding its accuracy or reliability.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High-Frequency Ultrasound: Obtaining Optimal Images and the Effect of Image Artifacts on Image Quality

Burk

Grap

Lucas

et al. 2017

Advances in Wound Care

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Objective: High-frequency ultrasound (HFUS) images are being researched for use in the prevention, detection, and monitoring of pressure injuries in patients at risk. This seminal longitudinal study in mechanically ventilated adults describes image quality, the incidence of image artifacts, and their effect on image quality in critically ill subjects. Approach: Mechanically ventilated subjects from three adult intensive care units were enrolled, and multiple sacral images from each subject were obtained daily. Using a subset of best image per patient per day, artifacts were grouped, and their effect on image quality was statistically evaluated.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High-Frequency Ultrasound: Obtaining Optimal Images and the Effect of Image Artifacts on Image Quality

Burk

Grap

Lucas

et al. 2017

Advances in Wound Care

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“…In Ref. 9, 15 pressure ulcers were examined using four different noninvasive techniques: Skin temperature, redness index, skin retraction time, and ultrasound ͑US͒ scanning. Results showed that temperature and retraction time could not alone characterize the ulceration stage, while a redness index was useful in some cases.…”

Section: Introductionmentioning

confidence: 99%

On the potential of ultrasound elastography for pressure ulcer early detection

et al. 2011

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published xx xx xxxx͒ Purpose: Pressure ulcers are areas of soft tissue breakdown induced by a sustained mechanical stress that damages the skin and underlying tissues. They represent a considerable burden to the society in terms of health care and cost. Yet, techniques for prevention and detection of pressure ulcers still remain very limited. In this article, the authors investigated the potential of ultrasound elastography for pressure ulcer early detection. Elastography is an imaging technique providing local information on biological tissue mechanical properties. It is relevant for pressure ulcer detection as this pathology is associated with a gradual stiffening of damaged tissues, beginning in the deeper tissues and progressing toward the skin surface. Methods: A 2D ultrasound elastography method was proposed and its ability in terms of pressure ulcer detection was validated through numerical simulations and physical acquisitions on pressure ulcer mimicking phantoms. In vivo experiments on a rat model are also reported. A maintained pressure was applied on the animal thigh, with a view to generate a pressure ulcer, and ultrasound data were acquired and processed before and after application of this pressure. Results: Numerical simulations demonstrated that a pressure ulcer can theoretically be detected at a very early stage with ultrasound elastography. Even when the ulcer region was characterized by a low stiffening ͑ratio of 1.8 relative to normal tissues͒, the corresponding elastogram clearly underlined the pathological area. This observation was confirmed by the results obtained on a physical phantom mimicking a pressure ulcer at an early stage. Computed elastograms showed strain differences between areas mimicking healthy and pathological tissues. Results corresponding to in vivo experiments revealed a difference in the way tissues behaved before and after the pressure was applied on the animal thigh, which strongly suggests the presence of a pathological area. Conclusions: Experiments demonstrated that ultrasound elastography is a promising technique for pressure ulcer detection, especially at an early stage of the pathology, when the disease is still visually undetectable. In the absence of any gold standard method, this is also a first step toward the development of a quantitative technique.

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“…Specifi c ultrasound fi ndings indicative of underlying tissue damage included hypoechogenic layers or pockets consistent with edema formation, and loss of clear differentiation of the various skin layers. 12,19,20 Aoi and colleagues 12 used a 10-MHz ultrasonic scanner and identifi ed discontinuity of the fascia layer as an additional indicator of deep tissue damage. Deprez and colleagues 21 suggest that pressure ulcer development is characterized by stiffening of the involved tissue, and that this stiffening can be detected through anot her ultrasound measurement, tissue elastography.…”

Section: Summary Of Consensus Statements From the Incontinence-associmentioning

confidence: 99%

Incontinence-Associated Dermatitis

Doughty

Junkin

Kurz

et al. 2012

Journal of Wound, Ostomy &Amp; Continence Nursing

102

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In 2010, an international consensus conference was held to review current evidence regarding the pathology, prevention, and management of incontinence-associated dermatitis (IAD). The results of this literature review were published in a previous issue of this Journal. This article summarizes key consensus statements agreed upon by the panelists, evidence-based guidelines for prevention and management of IAD, and a discussion of the major challenges currently faced by clinicians caring for these patients. The panelists concur that IAD is clinically and pathologically distinct from pressure ulcers and intertriginous dermatitis, and that a consistently applied, structured, or defined skin care program is effective for prevention and management of IAD. They also agreed that differential assessment of IAD versus pressure ulceration versus intertriginous dermatitis remains a major challenge. Panel members also concur that evidence is lacking concerning which products and protocols provide the best outcomes for IAD prevention and treatment in individual patients. Issues related to differential assessment, product labeling and utilization, staff education, and cost of care are the primary focus of this article.

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Evaluation of four non‐invasive methods for examination and characterization of pressure ulcers

Cited by 43 publications

References 8 publications

High-Frequency Ultrasound: Obtaining Optimal Images and the Effect of Image Artifacts on Image Quality

High-Frequency Ultrasound: Obtaining Optimal Images and the Effect of Image Artifacts on Image Quality

On the potential of ultrasound elastography for pressure ulcer early detection

Incontinence-Associated Dermatitis

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