Method for the measurement of susceptibility to decubitus ulcer formation

Abstract

A method for measuring the susceptibility of a patient to develop decubitus ulcers is described and initially evaluated. It is based on an indirect, noninvasive measurement of the transient regional blood flow response after a test pressure load which simulates the external stimulus for pressure-sore formation. This method was developed to determine the individual risk of a patient and to study the subfactors which contribute to the susceptibility. This would also offer the possibility of evaluating the effect of preventive treatment aimed at reducing the susceptibility. The method was found to discriminate between preselected elderly patients at risk on the one hand, and non-risk patients and healthy young adults on the other hand. No differences in blood flow responses were found between the non-risk elderly patients and the healthy young adults. This suggests that age per se is not a factor in the formation of pressure sores. In the risk group the recovery time after pressure relief was found to be three times as long as the duration of the pressure exercise. This indicates that the recovery time after pressure exercise may be as important as the period of pressure exercise in deducing the risk of developing decubitus ulcers.

The Most Effective Time Interval for Repositioning Subjects at Risk of Pressure Sore Development: A Literature Review

“…Contrasting results were reported by Meijer et al (1989), who found a drop in temperature response during pressure application for all participants in their study. They used transient skin temperature response as a measure of blood flow response at greater depths in the tissue.…”

“…Skin temperature under pressure in subjects at risk and subjects not at risk . Skin temperature reaction during a period of pressure was studied by Knox, Anderson, and Anderson (1994); Meijer et al (1989); and Schubert and Heraud (1994). Schubert and Heraud found that subjects not at risk had a more pronounced increase in skin temperature than did subjects at risk.…”

“…Most studies, however, have measured skin surface temperature. It is plausible that measuring skin surface temperature yields different results than the method used by Meijer et al (1989).…”

“…Skin temperature after the release of pressure in subjects at risk and not at risk . The release of pressure also induces an increase in skin temperature in both healthy subjects and those at risk (Barnett & Ablarde, 1994; Knox et al, 1994; Mahanty & Roemer, 1979; Meijer et al, 1989; Newman & Davis, 1981; Trandel et al, 1975). Thermal flares after individuals had been in a side‐lying position for 10 to 15 minutes were also measured by Newman and Davis (1981).…”

Assessment of patient support surfaces: principle, practice and limitations

“…Considerable experience is required before either method can be used reliably. A major limitation is that very close control of the ambient temperature is needed [60] to obtain sufficient reproducibility.…”