The accuracy of ultrasound, thermography, photography and sub-epidermal moisture as a predictor of pressure ulcer presence – a systematic review

Aim: To determine the accuracy of SEM, ultrasound, thermography and photography in predicting pressure ulcer presence.

Method: Systematic review.

Background: Pressure ulcers are areas of skin damage that develop, normally over bony prominences, as a result of pressure and shear. Pressure ulcers are a healthcare problem that impacts in the individual, healthcare system and society. Risk factors such as mobility and nutritional status also influence the onset and aggravation of pressure ulcers. Thus risk assessment tools can help identify those individuals that might present with risk factors for the onset of pressure ulcers. Nonetheless, these tools do not allow for the identification of tissue changes and for this reason it is necessary to identify other methods, like SEM, thermography, ultrasound and photography that might identify cellular and underlying tissue changes and predicting the presence of pressure ulcers, in order to prevent its further development.

Findings: Following a systematic search of the literature, four SEM, one thermography and five ultrasound studies were included in this review. Photography was not a method, considering the data in the studies retrieved, which allows for the early prediction of pressure ulcer presence. SEM and ultrasound were the best methods for allowing a more accurate prediction of early pressure ulcer presence.

Conclusion: It can be concluded that SEM and ultrasound are accurate on the early detection of pressure ulcers, based on the studies analysed and these methods should be further studied and used in practice for the prevention of pressure ulcer development.