Sub epidermal moisture measurement for early pressure ulcer detection

Sub epidermal moisture is related to the quantity of skin and tissue water1-3. Skin hydration is an important biophysical measure as a certain level of hydration is necessary for the skin to maintain its barrier function4. Inflammation and oedema that result from tissue damage, and that indicate excess of interstitial fluid in the tissues5 can be measured through the use of instruments that use electric and electromagnetic signals. Tissues have capacitive and conductive properties that are dependent on water content, with the uppermost layer being mainly capacitive and the deeper layers being mainly conductive4. Because SEM is related to skin and tissue water, it can be measured through the use of surface electrical capacitance3. Surface electrical capacitance of the skin is determined by the impedance of the skin to electrical forces, and thus can reflect oedema and water content of the epidermal and sub-epidermal tissues3. This paper will present recent findings from a number of studies, undertaken at the RCSI, using SEM for the early prediction of pressure ulcers. The overall aim of the presentation is to explore the role of SEM as a potential modality for the more effective recognition of impending pressure ulcer damage which to date, is only visible once damage is seen on the skin surface. 

  1. Bates-Jensen, B. M., McCreath, H. E., Kono, A., Apeles, N. C. & Alessi, C. Subepidermal moisture predicts erythema and stage 1 pressure ulcers in nursing home residents: a pilot study. J Am Geriatr Soc 55, 1199-1205 (2007).
  2. Bates-Jensen, B., McCreath, H., Pongquan, V. & Apeles, N. Subepidermal moisture differentiates erythema and stage I pressure ulcers in nursing home residents. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society 16, 189-197 ( 2008 ).
  3. Bates-Jensen, B., McCreath, H. & V, P. Subepidermal moisture is associated with early pressure ulcer damage in nursing home residents with dark skin tones: pilot findings. J Wound Ostomy Continence Nurs 36, 277-284 ( 2009).
  4. Alanen, E., Nuutinen, J., Nicklén, K., Lahtinen, T. & Monkkonen, J. Measurement of hydration in the stratum corneum with the MoistureMeter and comparison with the Corneometer. Skin Research and Technology 10, 32-37 (2004).
  5. Miettinen, M., Monkkonen, J., Lahtinen, M. R., Nuutinen, J. & T, L. Measurement of oedema in irritant-exposed skin by dielectric technique. Skin Research and Technology, 12, 235-240 (2006).
Presented by: 
Prof. Zena Moore PhD, MSc (Leadership in Health Professionals Education), MSc (Wound Healing & Tissue Repair), FFNMRCSI, PG Dip, Dip First Line Management, RGN
Professor and Head of the School of Nursing and Midwifery