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Using Alternative Light Source Technology to Enhance Visual Inspection of the Skin
摘要： BACKGROUND: The identification of deep tissue pressure injury (DTPI) in the early stages of evolution presents a challenge, as skin compromise is only visually apparent when evidence of damage reaches its outer layers. CASE DESCRIPTION: We describe use of an alternative light source (ALS) to enhance visual skin assessment in 3 cases. Case 1 was a 47-year-old African American man with a hyperpigmented inner buttocks and a mixture of partial- and shallow full-thickness skin loss from incontinence-associated dermatitis and friction. Case 2 was a 62-year-old African American woman with a gluteal cleft DTPI. Case 3 was a 57-year-old African American woman with a stage 3 pressure injury of the right buttock. CONCLUSION: The ALS enabled visualization of skin nuances not visible to the unaided eye. Based on this experience, we conclude that use of an ALS provided additional visual details when compared to traditional visual inspection. We found that as the ALS interplays with skin layers, penetrating and absorbing at differing depths, compromised skin appeared darker and more distinct when compared to adjacent, intact skin. Additional research is needed to determine whether the ALS enables earlier pressure injury detection, timelier and more effective intervention, decreased morbidity, and cost savings.
关键词： Alternative light source,Pressure injury,Deep tissue pressure injury,Pressure ulcer
更新于2025-09-23 15:22:29
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Quantitative Analysis of Heel Skin Microcirculation Using Laser Doppler Flowmetry and Tissue Spectrophotometry
摘要： OBJECTIVE: To examine perfusion changes in the heel skin of individuals with and without diabetes mellitus to understand how skin is pathologically affected by diabetes mellitus. METHODS: This case-control study was conducted at an academic hospital in Tuebingen, Germany. A total of 30 subjects were enrolled in the study: 15 with known type 2 diabetes mellitus and 15 without. Each subject was asked to lie in a supine position on a hard lateral transfer mat for 10 minutes. MAIN OUTCOME MEASURES: Heel perfusion was quantitatively assessed directly after relief of pressure and after 3 and 6 minutes after relief of pressure using laser Doppler flowmetry and tissue spectrophotometry. MAIN RESULTS: Directly after relief of pressure, blood flow increased in the superficial skin layers (2 mm below the surface of the skin) in both groups. However, in deep skin layers (8 mm below the surface of the skin), blood flow increased in patients with diabetes mellitus and decreased in healthy patients. Oxygen saturation (SO2) was higher in healthy subjects directly after pressure relief. CONCLUSIONS: The increase in blood flow in superficial skin layers indicates reactive hyperemia after exposure in both groups. The prolonged hyperemia in deep skin layers in patients with diabetes indicates increased tissue vulnerability. Despite the increase in blood flow in deep skin layers, the SO2 and thus supply of tissue in patients with diabetes were reduced.
关键词： diabetes mellitus,pressure injury,oxygen saturation,blood flow,perfusion,diabetic foot ulcers,laser Doppler flowmetry,pressure ulcer,microcirculation
更新于2025-09-12 10:27:22