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Clinical Research
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Initial assessment of tissue water content surrounding pressure ulcers in spinal cord injury patients Jeffrey J. Harrow, MD, PhD, Harvey N. Mayrovitz, PhD Problem: Pressure ulcers have varied trajectories of healing not predictable by stage alone. One of the parameters that might differ between a chronic, non-healing pressure ulcer and one that is healing is the amount of periwound edema. There has been no readily available method of quantifying this except for palpation. Herein we describe our preliminary findings in an ongoing investigation. Method: A noninvasive device for measuring relative tissue water content (RTW) has become commercially available*. It uses a 300MHz signal to measure RTW, on a scale of 1-80, with measurement depth controllable by using different diameter probes. Six subjects with spinal cord injury and chronic stage 3 or 4 pressure ulcers over the sacrum or ischium were studied. Measurements were done in triplicate at four standardized sites circumferentially around each wound. A control area, 4 cm proximal to the wound edge, was also measured. Effective measurement depth was 2.5 mm. Subjects were measured in the morning prior to arising from bed. Results: Periwound RTW averaged 47.7 ± 9.5 (mean ± sd), which was greater than in control areas in 4 of the 6 subjects, but overall was not statistically greater (P=0.1). This was partly a result of two wounds having very little tissue between skin and bone. However, the coefficient of variation (cv) of RTW around wounds (18.9 ± 10%) was significantly greater than cv around control sites (9.0 ± 3.8), P<0.05). Conclusion: These preliminary findings suggest that periwound edema can be detected with the present approach when edema is present. It further calls attention to the possibility of significant variability in periwound water content in both individual wounds and among wounds, a factor that needs to be considered in wound assessment. Overall, the findings indicate the need for further research to clarify and extend these concepts *Delfin MoistureMeter-D |
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