Early Diagnosis of Deep Tissue Pressure Injury

Pressure ulcers are a global health care concern. Development of a hospital acquired pressure injury (HAPI) increases hospital length of stay, readmissions, and morbidity and mortality.  The cost of treating a hospital acquired pressure injury imposes a significant financial burden on health care facilities.  Penalties also include publicly reportable quality metrics.   The Centers for Medicare and Medicaid Services’ (CMS) considers pressure ulcers “reasonably preventable”; thus, pressure injury (PI) prevention has become a priority across all inpatient settings.  A United States quaternary-care medical center located in the Midwest experiences a high incidence of hospital acquired deep tissue pressure injuries with higher incidence in the heart and vascular surgical population.  The WoundVision Scout device, a product of EHOB^®, utilizes visual and infrared imaging technology in the assessment of pathophysiological anomalies in the detection and quantification of depth of tissue injury before manifestation on the skin.  Because of the lack of evidence to support this technology, a feasibility trial was conducted to answer the questions: 1)  Does the study design, data collection method, and manageability of the Scout device support the identification of deep tissue injury (DTI) in an adequate number of participants by providing quality data within a reasonable timeframe, and 2)  In pre-and post-surgical heart and vascular patients, does the use of infrared imaging assist in the identification of existing, non-visible underlying DTI and possible pressure areas?  The feasibility study consisted of a sample of 30 surgery patients.  Deep tissue pressure injury was identified in 13% of patients pre-and post-operatively.  Areas of poor perfusion were identified in 86.7% of pre-operative patients and 63.3% of post-operative patients.  This technology is a useful adjunct to clinical care in the identification of existing, non-visible signs of at-risk tissue injury. A future study involving a larger sample size could add supportive evidence for this technology.