Subepidermal moisture (SEM) and bioimpedance: a literature review of a novel method for early detection of pressure‐induced tissue damage (pressure ulcers)

Abstract Current detection of pressure ulcers relies on visual and tactile changes at the skin surface, but physiological changes below the skin precede surface changes and have a significant impact on tissue health. Inflammatory and apoptotic/necrotic changes in the epidermal and dermal layers of the skin, such as changes in interstitial fluid (also known as subepidermal moisture (SEM)), may precede surface changes by 3–10 days. Those same epidermal and subepidermal changes result in changes in the electrical properties (bioimpedance) of the tissue, thereby presenting an objective, non‐invasive method for assessing tissue damage. Clinical studies of bioimpedance for the detection of pressure ulcers have demonstrated that changes in bioimpedance correlate with increasing severity of pressure ulcer stages. Studies have also demonstrated that at anatomical locations with pressure ulcers, bioimpedance varies with distance from the centre of the pressure ulcers. The SEM Scanner, a handheld medical device, offers an objective and reliable method for the assessment of local bioimpedance, and therefore, assessment of tissue damage before signs become visible to the unaided eye. This literature review summarises pressure ulcer pathophysiology, principles of bioimpedance and clinical research using bioimpedance technology to assess pressure ulcers.
Source: International Wound Journal - Category: Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research

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Pressure ulcers are amongst the commonest challenges faced by reconstructive surgeons on a daily basis. Grade III and IV presacral pressure sores require reconstruction by fasciocutaneous,1 musculocutaneous,2 perforator flaps3 and sometimes free tissue transfer. Very few options will remain if major flaps like musculocutaneous flaps are already utilized, in case the patient develops a recurrence Numerous studies have debated the choice of fasciocutaneous versus musculocutaneous flaps but none have used any relevant objective methods to logically show the advantage of one method over another.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Tags: Correspondence and Communications Source Type: research
ConclusionGradual postoperative closure of a traumatic abdominal wall hernia with an ostomy in place may result in stomal stenosis. Stomal patency must be carefully evaluated during this process.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONS: This case series is useful in defining new areas of research that can (1) identify the deformation induced by normal and frictional forces resulting from different positions of the bed chassis, (2) assess the impact of positioning the pelvis on elevated versus horizontal segments of the bed chassis, and (3) define the association between sacral and coccyx morphology and pressure ulcer occurrence in hospitalized patients.
Source: Advances in Skin and Wound Care - Category: Dermatology Tags: FEATURES: CASE SERIES Source Type: research
Journal of Wound Care,Volume 28, Issue 5, Page 278-282, May 2019.
Source: Journal of Wound Care - Category: Nursing Authors: Source Type: research
Bioprinting directly onto the body seems a logical evolution of the state of the art in this part of the field, given the emerging ability to bioprint full thickness skin, or at least a living structure very close to that. It is interesting to consider how bioprinting in situ could be made to work for internal organs. We might envisage something akin to keyhole surgery with a machine-guided printing head. The easier initial applications might include printing a patch of tissue directly onto the heart, akin to the present development of heart patches that are grown outside the body and then transplanted. The Lygenesis appro...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
CONCLUSIONS: We identified two studies which evaluated the effect of risk assessment on pressure ulcer incidence. Based on evidence from one study, we are uncertain whether risk assessment using the Braden tool makes any difference to pressure ulcer incidence, compared with training and risk assessment using clinical judgement, or risk assessment using clinical judgement alone. Risk assessment using the Waterlow tool, or the Ramstadius tool may make little or no difference to pressure ulcer incidence, or severity, compared with clinical judgement. The low, or very low certainty of evidence available from the included studi...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
What do hospital beds tell about patients? How does an „indoor GPS”-system work? How could sensors and connected devices enhance both patient experience and medical resource efficiency? Here, we tell you everything about IoT within the walls of health facilities. Emergency drones, Fitbits, and chatty hospital-beds In April 2045, Paul was walking down the street with her 4-year-old daughter, Lily, in downtown Boston. They were heading to the ice cream &deli at the corner of the square two minutes from their home. Suddenly, the man experienced chest pain, started to breathe heavily and collapsed. Lily looked ...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine Health Sensors & Trackers Healthcare Design AI connected digital digital health digital health sensors doctor future of hospital IoT patient smart smart algorithm Source Type: blogs
ConclusionsA multidisciplinary approach with orthopaedic surgeons for debridement, planning and establishing osseous and joint correction and consolidation, plastic surgeons for microvascular muscle flaps for soft tissue defect coverage as well as clinical microbiologists for the optimized anti-infective treatment is essential in these challenging rare cases.Level of evidenceLevel IV.
Source: European Journal of Medical Research - Category: Research Source Type: research
Bruin Biometrics (BBI) is looking to shake up the way patients are assessed for pressure ulcers with its SEM scanner. FDA granted de novo marketing authorization for the device which can help uncover a patient’s risk for bedsores and gauge whether there is tissue damage. The current standard for assessing pressure ulcers requires clinicians or healthcare givers to visually inspect patients' skin and remember to turn them over in their beds every few hours. The current standard also relies on risk assessment scales that judge which patients are most at risk for developing pressure ulcers and monitor them. ...
Source: MDDI - Category: Medical Devices Authors: Tags: Business Sterilization Source Type: news
  Bruin Biometrics’ SEM Scanner Bruin Biometrics said it has landed FDA de novo clearance for its SEM Scanner, a wireless, handheld device to help assess patients at increased risk for pressure ulcers. The scanner is a novel device that can objectively alert clinicians to specific anatomical areas of a patient’s body at increased risk for developing pressure damage before that damage is visible at the skin surface. Pressure sores typically appear at areas of bony prominence, such as the heels and sacrum. Get the full story on our sister site, Medical Design &Outsourcing. The post Bruin Biometrics&...
Source: Mass Device - Category: Medical Devices Authors: Tags: Blog Source Type: news
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