Table of Contents
ISRN Nursing
Volume 2013, Article ID 314248, 5 pages
Clinical Study

Do High Frequency Ultrasound Images Support Clinical Skin Assessment?

1The Institute of Nursing and Health Research, School of Health Sciences, University of Ulster, Newtownabbey BT37 0QB, UK
2School of Health Sciences, Faculty of Life and Health Sciences, University of Ulster, Newtownabbey BT37 0QB, UK
3School of Sociology, Social Policy & Social Work, Queen's University Belfast, Belfast BT7 1LP, UK
4Institute for Research in Social Sciences, School of Communication, University of Ulster, Newtownabbey BT37 0QB, UK
5Tissue Viability, The Royal Hospital, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
6Clinical Trials Research Unit, University of Leeds, Leeds LS2 9JT, UK
7School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, UK
8Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK
9School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA

Received 11 December 2012; Accepted 10 January 2013

Academic Editors: N. M. C. Alexandre and B. Mandleco

Copyright © 2013 Alison P. Porter-Armstrong et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


High frequency ultrasound imaging has been reported as a potential method of identifying the suspected tissue damage in patients “at risk” of pressure ulceration. The aim of this study was to explore whether ultrasound images supported the clinical skin assessment in an inpatient population through identification of subcutaneous tissue damage. Skin on the heels and/or sacral coccygeal area of fifty vascular surgery inpatients was assessed clinically by tissue viability nurses and with ultrasound pre operatively and at least every other day until discharge. Images were compared to routine clinical skin assessment outcomes. Qualitative classification of ultrasound images did not match outcomes yielded through the clinical skin assessment. Images corresponding to 16 participants were classified as subgroup 3 damage at the heels (equivalent to grade 2 pressure ulceration); clinical skin assessment rated no heels as greater than grade 1a (blanching erythema). Conversely, all images captured of the sacral coccygeal area were classified as normal; the clinical skin assessment rated two participants as grade 1b (non-blanching erythema). Ultrasound imaging is a potentially useful adjunct to the clinical skin assessment in providing information about the underlying tissue. However, further longitudinal clinical assessment is required to characterise images against actual and “staged” pressure ulceration.