Prevention of Pressure Wound Development With Infrared Thermal Camera

Pressure wound (PW) is generally defined as localized damage to the skin and subcutaneous soft tissue on a bone protrusion or caused by medical devices. Although it is a preventable complication and one of the quality indicators for healthcare institutions, the prevalence of PW is high.Up to 95% of pressure wounds are preventable, but pressure wounds are only detected when sores become visible. Infrared thermography is used in the physiological and anatomical assessment of skin and subcutaneous tissue abnormalities and in detecting pressure injuries by measuring temperature changes caused by circulatory problems.The aim of the researchers is to compare the development of PW in patients admitted to intensive care by imaging the skin temperature in pressure areas using the traditional method and an infrared camera.

Pressure wound (PW); It is localized skin and/or subcutaneous tissue damage, usually occurring on bony prominences, caused by pressure alone or by a combination of shear and pressure.PW is an important source of infection that increases the mortality and morbidity rates of patients, causes an increase in health care costs, causes patients to feel more pain and prolongs the duration of hospital stay, negatively affects the quality of life and causes physical, social and psychological problems, and is an important source of infection, septicemia, It is a global health problem that causes complications such as osteomyelitis and has begun to be accepted as a quality indicator of nursing care. PW, although the risk factors that cause pressure sores are known, there are evidence-level guidelines for preventing pressure ulcers, treatment methods are known, and technological and scientific developments are made, it still appears as a current and serious health problem today.Considering the results of international studies, it has been shown that the prevalence of pressure wounds varies between 7.2-11.6%, the incidence rates vary between 1.9-54.8%, and if precautions are not taken, pressure sores may develop in approximately 87% of patients hospitalized for a long time.Up to 95% of pressure wounds are preventable, but pressure wounds are difficult to detect at an early stage as they can only be detected when the sores become visible.This is because the metabolic demand of the skin is much lower than that of the muscles, the muscles need more oxygen and are more susceptible to ischemia than the skin and surrounding fatty tissue. In this case, the lesions develop in the deep muscle tissue and gradually reach the skin and become visible.Studies have shown that inflammatory and apoptotic/necrotic changes in the epidermal and dermal layers of the skin occur 3-10 days before surface changes.Therefore, a pressure wound in the early stages is difficult to distinguish visually from healthy tissue that responds normally to pressure-inducing factors. Studies have reported that a period of 1 to 7 days must pass from the moment an injury occurs to the tissue for it to appear visually.Risk factors leading to pressure wounds; It can be detected in advance using traditional methods such as visual assessment and the Braden Risk Scale, but these methods are affected by skin color and only 20-40% of pressure wounds can be detected.Infrared thermal camera is a temperature measurement technique that visualizes body thermal energy produced by cellular metabolism and blood circulation in the human body.In body parts where blood flow is impaired, temperature losses occur due to the slowdown of cellular metabolism. Accordingly, when blood flow in the body increases or decreases, there is an increase or decrease in thermal energy measured by an infrared thermal camera. Thus, the infrared thermal camera can be used for physiological and anatomical evaluation of abnormalities in the skin and subcutaneous tissue. The aim of the researchers is to disrupt the basic wound change by imaging the skin temperature under pressure conditions admitted to intensive care with the traditional method and a split camera. New evaluation tools are needed to detect the distribution and pressure sores in the early stages.

Eligibility Criteria:
Inclusion Criteria:

* Patients receiving treatment in intensive care
* Patients aged 18 and over
* Patients with Braden score less than 18 points
* Patients who are not transferred from another intensive care unit
* Patients who can tolerate supine, prone and right/left lateral position changes and turns

Exclusion Criteria:

* Patients with previous acute or chronic skin damage or burns in the observation area
* Patients with Braden score over 18 points
* Patients with full-thickness pressure sores
* Patients with protective dressings on the skin or undergoing hot and cold therapy that may affect the skin