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Utility of High-Frequency Ultrasound: Moving Beyond the Surface to Detect Changes in Skin Integrity

Lucas, Valentina S. PhD, RN, ANP-BC; Burk, Ruth S. PhD, RN; Creehan, Sue BSN, RN, CWON; Grap, Mary Jo PhD, RN, FAAN

doi: 10.1097/PSN.0000000000000031
Departments: Wound Care Management Department

Ultrasound imaging is a versatile modality frequently used in clinical medicine, most likely due to its low cost, low risk to patients, and the ability to provide images in real time. Ultrasound used typically in clinical settings has frequencies between 2 and 12 MHz. Lower frequencies produce greater resolution but are limited in depth penetration; higher frequencies produce greater resolution, but depth of penetration is limited. High-frequency ultrasound (HFUS) shows promise for detection of certain changes in the skin and this has implications for early detection of changes associated with pressure ulcer formation and wound healing. The purpose of this article was to provide an overview of where HFUS has been used with the skin and provide some discussion on its utility with detecting skin changes related to pressure.

Valentina S. Lucas, PhD, RN, ANP-BC, is a nurse practitioner in the Division of Plastic and Reconstructive Surgery at Virginia Commonwealth University Health System. She was an investigator for the NIH-funded (R01 NR010381) study “Effect of Backrest Elevation on Skin Integrity in the Critically Ill,” which included the use of high-frequency ultrasound technology.

Ruth S. Burk, PhD, RN, is Assistant Professor at University of Texas School of Nursing at Houston. She was a doctoral research assistant for the NIH-funded (R01 NR010381) study “Effect of Backrest Elevation on Skin Integrity in the Critically Ill,” which used the high-frequency ultrasound technology described here.

Sue Creehan, BSN, RN, CWON, is Certified Wound Ostomy Nurse, the Program Manager for the wound care team at VCU Medical Center, the organizational champion for their interdisciplinary hospital-acquired pressure ulcer reduction program, and chair of the unit-based champions of skin integrity team.

Mary Jo Grap, PhD, RN, FAAN, is the Nursing Alumni Distinguished Professor at Virginia Commonwealth University School of Nursing. She is the Principal Investigator for the NIH-funded (R01 NR010381) study “Effect of Backrest Elevation on Skin Integrity in the Critically Ill” that included the use of the high-frequency ultrasound technology described here.

Address correspondence to Valentina S. Lucas, PhD, RN, ANP-BC, at Virginia Commonwealth University, Division of Plastic and Reconstructive Surgery, P.O. Box 980154, Richmond, VA 23298 (e-mail: vslucas@vcu.edu).

The authors report no conflicts of interest.

Copyright © 2014 by American Society of Plastic Surgical Nurses